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Ortiz-Pinto M, Pérez-Gómez B, Galán I, Sarmiento-Suárez R, Gómez-García T, Fernández-Navarro P, Padrón-Monedero A, Noguer I. Hospital admissions/mortality ratio: a composite health indicator for monitoring NCD. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Our aim was to test the usefulness of a new tool to monitor NCD. We evaluated a composite indicator, the ratio of hospitalizations vs mortality rates (HMR), by assessing its capacity of identifying additional variability among regions. In this communication, we present the analysis corresponding to ischemic heart disease as an example.
Methods
We used the Hospital Morbidity Survey and the Death Statistics for Spain in 2016, both provided by the National Institute of Statistics, to calculate age-adjusted hospitalisation and mortality rates for ischemic heart disease for men and women in all 52 provinces of Spain. Subsequently, we computed HMR, the ratio of the age-adjusted of hospital morbidity and mortality rates. The correlation and linear adjustment between provincial mortality and morbidity rates, as well as mortality and HMR, were also estimated by sex.
Results
The rate of hospital admissions for ischemic heart disease in Spain was 407 per 100,000 in men and 129.4 in women. The mortality rate was 93.1 per 100,000 in men and 40.3 in women. In both sexes, the highest morbidity and mortality rates were observed in the south of Spain. Pearson correlation between morbidity and mortality rates were 0.53 (p < 0.01) in men and 0.75 (p < 0.05) in women. HMR showed a different spatial pattern with important variability. In men the average ratio was 4.3, with a range of 2.8 (Tenerife) to 7.1 (Melilla); in women the average was 3.2 with a range between1.7 (Zamora and Tenerife) and 4.7 (Barcelona), and in both sexes very high ratios were found in Catalonia's provinces. Association between mortality rate and HMR showed a negative correlation in both men (-0.39; p < 0.01) and women (-0.24; p < 0.05).
Conclusions
HMR is a composite indicator that provides complementary information regarding the individual analysis of hospital morbidity and mortality rates. HMR of ischemic heart disease shows an important geographical variability and an inverse association with mortality.
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Affiliation(s)
- M Ortiz-Pinto
- National School of Public Health, Carlos III Institute of Health (ISCIII), Madrid, Spain
| | - B Pérez-Gómez
- National Center for Epidemiology, Carlos III Institute of Health (ISCIII), Madrid, Spain
| | - I Galán
- National Center for Epidemiology, Carlos III Institute of Health (ISCIII), Madrid, Spain
| | - R Sarmiento-Suárez
- National School of Public Health, Carlos III Institute of Health (ISCIII), Madrid, Spain
| | - T Gómez-García
- National School of Public Health, Carlos III Institute of Health (ISCIII), Madrid, Spain
| | - P Fernández-Navarro
- National Center for Epidemiology, Carlos III Institute of Health (ISCIII), Madrid, Spain
| | - A Padrón-Monedero
- National Center for Epidemiology, Carlos III Institute of Health (ISCIII), Madrid, Spain
| | - I Noguer
- National School of Public Health, Carlos III Institute of Health (ISCIII), Madrid, Spain
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Padrón-Monedero A, Sarmiento-Suárez S, Gómez-García T, Ortiz-Pinto M, Pérez-Gómez B, Fernández-Navarro P, Galán I, Noguer I. Towards an EU sustainable health information infrastructure. Integrating technical and political views and interest. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Health information systems (HIS) play a key role in providing information for decision-making. Europe lacks of an integrated HIS on non-communicable diseases (NCD) and Health Systems Performance (HSP) able to compare health problems across countries. NCDs are the main contributor to the EU-burden of disease, including the highest mortality rates. There is a general agreement among public health policy makers and researchers on the need of an integrated EU health information (HI) infrastructure to monitor risk factors, NCD and HSP. Such infrastructure would provide common inputs for public health and research to prioritize health policies. However, there is no EU-EEA consensus on how to go forward with this initiative.
Methods
The Information for Action (InfAct) project is aimed at establishing a sustainable HI infrastructure on HIS and HSP by cataloging resources, experience, research capacities and expertise into a 'one-stop shop'. Significant political will is needed to support and systematically feed a functional and permanent governance structure. InfAct provides a ground for Member States to discuss and generate consensus through two main boards: 1) Technical Dialogues (TD), composed by national experts, to discuss scientific aspects, feasibility and added value; and 2) Assembly of Members (AoM) where political representatives from Ministries of Health and Research provide the framework of political acceptance and guarantee of implementation and future development.
Results
Both boards reveal different interests and concerns. The AoM rather focused on resources and necessary political decisions based on expected returns. The TD focused on feasibility aspects and new adaptations required from current systems. The feedback provided by both boards is key to develop a sustainable EU-HIS infrastructure.
Conclusions
The TD and the AoM are key forums to provide feedback, guidance and advocacy to build a sustainable EU-HIS infrastructure
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Affiliation(s)
- A Padrón-Monedero
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - S Sarmiento-Suárez
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain
| | - T Gómez-García
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain
| | - M Ortiz-Pinto
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain
| | - B Pérez-Gómez
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - P Fernández-Navarro
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - I Galán
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - I Noguer
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain
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Fernández-Navarro P, Pérez-Gómez B, Gómez-García T, Sarmiento-Suárez R, Padrón-Monedero A, Ortiz-Pinto M, Galán I, Noguer I. Use of non-health EU databases for health surveillance. En-risk application. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
To combine health information and environmental health determinants is key, for epidemiological monitoring and health risk studies but its integration represents a challenge that requires specific expertise. An example of a potentially useful source of significant environmental data relevant for health is the European Pollutant Release and Transfer Register (E-PRTR), which allows estimating exposure to industrial pollution. Our aim was to develop an easy-to-use tool that allows to perform a screening suggesting the presence/absence of excess risk of a disease linked to residential proximity to industrial pollution.
Methods
En-risk: java interactive tool was developed to merge E-PRTR information and municipal mortality/morbidity data, to perform an exploratory spatial analysis of association between them by type of industrial facility using distance as proxy of exposure. The application needs cartography of the country and a database of the annual observed deaths (mortality) or cases (morbidity) and population broken down by age groups and sex per municipality. With this it calculates the expected number of deaths, the distance from the municipal centroids to the industrial location (classifying municipalities as exposed or not exposed), and perform the statistical analyses. Municipal lung cancer deaths (2005-2009) in Spain provided by the National Institute of Statistics were analyzed with this application as an example.
Results
En-risk gives a table of Relative Risk of mortality/morbidity due to exposure to industrial pollution by industrial sector and sex. The analysis in lung cancer deaths showed an excess of mortality associated to proximity to several industrial sectors.
Conclusions
En-risk facilitates the study of the relationship between industrial pollution and health around Europe. It can be used by public health services to identify health problems.
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Affiliation(s)
- P Fernández-Navarro
- National Center for Epidemiology, Carlos III Institute of Health (ISCIII), Madrid, Spain
| | - B Pérez-Gómez
- National Center for Epidemiology, Carlos III Institute of Health (ISCIII), Madrid, Spain
| | - T Gómez-García
- National School of Public Health, Carlos III Institute of Health (ISCIII), Madrid, Spain
| | - R Sarmiento-Suárez
- National School of Public Health, Carlos III Institute of Health (ISCIII), Madrid, Spain
| | - A Padrón-Monedero
- National Center for Epidemiology, Carlos III Institute of Health (ISCIII), Madrid, Spain
| | - M Ortiz-Pinto
- National School of Public Health, Carlos III Institute of Health (ISCIII), Madrid, Spain
| | - I Galán
- National Center for Epidemiology, Carlos III Institute of Health (ISCIII), Madrid, Spain
| | - I Noguer
- National School of Public Health, Carlos III Institute of Health (ISCIII), Madrid, Spain
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