Eurstat activities n nnmnetary health care statistics The way ahead fr a Cmmissin Regulatin Hartmut Buchw, Estat F5
Legal basis Health Plicy Cntext Data s far CG CARE 2011 Outline The way ahead TF n implementing Regulatin (EC) 1338/2008 n nnmnetary Health Care (TF IR HCARE) Mandate Objectives Time frame First results f the kick-ff meeting 2
Legal basis Article 168 f the Treaty t encurage cperatin between Member States in the field f Public Health Framewrk Regulatin (EC) n 1338/2008 t implement statistics fr Eurpean Cmmunity Health indicatrs (ECHI) and ther indicatrs with explicit fcus n health care Cmmissin Regulatin n health care expenditure statistics is well advanced, adptin planned by end f this year Member States agreed t subsequently start n nnmnetary health care statistics in 2014 3
Health Plicy Cntext Grwing imprtance f health fr achieving Eurpe 2020 bjectives Challenges: Ecnmic crisis and subsequent health systems refrms Aging ppulatin ü Grwing burden f chrnic diseases ü Increasing patients expectatins ü Grwing csts f health care Deminishing Member States resurces fr imprving cst effectiveness, accessibility and sustainability f health care systems 4
Health Plicy Basis Cuncil Wrking Party n Public Health n 8 Octber 2013 and Cuncil Cnclusins n the Reflectin prcess n mdern, respnsive and sustainable health systems f 10 December 2013: Encurage Member States and the Cmmissin t enhanced ecnmic plicy crdinatin at natinal and EU level 5
Health Plicy Instruments The Scial Prtectin Cmmittee Indicatrs Sub-grup (SPC-ISG) in Nvember 2013: First Jint Assessment Framewrk (JAF) fr Health Part f the Eurpe 2020 strategy and the Eurpean Semester Evidence-based tl fr cuntry specific recmmendatins 2014: Pilts in selected Member States Majr cncern: Data gaps and data quality at EU-28 level 6
Health Plicy Instruments The Scial Prtectin Cmmittee Indicatrs Sub-grup (SPC-ISG) in Nvember 2013: First Jint Assessment Framewrk (JAF) fr Health Part f the Eurpe 2020 strategy and the Eurpean Semester Evidence-based tl fr cuntry specific recmmendatins 2014: Pilts in selected Member States Majr cncern: Data gaps and data quality at EU-28 level 7
Data availabilty frm JQ 2013 34 cuntries (EU-28 Member States, EFTA cuntries, FYROM and Turkey) 8
Table 1a. Percentage f cuntries that prvided recent data (2011-2012) n physicians Practising physicians 74% Prfessinally active physicians 65% Physicians licensed t practice 47% Physicians by gender 85% Physicians by age 71% Generalist medical practitiners 79% f which general practitiners 71% f which ther generalist medical practitiners 56% 9
Table 1b. Percentage f cuntries that prvided recent data (2011-2012) n physicians Specialist medical practitiners 82% f which general paediatricians 79% f which bstetricians and gynaeclgists 79% f which psychiatrists 82% f which medical grup f specialists 82% f which surgical grup f specialists 82% f which ther specialists nt elsewhere classified 74% Medical dctrs nt further defined 53% 10
Table 2a. Percentage f cuntries that prvided recent data (2011-2012) n midwives, nurses and caring persnnel Practising midwives 59% Prfessinally active midwives 50% Midwives licensed t practice 38% Practising nurses (Ttal) 59% Practising nurses (Prfessinal nurses) 59% Practising nurses (Assciate prfessinal nurses) 56% Prfessinally active nurses (Ttal) 53% Prfessinally active nurses (Prfessinal nurses) 53% Prfessinally active nurses (Assciate prfessinal nurses) 50% 11
Table 2b. Percentage f cuntries that prvided recent data (2011-2012) n midwives, nurses and caring persnnel Nurses licensed t practice (Ttal) 35% Nurses licensed t practice (Prfessinal nurses) Nurses licensed t practice (Assciate prfessinal nurses) 29% 26% Practising caring persnnel (persnal care wrkers) Prfessinally active caring persnnel (persnal care wrkers) 44% 35% 12
Table 3. Percentage f cuntries that prvided recent data (2011-2012) n dentists, pharmacists and physitherapists Practising dentists 65% Prfessinally active dentists 53% Dentists licensed t practice 53% Practising pharmacists 65% Prfessinally active pharmacists 59% Pharmacists licensed t practice 41% Practising physitherapists 82% 13
Table 4. Percentage f cuntries that prvided recent data (2011-2012) n hspital emplyment Ttal hspital emplyment HC 65%/FTE 50% Physicians HC 68%/FTE 47% Prfessinal nurses and midwives HC 68%/FTE 47% Assciate prfessinal nurses HC 56%/FTE 44% Health care assistants HC 50%/FTE 41% Other health service prviders HC 59%/FTE 47% Other staff emplyed HC 56%/FTE 41% 14
Table 5. Percentage f cuntries that prvided recent data (2011-2012) n graduates Medical graduates 74% Dentists graduates 71% Pharmacists 65% Midwives graduates 65% Nursing graduates (Ttal) 71% Prfessinal nursing graduates 65% Assciate prfessinal nursing graduates 62% 15
CG CARE 2011 Cncepts fr physicians/health emplyment Keep the three cncepts (practising, prf. active/licenced) G fr estimates n practising prfessins Split prfessinal/assciate prf. midwives Failed in praxis nly few cuntries able t reprt Definitins: Mre explanatins with examples ISCO cdes - t be better specified/illustrated fr each variable Nt all cuntries use ISCO g fr it! Structured Meta data needed Data surce - Data cverage - Deviatin frm prpsed definitin 16
Tasks: recmmend ü ü ü TF IR HCARE - the way ahead Mandatry variables n subjects cvered and their characteristics; Data and metadata t be transmitted, and Reference perid and the transmissin f results Time Frame ü Kick ff February 2014 ü Outline fr discussin with TG CARE, 22 May 2014 ü First draft fr discussin with WGPH in December 2014 ü Final draft fr discussin with WGPH in December 2015 17
TF IR HCARE - Fcus Legal Framewrk Regulatin n 1338/2008 Current annual data cllectin: JQNMHC tgether with OECD and WHO Additinal Eurstat mdule Main pints fr cnsideratin: Natinal and internatinal data relevance Data availability Timetable 18
TF IR HCARE Kick-ff meeting In general The regulatin shuld be very basic n majr variables Establishment f clear definitins will be crucial N cmpetitin t the JQ: Cllectin f additinal vluntary variables will remain Quality will be an issue Availability f data des nt necessarily reflect relevance Estimates shuld be included, with surces and methds well defined 19
TF IR HCARE Kick-ff meeting 2 Mre specific essential variables n emplyment & educatin Physicians (Head Cunt) Practising physicians Physicians by age grup and by gender Physicians by categries Generalist medical practitiners General practitiners Specialist medical practitiners 20
TF IR HCARE Kick-ff meeting 3 essential variables n emplyment & educatin cnt. Practising midwives (ttal) Practising nurses (ttal) Medical graduates Midwives graduates Nursing graduates 21
Availability f recent data (ref yr 2011-2012) Percentage cnsidering the ttal number f variables f the JQ + Eurstat mdule: 211 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Belgium Bulgaria Cratia Czech Republic Denmark Germany Estnia Ireland Greece Spain France Italy Cyprus Latvia Lithuania Luxemburg Hungary Malta Netherlands Austria Pland Prtugal Rmania Slvenia Slvakia Finland Sweden United Kingdm Iceland Liechtenstein Nrway Switzerland Turkey FYROM 22
Availability f recent data (ref yr 2011-2012) Percentage cnsidering the variables f the JQ Health n emplyment and educatin: 58 23
TF IRHCARE next steps 1. Evaluatin f all current variables n plicy relevance Internatinal and natinal In view f citizens and the health systems In view f indicatr requirements at EU level, e.g. n ECHI and SPC ISG JAF Cnclusin: T keep/drp the single variable as a mandatry ne 2. Availability f the nes t g fr reasns fr nn-availability (last 5 yrs) Check fr Definitins clarity Surces Others 24
TF IRHCARE next steps 3. Estimates Basic criteria fr accepting estimates prpsals by the TF 4. Quality Cverage Timeliness Deviatin frm the definitin 5. Ptential fr imprvements within the given time frame 25
Thanks fr yur attentin 26