Soixante-quatrième session du Comité régional de l’Europe : Copenhague, 15-18 septembre 2014 : les systèmes d’information sanitaire en Europe : où allons-nous ?

COMITÉ RÉGIONAL DE L’EUROPE, SOIXANTE-QUATRIÈME SESSION Copenhague (Danemark), 15-18 septembre 2014 Les systèmes d’information sanitaire en Europe : où allons-nous ? Séance d’information technique Mercredi 17 septembre 2014, 13 heures The data for the core health indicators were compiled, validated and processed in a standard way by WHO, the Organisation for Economic Co-operation and Development (OECD), EUROSTAT, other United Nations agencies and international networks, in order to improve the international comparability of the statistics. Nevertheless, many factors may influence the accuracy and comparability of national statistics, such as variation in definitions, incomplete registration, and other national specificities in data recording and processing. The international comparison of indicators should therefore always be interpreted with caution. Four mortality-based indicators (life expectancy and rates for infant, child (under 5 years) and maternal mortality) are presented, based on official mortality data from countries. Cause-specific mortality rates (indicators 15–21) are age-standardized death rates, calculated using the European standard population structure (see the European Mortality Database (http://data.euro. who.int/hfamdb/help/mTechnical.htm)). Age- standardization improves international comparability by removing the effects in mortality rates of intercountry differences in population age structures. The proportion of ill-defined causes of death is used as an indication of the quality of the certification and coding of causes of death. The bottom row in the data tables, the WHO European Region, gives the population-weighted average for all countries in the Region for which data are available. The exception is indicator 1, mid- year population, where the value is the sum of the countries’ populations. © World Health Organization 2014 All rights reserved. The Regional Office for Europe of the World Health Organization welcomes requests for permission to reproduce or translate its publications, in part or in full. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part if the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. World Health Organization, Regional Office for Europe UN City, Marmorvej 51, DK-2100 Copenhagen Ø, Denmark Tel.: +45 45 33 70 00; Fax: +45 45 33 70 01 Email: contact@euro.who.int; Website: www.euro.who.int Indicators related to the Millennium Development Goals (MDGs) are indicated as such. Data were retrieved from the WHO European Health for All Database (HFA-DB), unless specified in the tables. The range of data presented was limited to the years 2009–2012 for the sake of actuality and comparability. Additional indicators and more detailed data can be found in the databases on the websites of the WHO Regional Office for Europe (http://www.euro.who.int/ en/what-we-do/data-and-evidence/databases) and WHO headquarters (www.who.int). Technical notes and sources Indicator Data source 1, 2, 3, 4 The national data reported by countries directly to WHO or, when unavailable, World population prospects: the 2012 revision, from the United Nations Department of Economic and Social Affairs, Population Division 3 Reports of the World Bank, the United Nations Development Programme and country statistical yearbooks 5 World urbanization prospects: the 2011 revision from the United Nations Department of Economic and Social Affairs, Population Division 7 Yearbook of labour statistics from the International Labour Organization, Department of Statistics 8, 9 The World Development Indicators database of the World Bank 29 The WHO Global Health Observatory 28, 30, 31 WHO estimates based on nationally reported data and data or estimates from the International Monetary Fund, the World Bank, the United Nations and OECD 32, 33 OECD Health Data 46, 47 Progress on sanitation and drinking-water. 2013 update from the WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation 49-58 For definitions and data sources of the core Health 2020 targets indicators see: World Health Organization Regional Office for Europe. Targets and indicators for Health 2020, version 2. Copenhagen, 2014, 63p. Data is taken from the WHO European Health for All family of databases Data on proportion of children of school age not enrolled is taken from the UIS Statistics, United Nations Educational, Scientific and Cultural Organization (UNESCO) Data on life satisfaction was taken from the Human Development Report, 2011, United Nations Development Program (UNDP). Health 2020 targets indicators: tools for monitoring progress 49 50 51 52 53 BURDEN OF DISEASE AND RISK FACTORS PREMATURE MORTALITY TOBACCO ALCOHOL OVERWEIGHT AND OBESITY EXTERNAL CAUSES OF INjURY AND POISONING Premature mortality Age-standardized mortality rate from 4 NCD selected causes** per 100 000 Age-standardized prevalence (%) of current tobacco smoking** among adults ≥ 15 years Yearly con- sumption per adult ≥ 15 years (litres of pure alcohol equivalent) Age-standardized prevalence (%) among adults ≥ 20 years Age-standardized mortality rate from external causes of injury and poisoning, all ages, per 100 000 BMI≥25 BMI≥30Total Males Females Males Females Total Males Females Country 2012 2012 2012 2011 2011 2012 2008 2008 2012 2012 2012 Albania … … … 48.0 5.0 5.0 54.2 21.1 … … … Andorra … … … … … 13.3 … … … … … Armenia 509.0 713.8 344.5 47.0 2.0 3.9 55.1 23.4 44.0 72.4 19.7 Austria 256.8 b 332.8 b 186.2 b 46.0 47.0 12.1 49.6 18.3 36.9 b 55.2 b 20.7 b Azerbaijan … … … 34.0 <1 1.4 57.4 24.7 … … … Belarus 724.2 d 1161.2 d 397.3 d 50.0 11.0 14.4 … … 134.0 d 233.8 d 50.8 d Belgium 266.8 b 335.6 b 201.0 b 31.0 23.0 10.6 51.5 19.1 47.0 c 65.5 c 30.3 c Bosnia and Herzegovina 408.2 b 544.3 b 289.3 b 44.0 27.0 4.3 57.6 24.2 28.1 b 48.3 b 10.1 b Bulgaria 573.3 b 797.4 b 365.1 b 48.0 31.0 10.2 54.3 21.4 32.7 b 53.0 b 13.8 b Croatia 407.2 b 572.0 b 260.7 b 36.0 30.0 10.7 53.2 21.3 52.0 78.8 27.7 Cyprus 200.8 b 265.1 b 139.9 b 41.0 18.0 8.7 55.9 23.4 28.1 b 43.2 b 14.7 b Czech Republic 365.5 b 500.5 b 249.4 b 40.0 32.0 12.7 61.7 28.7 46.0 70.9 22.6 Denmark 262.9 b 305.4 b 221.3 b 30.0 27.0 10.4 48.4 16.2 30.5 b 43.5 b 18.2 b Estonia 416.9 b 641.5 b 244.8 b 43.0 21.0 11.4 51 18.9 77.2 b 135.8 b 27.8 b Finland 250.0 b 335.0 b 168.4 b 27.0 20.0 9.7 53 19.9 57.3 b 88.8 b 28.4 b France 242.2 c 329.3 c 160.8 c 39.0 32.0 11.7 45.9 15.6 43.0 c 63.2 c 25.5 c Georgia 262.5 c 381.1 c 168.2 c 55.0 3.0 5.3 53 … 22.0 c 39.0 c 7.1 c Germany 260.6 332.0 191.7 35.0 25.0 11.2 54.8 21.3 27.0 38.2 16.4 Greece 259.2 b 364.5 b 160.9 b 46.0 34.0 7.9 49.1 17.5 26.3 b 41.9 b 10.9 b Hungary 565.6 795.9 373.5 35.0 27.0 10.8 57.7 24.8 52.0 82.1 27.0 Iceland 213.8 d 268.9 d 157.7 d 19.0 18.0 6.3 56.4 21.9 35.0 d 48.8 d 20.1 d Ireland 254.3 c 303.4 c 205.4 c … … 11.9 60.9 24.5 35.0 c 50.7 c 20.1 c Israel 198.8 b 240.7 b 161.1 b 35.0 17.0 2.7 60.1 25.5 24.7 b 36.5 b 13.9 b Italy 224.1 c 288.6 c 164.2 c 31.0 18.0 6.1 49.2 17.2 25.0 c 37.1 c 14.3 c Kazakhstan 756.4 c 1100.3 c 494.3 c 40.0 9.0 6.6 56.7 24.4 116.0 c 198.1 c 48.9 c Kyrgyzstan 661.1 c 908.8 c 455.4 c 45.0 2.0 2.4 c 46.6 17.2 87.0 c 144.9 c 34.3 c Latvia 564.8 877.1 331.9 46.0 20.0 9.8 53.6 22.0 82.0 141.0 32.5 Lithuania 535.0 c 847.4 c 303.8 c 43.0 25.0 12.9 56.9 24.7 113.0 c 197.9 c 42.9 c Luxembourg 241.1 b 294.3 b 187.8 b 22.0 25.0 11.4 56.7 23.4 40.4 b 54.3 b 27.2 b Malta 245.5 b 303.7 b 189.4 b 31.0 20.0 7.6 61.6 26.6 19.5 b 32.0 b 7.8 b Monaco … … … … … … … … … … … Montenegro 446.8 d 565.8 d 344.1 d … … 6.6 54.6 … 35.0 d 53.7 d 18.7 d Netherlands 254.9 b 286.2 b 223.9 b 29.0 23.0 9.3 47.8 16.2 26.3 b 34.6 b 18.6 b Norway 212.4 248.2 176.0 28.0 26.0 6.6 55 19.8 36.0 48.7 23.5 Poland 427.8 b 600.5 b 277.8 b 38.0 27.0 10.7 55.7 23.2 54.9 b 92.4 b 20.4 b Portugal 240.6 b 331.9 b 159.5 b 30.0 15.0 10.8 55.3 21.6 29.2 b 46.1 b 14.3 b Republic of Moldova 621.9 872.6 419.8 43.0 5.0 6.1 49.2 20.4 85.1 139.8 38.3 Romania 513.9 b 730.6 b 326.2 b 38.0 18.0 9.0 48.6 17.7 53.0 c 87.1 c 22.2 c Russian Federation 746.7 c 1154.6 c 448.7 c 59.0 25.0 11.1 57.8 24.9 141.0 c 246.3 c 57.3 c San Marino … … … … … … … … … … … Serbia 502.9 658.4 362.7 38.0 27.0 9.7 55.9 23.0 37.0 59.9 16.4 Slovakia 458.8 c 666.4 c 283.7 c 39.0 19.0 11.0 58.4 … 50.0 c 84.3 c 19.5 c Slovenia 289.5 c 393.1 c 189.6 c 28.0 21.0 10.3 61.3 … 56.0 c 87.0 c 28.7 c Spain 227.7 b 318.2 b 143.5 b 33.0 27.0 9.8 58.2 24.1 22.6 b 33.5 b 12.2 b Sweden 209.2 c 243.4 c 175.0 c 25.0 24.0 7.3 50 16.6 35.0 c 50.7 c 21.1 c Switzerland 198.9 c 248.2 c 151.3 c 31.0 22.0 10.0 44.3 14.9 32.0 c 45.6 c 20.4 c Tajikistan … … … … … 0.3 c 33.8 9.9 … … … MKD* 492.1 c 625.6 c 366.9 c … … 4.0 c 52.8 20.3 28.0 c 41.9 c 15.5 c Turkey 319.7 b 433.0 b 213.3 b 42.0 13.0 1.4 63.6 29.3 20.3 b 29.7 b 11.7 b Turkmenistan … … … … 2.2 43.6 14.3 … … … Ukraine 669.6 1019.0 415.3 49.0 14.0 8.4 51.8 20.1 83.0 145.2 31.8 United Kingdom 266.2 c 320.8 c 214.3 c 22.0 22.0 10.3 61.5 24.9 26.0 c 36.8 c 16.1 c Uzbekistan … … … 22.0 3.0 … 48.1 17.3 … … … WHO European Region … … … … … 9.8 … … 60.4 b 99.2 b 27.4 b * The former Yugoslav Republic of Macedonia ** Cardiovascular diseases, cancer, diabetes mellitus and chronic respiratory diseases. *** Smoking of any form of tobacco (e.g. cigarettes, cigars and pipes and excluding smokeless tobacco) at the time of the survey including daily and non-daily smoking. **** See Technical Notes for description and sources Note: a=2013 b=2011 c=2010 d=2009 * OOP = out-of-pocket health expenditure 54 55 56 57 58 UNIVERSAL HEALTH COVERAGE DETERMINANTS AND WELL BEING UNIVERSAL HEALTH COVERAGE HEALTH PROTECTION INFANT MORTALITY INEqUITY SOCIAL DETERMINANTS WELL BEING Children immunized (%) against: Private households’ OOP* as % of total health expenditure Total health expenditure as % of Gross Domestic Product Infant mortality rate per 1000 live births Unemployment rate (%) Population with improved sanitation (%) poliomyelitis measles Male Female Rural Urban 2012 2012 2012 2012 2012 2012 2012 2012 2012 98.9 98.5 52.2 6.0 … … … 93.9 94.7 99.0 98.0 17.5 8.3 … … … 100.0 100.0 96.3 97.2 54.6 4.5 11.7 9.7 17.3 90.4 95.9 83.0 76.0 15.2 11.5 4.36 b 2.8 b 4.3 100.0 100.0 95.9 97.3 69.0 5.4 … … 0.9 c 100.0 100.0 97.8 97.9 19.5 5.0 5.34 d … d 0.5 93.0 91.6 99.0 96.0 19.7 10.8 4.15 c 3.0 c 7.6 100.0 100.0 87.9 91.4 27.8 9.9 6.71 b 4.8 b 27.6 b 95.8 99.7 95.3 93.7 42.3 7.4 9.17 6.3 12.3 100.0 100.0 95.8 94.8 13.9 6.8 3.69 3.5 15.8 98.2 98.6 99.0 86.0 49.5 7.3 3.48 b 2.1 b 11.8 100.0 100.0 99.3 98.0 14.2 7.7 2.9 2.3 7.0 100.0 100.0 91.0 87.0 12.6 11.2 3.34 b 3.4 b 6.1 100.0 100.0 94.2 93.6 18.4 5.9 2.38 b 2.4 b 10.2 97.9 99.7 99.0 97.0 18.6 9.2 2.59 b 2.1 b 7.7 100.0 100.0 98.7 89.4 7.4 11.8 3.86 c 3.2 c 9.9 100.0 100.0 87.0 88.0 64.7 9.2 12.5 c 9.8 c … 93.4 95.6 94.7 96.6 12.1 11.3 3.49 3.0 5.9 b 100.0 100.0 99.0 99.0 29.7 9.3 3.59 b 3.1 b 17.7 b 98.6 99.4 99.0 99.0 27.1 7.8 4.73 5.0 10.9 100.0 100.0 89.0 90.0 17.9 9.1 1.95 d 1.6 d 6.0 100.0 100.0 95.0 92.0 15.0 8.1 4.17 c 3.4 c 14.4 b 99.0 99.6 95.0 96.0 25.0 7.5 3.79 b 3.3 b 6.9 100.0 100.0 97.0 90.0 20.2 9.2 3.63 c 3.1 c 10.7 … … 98.5 95.9 41.7 4.2 18.4 c 14.5 c 5.3 97.3 96.8 94.0 98.0 34.8 7.1 c 24.79 c 19.7 c 2.5 b 93.3 93.6 92.1 90.3 37.4 6.0 7.02 5.5 15.0 … … 92.8 93.4 28.5 6.7 4.66 c 3.9 c 13.4 … 95.4 99.0 96.0 11.2 6.9 4.12 b 1.5 b 4.9 b 100.0 100.0 98.7 92.7 32.3 9.1 5.92 b 6.7 b 6.4 100.0 100.0 99.0 99.0 7.0 4.4 … … … 100.0 100.0 94.2 90.3 36.7 7.6 6.31 c 5.2 c 19.7 90.0 91.9 96.7 96.1 5.6 12.4 4.06 b 3.2 b 5.3 82.0 85.9 95.0 94.0 13.4 9.0 2.84 2.1 3.2 100.0 100.0 95.3 97.9 22.8 6.7 5.14 b 4.3 b 13.4 … 95.5 98.0 97.0 31.7 9.5 3.52 b 2.7 b 15.7 100.0 100.0 92.0 93.6 45.3 11.7 9.57 10.1 2.8 86.1 89.0 92.0 94.0 21.8 5.1 10.57 b 8.2 b 7.0 … … 97.6 98.1 34.3 6.3 8.42 c 6.8 c 6.6 b 70.4 74.4 96.2 87.1 12.3 6.5 4.8 b … … 94.6 90.3 37.1 10.5 6.37 6.0 24.6 97.2 98.5 98.7 99.0 22.8 7.8 6.38 c 5.0 c 14.0 99.7 99.9 96.0 95.0 11.9 8.8 2.1 c 3.0 c 8.9 100.0 100.0 96.7 97.4 20.3 9.6 3.37 b 3.0 b 25.0 100.0 100.0 98.0 97.0 16.1 9.6 2.69 c 2.4 c 7.7 100.0 100.0 96.0 92.0 28.1 11.3 3.67 c 4.0 c 4.1 b 100.0 100.0 96.4 94.5 60.1 5.8 c … … … 94.7 95.4 96.9 96.1 35.9 7.1 c 8.23 c 6.9 c 31.0 91.3 97.0 97.0 98.0 16.8 6.3 12.25 b 11.1 b 9.3 91.0 97.2 97.8 98.8 36.8 2.0 … … … 99.1 100.0 73.5 79.2 42.4 7.6 9.29 7.4 8.1 c 94.3 96.5 95.0 92.0 9.9 9.4 4.63 c 4.0 c 8.0 b 100.0 100.0 99.8 99.9 44.1 5.9 … … … 100.0 100.0 95.4 94.6 24.2 8.3 8.28 6.7 9.3 91.9 94.1 0% 10% 20% 30% 40% 50% 60% No and not planned for the future No, but planned for the future Yes, another strategy Yes, comprehensive health policy 2013 2010 0% 10% 20% 30% 40% 50% No, and not planned for the future No, but planned for the future Indicators defined Targets defined 2013 2010 0% 10% 20% 30% 40% 50% 60% No Yes, included elsewhere Yes, stand alone 2013 2010 0% 10% 20% 30% 40% 50% No, and not planned for the future Yes, in process Yes, adopted 2013 2010 0% 10% 20% 30% 40% 50% No, and not planned for the future Yes, in process Yes, adopted 2013 2010 y = 0.1779x - 7.8742 R = 0.47786 65 69 73 77 81 85 0 2 4 6 8 10 Li fe s at is fa ct io n sc or e Life expectancy at birth (years) European regional average European regional average DOES HI/SDH* POLICIES STRATEGIES EXIST? ALL ANSWERS (N=31 AND 36 FOR 2010 AND 2013, RESPECTIVELY) TARGET SETTING PROCESS EXISTS? ALL ANSWERS (N=31 AND 36 FOR 2010 AND 2013, RESPECTIVELY) HEALTH POLICY ALIGNED WITH H2020? ALL ANSWERS (N=31 AND 36 FOR 2010 AND 2013, RESPECTIVELY) IMPLEMENTATION PLAN IN PLACE? ALL ANSWERS (N=31 AND 36 FOR 2010 AND 2013, RESPECTIVELY) ACCOUNTABILITY MECHANISM IN PLACE? ALL ANSWERS (N=31 AND 36 FOR 2010 AND 2013, RESPECTIVELY) LIFE EXPECTANCY AT BIRTH AND LIFE SATISFACTION IN EUROPEAN COUNTRIES** ** Only indicators that are reported by country to WHO are reported in the tables Health 2020: qualitative indicators 0 400 800 1200 Be lar us Ru ss ian F ed er at ion Ka za kh st an Uk ra in e Re pu bl ic of M old ov a La tvi a Ky rg yz st an Hu ng ar y Lit hu an ia Bu lg ar ia Ro m an ia Se rb ia Ar m en ia Es to ni a Sl ov ak ia M KD * Po lan d Cr oa tia M on te ne gr o Bo sn ia an d He rz eg ov in a Cz ec h Re pu bl ic Tu rk ey Sl ov en ia Ge or gi a Gr ee ce Ge rm an y Fin lan d Au st ria Po rtu ga l Be lg iu m Fr an ce Sp ain Un ite d Ki ng do m De nm ar k M alt a Ne th er lan ds Ire lan d Lu xe m bo ur g Ita ly Cy pr us Ice lan d No rw ay Isr ae l Sw itz er lan d Sw ed en Males Females Ag e- st an da rd iz ed m or ta lit y ra te fo r c au se s co m bi ne d, ag es 3 0- 69 y ea rs , p er 1 00 0 00 Min Max European average 0 70 80 1999 2003 2006 2009 2012 MORTALITY FROM SELECTED* NON COMMUNICABLE DISEASES IN EUROPEAN COUNTRIES, AGES-30-69 YEARS, BY SEX MORTALITY FROM SELECTED NON COMMUNICABLE DISEASES IN EUROPEAN COUNTRIES, AGES 30-69 YEARS, BY SEX PROPORTION OF CHILDREN OF SCHOOL AGE NOT ENROLLED IN THE EUROPEAN REGION, TRENDS, 1999-2012 MORTALITY FROM SELECTED NON COMMUNICABLE DISEASES IN EUROPEAN COUNTRIES, AGES-30-69 YEARS, BY SEX 0 4 8 12 16 20 1999 2003 2006 2009 2012 Min Max European average Ischaemic heart disease Cerebrovascular disease Diabetes mellitus Chronic obstructive respiratory disease Female breast cancerAg e- st an da rd iz ed d ea th r at e, 0– 64 y ea rs , p er 1 00 0 00 Lung cancer 75 50 25 0 1990 1995 2000 2005 2010 LEADING CAUSES OF DEATH FROM NON-COMMUNICABLE DISEASE IN EUROPE, TRENDS 1990–2012 Life expectancy (in years) 68.67 82.83 Health 2020: quantitative indicators Core Health Indicators in the WHO European Region Special focus: Health 2020 targets indicators * Health inequities/Social determinants of health * Cardiovascular diseases, cancer, diabetes mellitus and chronic respiratory diseases. BACK PAGE FRONT PAGEPAGE EDGE /FOLD PAGE EDGE /FOLD core indicators booklet 2014 [ENG] 24 long [CORRECTIONSv3].indd 7-12 02/09/2014 00:29 © iStock ORGANISATION MONDIALE DE LA SANTÉ • BUREAU RÉGIONAL DE L’EUROPE UN City, Marmorvej 51, DK-2100 Copenhague Ø, Danemark Téléphone : +45 45 33 70 00 Fax : +45 45 33 70 01 Courriel : governance@euro.who.int Site Web : http://www.euro.who.int/fr/who-we-are/governance Comité régional de l’Europe EUR/RC64/TD/4 Soixante-quatrième session Copenhague (Danemark), 15-18 septembre 2014 28 août 2014 ORIGINAL : ANGLAIS Séance d’information technique, mercredi 17 septembre 2014 13 heures Les systèmes d’information sanitaire en Europe : où allons-nous ?  Cette séance d’information technique vise à donner un aperçu des progrès réalisés par les agences internationales collaborant dans le domaine de l’information sanitaire pour le bien- être en Europe.  Les participants seront mis au courant des activités menées par le Bureau régional de l’OMS pour l’Europe, la Commission européenne (CE) et l’Organisation de coopération et de développement économiques (OCDE) depuis la signature de la déclaration conjointe avec la CE en 2010 et du plan d’action conjoint avec l’OCDE en 2012. En outre, une association caritative, la Wellcome Trust, qui d’ailleurs apporte son soutien au travail réalisé par le Bureau régional en matière d’information sanitaire, livrera sa vision des bases factuelles et de l’information pour le bien-être en Europe.  Chaque expert présentera un bref aperçu des mesures concrètes prises par son agence respective en vue d’améliorer l’information pour la santé et le bien-être en collaboration avec les organisations partenaires. Le Bureau régional explicitera la feuille de route visant à mettre en place un système d’information sanitaire pour l’Europe avec la CE et l’OCDE, l’Initiative européenne d’information sanitaire, ainsi que le lancement par le Bureau régional du nouveau portail en ligne dans ce domaine. Il présentera aussi d’autres outils permettant d’aider les États membres à renforcer leur système d’information sanitaire.  La séance sera surtout l’occasion d’engager un débat à la suite de l’exposé des experts durant lequel les participants feront notamment part de leurs commentaires sur les progrès réalisés et de leurs attentes vis-à-vis des experts. Des propositions seront également émises quant aux prochaines mesures à prendre. = = =