Data collection on health indicators at sub-national level - Page updated

Data collection on health indicators at sub-national level - Page updated

In health monitoring, health indicators at regional level allow health professionals and decision-makers to place their own region within the wider context of all other regions across the EU or cross-border regions. In addition, the EU Cohesion Policy aims to reduce economic and social disparities between regions in Europe and health has increasingly been recognised as an important asset for regional development and competitiveness.

Regional health data in Eurostat

Eurostat is constantly developing comparable regional health statistics. Currently causes of death data and health care resources & patient data are available at NUTS2 level (Nomenclature of Territorial Units for Statistics). Eurostat population statistics at regional level are also relevant for the health area.

Further information:

• Eurostat database for regional statistics
• Statistics Explained article 'Health statistics at regional level'
• Overview on NUTS classification
• Eurostat Regional Yearbook, including a chapter on health
• Eurostat Statistical Atlas, including health-related maps
• GISCO (the Geographical Information System at the Commission)

Challenge when dealing with regional health statistics

The difficulty with statistics on health at regional level stems from the fact that regional, provincial or local government statistics or the breakdown by region which is of interest to health authorities in the Member States sometimes do not tally with the NUTS classification, use of which is compulsory in the EU. The EU-funded project ISARE-3 (Health Indicators in the European Regions) made a recommendation on appropriate "health regions" for some EU Member States. ISARE projects and I2SARE project (Health inequalities indicators in the region of Europe) made a useful contribution towards understanding the role of 'health regions', and fostering their use as units for the exchange of health indicators.

The Regions for Health Network (RHN)

The Regions for Health Network (RHN) is organised through the WHO Regional Office for Europe. The Regions for Health Network complements work for health carried out at the national level by working with sub-national actors.

When drafting health proposals, policymakers require data on a wide range of factors affecting health, such as the social, economic and administrative environment.

The EU compiles indicators on many of these issues outlined below.

Sustainable development indicators

In 2016 the European Commission launched a Communication on Next steps for a sustainable European future [COM(2016)739]. It maps the policies contributing to the 17 United Nations Sustainable Development Goals (SDGs), in particular for the SDG 3 to ensure healthy lives and promote well-being for all at all ages.

Yearly EU monitoring is based on the EU SDG indicator set. The following 6 indicators were selected for Goal 3 on health and well-being:

• Life expectancy at birth
• Self-perceived health
• Smoking prevalence
• Preventable and treatable mortality
• Death rate due to tuberculosis, HIV and hepatitis
• Self-reported unmet need for medical care.

In addition, indicators for other SDG Goals have also been attributed to Goal 3 as 'multi-purpose indicator' such as:

• Obesity rate
• People killed in accidents at work
• People killed in road accidents
• Disturbance by noise
• Concentration of particulate matter.

Some of these indicators are common to the European Core Health Indicators (ECHI) shortlist.

Evaluating progress

The European Commission evaluates progress towards the agreed goals in a yearly report on SDG monitoring. Last report is available together with several additional tools to assess the EU situation.

• EU approach to sustainable development
• Eurostat overview on Sustainable Development Goals
• GDP and beyond
• Greening the European Semester
• Global health
• Measuring Distance to the SDG Targets - An assessment of where OECD countries stand (June 2017)

European Pillar of Social Rights

The European Pillar of Social Rights is to deliver on a more social and fair Europe and is a key priority for the European Commission. The Public support / Social protection and inclusion strand includes indicators on health care:

• Self-reported unmet need for medical care
• Out-of-pocket expenditure on healthcare
• Healthy life years at 65.

See also the EU social indicators and Joint Assessment Framework (JAF) on health.

EU Youth health indicators

The EU Youth Strategy sets out a framework for cooperation from 2020-2027. It focuses on three core areas of action, around the three words: Engage Connect Empower, while working on joined-up implementation across sectors. Eleven European Youth Goals identify cross-sectoral areas that affect young people’s lives and point out challenges, including mental health and wellbeing.

• EU Youth indicators dashboard

See also the 2017 module on children’s health from the EU-SILC (European Statistics on Income and Living Conditions) survey.

Healthcare quality indicators and patient reported measures

The Health Care Quality Indicators project (HCQI), led by the Organisation for Economic Co-operation and Development (OECD) with European Commission support, aims to measure and compare the quality of health services in different countries. The key areas are:

• Primary Care
• Acute Care
• Mental Health Care
• Cancer Care
• Patient Safety
• Responsiveness and Patient Experiences

Typically, the success of health care is assessed on the basis of survival rates, or rates of cure, after treatment. This tends to mask important differences, which only emerge when considering outcomes and experiences reported by patients themselves.

Supported by the Commission, OECD’s Patient-Reported Indicators Survey (PaRIS) will address critical information gaps and build a patient-centred view of health system performance.

Work on accelerating the adoption and reporting of patient-reported indicators in individual disease areas (breast cancer, hip and knee replacements and mental health) and a new international patient survey is being developed (focusing on complex, chronic conditions being treated in primary care).