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Priority area: Health information |
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Action: Developing and co-ordinating the health information and knowledge system |
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As part of the Health Information and Knowledge System, the oral health project objective is to provide quality, relevant and timely data, information and knowledge in order to support public health decision-making at European, national, sub-national and local level.
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Choosing the most relevant set of data indicators, an up-to-date information technology, methods and relevant statistical analysis, represent some of the essential steps to assure a functional Health Information System. The argument in favour of developing a second plan linked to oral health indicators within the European Community’s SANCO Monitoring Programme is based on an analysis of the current situation and the need to organize and achieve oral health system monitoring. |
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The scopes and purpose of the EGOHID Phase I project for 2003-2004 were to support the exchange of expectations and experiences among experts of oral health statistics and their audience, policy makers in particular. It was also to recommend a list of essential indicators through the conduct a systematic review and to outline a process for identifying a set of core indicators for oral health that will help professionals and decision-makers to promote and improve the global oral health promotion, quality of care and surveillance of people in Europe . |
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However, a critical analysis of the methodological criteria used in “Materials, Methods, and Results”, rubrics of the international scientific literature on cross-section studies published for the oral health period 1986-1996 has underlined that new and complementary trends should be recommended so as to improve the production of higher quality information in oral health epidemiology.
Standardized procedures including health interviews surveys, health clinical surveys in relation with core indicators should be developed and used. The expansion of oral epidemiology during the 1970s overcame the obvious shortcomings in terms of knowledge about the oral health status of populations even though developed actions mainly targeted school children. Collected data favoured cross-section studies with no repetitive character since their aim was not to target the cohorts. |
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Similarly thought should be given to the design and implementation of a "sentinelles" surveillance system, based on oral health primary care which would support national health surveillance systems such as Health National Interview Survey and Health National Clinical Survey. |
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At this stage of the produced information analysis, research and development perspectives should focus on the setting up of a health monitoring and recording system and furthermore, on respecting the rules of results dissemination that should lie within a benchmark methodological framework. The analysis of the publications showed weaknesses in the evaluation of oral health trends: weaknesses in terms of methodology, quality control, and presentation of results. The interpretation and conclusions in public oral health are therefore limited. New or complementary measures should be taken in order to improve the quality of medical information in oral health epidemiology. |
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EGOHIDP Phase II is part of the overall process to provide decision-makers with efficient methodological tools, based on proven evidence, to initiate and develop an operational community health surveillance system in close relation to the other surveillance programmes supported by SANCO (ECHI, ISARE, EIKS, EUROHIS).
It is also a continuation of EGOHIDP Phase I which objective was to recommend a list of essential oral health indicators These indicators will facilitate further promotion of oral health and non communicable disease surveillance in Europe to collect information, to monitor changes, to assess the effectiveness of the service and to plan oral health services within the framework of an inter-sectorial preventive policy based on health determinants.
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The main attempted output of the project is a promotion of systematic identification and technical specifications of oral health indicators through the use of an oral health outcome framework including information on the level of development of existing indicators and issues where indicators are lacking and require research.
In the longer term, EGOHIDP Phase I and II will facilitate service specifications across area health services with a view to maintaining and improving performance and with the enhancement of the capacity to analyze the social, economic, behavioural and political determinants with particular reference to poor and disadvantaged populations. |
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General objective is to support European Member States in their efforts to reduce the public heath impact of morbidity and disability related to oral diseases. As part of the Health Information and Knowledge System, the oral health project objective is to provide quality, relevant and timely data, information and knowledge in order to support public health decision-making at European, national, sub-national and local level. Choosing the most relevant set of data indicators, an up-to-date information technology, methods and relevant statistical analysis, represent some of the essential steps to assure a functional Health Information System.
The objectives of the programme are in line with those of the public health Community action programme. (2003-2008)
(i) To strengthen the health system performance through a better system organization.
(ii) To improve the quality of the health information while facilitating Member States cooperation
(iii) To encourage the development of relevant and action-oriented community health policies with priority focus at reducing health inequalities.
More specifically, this project is embodied in the European public health surveillance policy health. It will contribute to reducing disease morbidity in children and vulnerable populations, it will promote equality of populations in addressing the specific needs of the least advanced countries.
The Programme 2002-2003 European Global Oral Health Indicators ( SPC 2002472) has identified and harmonized essential indicators of oral health - problems, determinants and risk factors related to lifestyle of critical oral health care, its quality of care and of essential health resource. The next step –EGOHIDP Phase II- according to existing morbidity projects DG SANCO ( ECHI, EUROHIS, ISARE, …) will establish methodological criteria for collection of data to implement and promote oral health indicators in an operational way in order to be able to support and achieve the overall objectives. |
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The four sub-objectives of the EGOHIDP II should be:
(i) To develop recommended common instruments for national health interview surveys (NHIS),
(ii) To develop recommended common instruments for national health clinical surveys (NHCS)
(iii) To develop a methodology for improved NHIS and NHCS data, routinely collected in 25 European countries at the primary oral health care level
(iv) To develop methods to adjust national data to allow cross national comparisons
The next step is to promote the actual implementation of these instruments in the national health interview survey, the national health clinical survey and to evaluate their performance. |
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The following indicators are recommended to evaluate the impact of Phase II:
Indicator 1: Proportion of Member States who develop an oral health surveillance system based on predictable and non discriminatory rules
Indicator 2: Proportion of the 10 new Member States who contribute to the development of an oral health surveillance system based on predictable and non discriminatory rules.(To address the specific needs of the least advanced countries)
Indicator 3: Proportion of recommended national health interviews surveys (NHIS) common instruments available in new Members States via official translation
Indicator 4: Proportion of recommended national clinical surveys (NCIS) common instruments available in new members states via official translation
Indicator 5: To ensure access for all of new knowledge via Internet
Indicator 6: Total number of NHIS material produced in the EGOHIPD Phase II
Indicator 7: Total number of NHCS material produced in the EGOHIPD Phase II
Indicator 8: A wide ranging review of existing methods and instrument for NHIS and NHCS national surveys
Indicator 9: Production of a methodological report for improved NHIS and NHCS data, routinely at the primary oral health care level (NHPHCS)
Indicator 10: Final project report produced for the European Commission
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Within the European Global Oral Health Indicators Development Project Phase I valuable core indicators based on agreed and uniform definitions were created. Since indicators are an essential requirement for comparisons to be made over time not only between regions and care units but also at national level, these comparisons can be used as a basis in development and quality work at all levels of dental care and dental services. Although the prerequisites for monitoring the quality of care in Europe are good, despite major disparities between Members States, further development and promotion of models and methods for performance assessment is needed in order to be able to deliver policy-relevant information to the nation’s health policy makers.
The universe of potential quality methods is very large, making a full review infeasible. Supporting evidence might be absent or inadequately documented. Existing data sources might not permit the construction of the desirable indicators, because the required variables are not at all recorded or differently recorded. Dedicated data collection that would yield comparable information on a national level might be prohibitively expensive. Thus, to tackle the problem in a way that respects time and resource constraints, an opportunistic rather than idealistic approach seems warranted.
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The main disadvantage of relying on existing data sources is that the data systems have usually been designed for purposes other than quality measurement and may therefore not always provide exactly the desired information. The following limitations are commonly observed:
• Limited geographic coverage – in several countries, data are only available for selected regions.
• Limited coverage of populations –collection of administrative data is sometimes linked to individual characteristics, such as insurance status.
• Data access limitations – data collected by institutions other than national government or national institutes may sometimes not be readily accessible due to confidentiality issues or property rights issues, which prevent any release.
The phase II should identified the most promising methods in the respective area, discuss their policy relevance and scientific soundness. It should focus on a set of recommendation of development of the use of common methods for which there is agreement on validity, importance and for which comparable data are available in most EU-countries. |
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- A promotion of systematic identification and technical specifications of oral health indicators through the use of an oral health outcome framework including information on the level of development of existing indicators and issues where indicators are lacking and require research
- A facilitation of comparisons of indicator data by promoting standardization method component of indicators,
- To improve the capacity of health services to monitor their oral health improvement activities in a standardized manner in the longer term
- In the longer term, to facilitate service specifications across health services with a view to maintaining and improving performance
- Enhancement of the capacity to analyze the social, economic, behavioural and political determinants with particular reference to poor and disadvantaged populations.
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