national implementation reports · - landes-frauen- und kinderklinik linz - landeskrankenhaus...

1

National Implementation Report June 2014

Country: AUSTRIA

Question Status 2011 Status 2014 (please report only changes)

1. Respondent 1.1. Name, title Dr. Rupert Kisser Dr. Robert Bauer 1.2. Function IDB-National Data Administrator; responsible

for European and international affairs in the department for research and knowledge management of the Austrian Road Safety Board

National IDB data administrator.

1.3. Affiliation, address Austrian Road Safety Board, A-1100 Wien, Austria

Austrian Road Safety Board, A-1100 Wien, Austria

1.4. Tel-nr., e-mail-address +43-664-5345369, [email protected]

+43-577077-1320, [email protected]

1.5. Website www.kfv.at www.kfv.at 2. Focus of your institution in injury

monitoring

2.1. Please describe briefly (300 – 500 words) The Austrian Road Safety Board (ARSB - KFV)

2


why and for what purpose your institution handles or reports injury data, in particular data from emergency departments on home and leisure accidents – or how you plan to do it

deals with many data, e.g. road accident data collected by the police, general health data as injury related mortality and hospitalization data, and in particular, with data from ED’s on all kind of injures. ARSB - KFV is a private agency mainly funded by the private insurance sector, its mission is risk management for all (not work related) injuries, although the focus is on road traffic accidents and injuries. Main purpose of the ED injury surveillance system is prevention of home, leisure and sport injuries: risk analysis, development of safety measures, advising policy makers, administrators and industry, informing the wider public, providing training courses for specific target groups, evaluating the impact of measures and programmes. Figures on specific injury risks (frequency of injuries during certain activities, in certain locations, dealing with certain products etc.) are practically indispensable for almost all our activities, representing most steps of the public health circle.

3. Systematic ED based injury surveillance 3.1. Has specific injury surveillance been

pursued in EDs in past three years, with focus on home and leisure accidents, external causes of injuries, or product related injuries? (e.g. IDB, EHLASS, EPAC, LIS, AWISS)

2008-2010: Yes. The Austrian Road Safety Board collects data in EDs, according to the IDB-all injury coding system (all injures since 2007, only home, leisure, and sport according to IDB-V2000 before 2007)

2011-2014: no change

3


3.2. If yes: Please describe briefly the system (500 – 700 words)

3.3. What is the formal status of this monitoring system? (e.g. based on law, implementation regulation, guideline, initiative by an authority, private initiative)

Voluntary data collection, with financial support from the Ministry for Labour, Social Affairs, and Consumer Protection

3.4. Who provides the funding for data collection, handling and reporting?

Austrian Road Safety Board (NGO) about 65%, Ministry about 35%

Austrian Road Safety Board (NGO) about 80%, Ministry about 20%

3.5. Who is responsible for dealing with ED injury data? (Please provide institution, unit, address, name of responsible person)

Austrian Road Safety Board/department for IT and logistics, Mr Martin Donabauer, Schleiergasse 18 A-1100 Wien, Austria, [email protected] Phone: +43-577077-1180 www.kfv.at

3.6. Does your organisation have access to this data (if you are not the responsible organisation)?

Yes

3.7. Which coding system (for external causes) is used in the ED based monitoring? (e.g. only 2-digits V01-Y98 of ICD-10, IDB-All injuries, ICECI, NOMESCO)

IDB-AI (Manual 2005) https://webgate.ec.europa.eu/sanco/heidi/images/d/de/Coding_manual_V1.1_2005.pdf

IDB-All injuries, latest version

3.8. Who actually collects the data in hospitals? (e.g. patients fill in forms, nurses or doctors interview patients)

Data is collected by trained IDB interviewers, employed by the Austrian Road Safety Board (no hospital staff).

3.9. How is the sampling of hospitals been done (How was the representativeness of the sample of hospitals ensured)?

Selection of hospitals has been done according to hospital size (three categories) and geographical distribution (major city,

mailto:[email protected]

http://www.kfv.at/

https://webgate.ec.europa.eu/sanco/heidi/images/d/de/Coding_manual_V1.1_2005.pdf

https://webgate.ec.europa.eu/sanco/heidi/images/d/de/Coding_manual_V1.1_2005.pdf

4


mountainous, province city catchment area). Cases are weighted according to the population of all hospitalized patients in all Austrian general hospitals (age group, gender, type of injury).

3.10. How is the sampling of cases within hospitals been done (How was the representativeness of the samples in hospitals ensured)?

Random sample. Interviews are conducted throughout the week on different days, during different times.

3.11. How is data entry been done? (paper/pencil or tablet-PC with special data entry software, data linked with internal hospital system etc.)

By tablet PC (specific data entry programme)

3.12. What kind of quality control measures are in place to ensure accuracy, reliability, coherence and comparability (what procedures, tools are applied)?

Interviewers are paid for complete data sets (deducts for incomplete data). Data entry software allows only specified categories according to the coding manual. After transfer to the central database, plausibility is checked for illogical (very rare) compositions; illogical compositions are verified or corrected in telephone conversations with the interviewers. Variations of data from different hospitals/interviewers are checked continuously. There is a coding helpdesk available for the interviewers, where cases with doubtful coding are collected. Feedback is given to interviewers (on results of these analyses) on a monthly basis. Additionally

5


“feedback” meetings take place at least once per year.

3.13. How many hospitals (ED) have been involved in the last year? (Please provide a list of involved hospitals if possible, addresses and names of contact persons: link or attachment)

2010: Nine (9): - Landeskrankenhaus Universitätsklinik

Innsbruck - Landeskrankenhaus Klagenfurt - Unfallkrankenhaus Klagenfurt - Unfallkrankenhaus Wien Meidling - Allgemeines Krankenhaus der Stadt Linz - Landes-Frauen- und Kinderklinik Linz - Landeskrankenhaus Bruck/Mur - Landeskrankenhaus Feldkirch Landeskrankenhaus Bregenz

2013: Five (5) - Unfallkrankenhaus Wien Meidling - Allgemeines Krankenhaus der Stadt Linz - Landes-Frauen- und Kinderklinik Linz - Landeskrankenhaus Feldkirch - Landeskrankenhaus Bregenz

3.14. Approx., how many cases have been collected in the last year?

2010: 8.300 2013: 10.000

3.15. What is the average production time for data release?

Eight weeks for availability in data base. Six months for data report (including other sources as mortality statistics).

2 weeks after end of data-collection for availability of yearly IDB data in database.

3.16. Were (national) incidence rates for home, leisure and school injuries derived? What method was used?

Yes, crude rate & age adjusted rate.

3.17. Is there a national (annual) report about figures and findings of the ED based system? (Please provide link or file of last report)

Yes. This report focuses on product/service related unintentional injuries (IDB Austria annual report) and is published by the ARSB for the Federal Ministry for Labour and Consumer Protection. http://www.bmask.gv.at/cms/site/attachments/4/9/1/CH0147/CMS1224077606935/idb_austria_jahresbericht_2007.pdf

New web link: http://www.sozialministerium.at/site/Konsumentenschutz/Produktsicherheit/Unfalldatenbank

http://www.bmask.gv.at/cms/site/attachments/4/9/1/CH0147/CMS1224077606935/idb_austria_jahresbericht_2007.pdf



http://www.sozialministerium.at/site/Konsumentenschutz/Produktsicherheit/Unfalldatenbank

http://www.sozialministerium.at/site/Konsumentenschutz/Produktsicherheit/Unfalldatenbank

6


3.18. Please check what has been done with the opportunities you identified earlier in 2011. Please describe also briefly (500-700 words) current opportunities for optimizing the system (e.g. new IT developments, re-organisation of health information, demands for more effective prevention)

There is the opportunity to make use of a larger database on injuries treated in ED’s: The Austrian Workers Compensation Board (AUVA) operates seven accident hospitals (dealing with all kinds of injuries), in which about 300.000 Patients are treated (40.000) hospitalized. AUVA has established detailed medical documentation system which comprises also information about external cause of injuries. It has to be explored how far this system is compatible with the (new) European IDB.

Any involvement of the workers compensation board would need a demand from the MoH. The MoH decided not to take any initiative regarding the workers compensation board. So there was no change to the status of 2011: Data are collected by ARSB only.

3.19. Please check what has been done with the challenges you identified earlier in 2011. Please describe briefly (500-700 words) challenges to the system (e.g. reorganization of lead agency, severe budget cuts, decisions on reducing the scope)

Currently, the IDB data collection is challenged by reorganization measures with the Road Safety Board (dissolution of the department for home, leisure and sport and swop of the responsibility for IDB to the department of safety counselling), combined with budget cuts and increased need for third party co-funding. The number of hospitals has been reduced, and funding is only secured till the end of 2011. It is undecided, how far the Road Safety Board will deal with violence, home, leisure and sport accidental injuries in the future (which is not the Board’s core business).

The IDB data collection has been downsized in terms of number of hospitals (see above), but has continued so far without interruption.

4. National injury reporting 4.1. Please quote recent publications using your

IDB data (or provide a web-link) 2008-2010: 2011-2014:

G. Ruedl1, M. Burtscher1, M. Wolf1, L.

7


Ledochowski1, R. Bauer, K.-P. Benedetto3 and M. Kopp. 2013. Are self-reported risk-taking behavior and helmet use associated with injury causes among skiers and snowboarders? Scand J Med Sci Sports. DOI: 10.1111/sms.12139

R. Bauer, M. Steiner, R. Kisser, S. M. Macey, D. Thayer. 2014. Unfälle in der EU - Ergebnisse des EuroSafe-Reports. Bundesgesundheitsblatt - Gesundheitsforschung – Gesundheitsschutz. DOI: 10.1007/s00103-014-1969-5.

4.2. Is there a comprehensive reporting on accidents/injuries available, comprising home, leisure, road, and workplace injuries at various levels of severity (deaths, hospitalizations, ambulatory treatments) – or is there any intention to produce such report? (Please provide link to the website or attach the report)

There is an annual comprehensive report on general the health burden of injuries, compiling practically all data sources on accidents and injuries in Austria (IDB, mortality statistics, hospital discharge statistics, road traffic accidents statistics, etc.). Special attention is given to home, leisure and sport accidents (where the main information source is the IDB surveillance system). This report is published by the Austrian Road

There is an online query tool on accidents, compiling different data sources on accidents and injuries in Austria (IDB, mortality statistics, hospital discharge statistics, road traffic accidents statistics, etc.). Special attention is given to home, leisure and sport accidents (where the main information source is the IDB surveillance system). The online query tool is accessible is maintained by the Austrian Road Safety Board and accessible at:

8


Safety Board. http://www.kfv.at/heim-freizeit-sport/freizeitunfallstatistik/

http://www.kfv.at/unfallstatistik/

4.3. Who is responsible for the comprehensive injury reporting? (Please provide institution, unit, address, name of responsible person)

Austrian Road Safety Board (see above)

5. Key stakeholders (main data users) 5.1. Which is the competent authority (most

probably in the Ministry of Health) for injury statistics, in particular on and home and leisure accidents? (please provide unit, addresses, name of responsible person)

Federal Ministry of Health, Department I/B/11. Head of department Mrs Dr. Ulrike Schermann-Richter. Radetzkystraße 2 1030 Wien Phone: +43-1-711 00 – 0 [email protected] www.bmg.gv.at

5.2. Which authority or agency (Ministry of health, Health Council) is competent for funding injury prevention (home and leisure) and prevention research? (please provide unit, addresses, name of responsible person)

Federal Ministry of Health/Department III/6. Head of department Mrs Mag. Judith delle Grazie. Radetzkystraße 2 1030 Wien Phone: +43-1-711 00 – 0 [email protected] www.bmg.gv.at

5.3. Which authority (most probably in the Ministry of Consumer Affairs) is competent for the safety of consumer products?

Federal Ministry of Labour, Social Affairs and Consumer Protection/Department III/2. Head of department Mrs. Dr. Disa Medwed.

http://www.kfv.at/heim-freizeit-sport/freizeitunfallstatistik/

http://www.kfv.at/heim-freizeit-sport/freizeitunfallstatistik/

http://www.kfv.at/unfallstatistik/


http://www.bmg.gv.at/


http://www.bmg.gv.at/

9


(please provide unit, addresses, name of responsible person)

1010 Wien, Stubenring 1 Phone: +43-1-711 00 – 0 [email protected] www.bmsk.gv.at

5.4. Which unit in the national bureau of statistics is responsible for health statistics as mortality and hospital discharge statistics? (please provide unit, addresses, name of responsible person)

Statistik Austria, Directorate Population and Society, Department Health Statistics; head of the department Mag. Jeannette Klimont Hintere Zollamtsstr. 2b A-1030 WIEN [email protected] Phone: +43-1-711 28 72 62 www.statistik.at

5.5. Is there a national public health institute, which is dealing with injury data? (If yes, please provide unit, addresses, name of responsible person)

Yes, but it does not deal with injury data.

5.6. Is there any (other) relevant body (agency) for the prevention of home and leisure accidents (e.g. for campaigning)? (If yes, please provide unit, addresses, name of responsible person) If there are more than one, please provide information on the most important ones

Worker s Compensation Board (Allgemeine Unfallversicherung-Anstalt AUVA) Adalbert-Stifter-Straße 65 1200 Wien Phone: +43-1-331 11-0 www.auva.at/hauptstelle

5.7. Is there any (other) relevant institute with research interest in home and leisure injury

No


http://www.bmsk.gv.at/


http://www.auva.at/hauptstelle

10


prevention? (If yes, please provide unit, addresses, name of responsible person)

5.8. Is there a more or less formalized collaboration of these key stakeholders? (If yes, please characterize)

No

5.9. Is there a national action plan for (home and leisure) injury prevention? (If yes, please provide a link or document)

There is a current project aiming on the development of a national action plan, involving several federal ministries, the social (health) insurers, and the federal provinces (which have many competencies regarding injury prevention). The current project is to update a proposal for such action plan, which was developed by the Ministry of Health in 2006. The new plan for 2012-2020 shall be available by the end of 2011. Responsible is the ARSB (Dr. Rupert Kisser, [email protected])

The new plan has been completed together with key stakeholders in February 2012. However, the MoH has refrained from implementation due to various challenges (in particular lack of responsibilities at federal level).

6. Signature


11

6.1. Place, date 16.08.2011 16.07.2014

6.2. Signature

6.3. Name Dr. Rupert Kisser Dr. Robert Bauer

1


Country: CYPRUS

Question Status 2011 Status 2014 (Please report only changes)

1. Respondent 1.1. Name, title Pavlos Pavlou, Dr 1.2. Function Coordinator, Health Monitoring Unit 1.3. Affiliation, address Ministry of Health, 1 Prodromou & 17

Chilonos Street, 1448 Nicosia, Cyprus.

1.4. Tel-nr., e-mail-address +357-22-605381 or 22-605457 [email protected]

1.5. Website www.moh.gov.cy 2. Focus of your institution in injury

monitoring

2.1. Please describe briefly (300 – 500 words) why and for what purpose your institution handles or reports injury data, in particular data from emergency departments on home and leisure accidents – or how you

In Cyprus, accidents and injuries cause a large share of mortality and long term disability among the young, the economically active and the elderly. There is a need to reduce the incidence of all injuries and lessen their burden


http://www.moh.gov.cy/

2


plan to do it on society. Existing knowledge shows that the underlying risk factors which cause injuries can be predicted. There is therefore, considerable potential for prioritization of possible areas for action and cost-effective prevention. These interventions need to be based on sound, reliable and timely information with regard to the factors that influence the occurrence of accidents.

Injury data need to be collected in a standardized way in order to provide comparable information across countries. They need to be relevant and accurate in order to yield maximum useful knowledge. Hospital discharge data, routine emergency department data and health surveys in Cyprus can provide some useful statistics on injuries. However, they do not provide sufficient information on external causes of injuries or product related information. The IDB data set is designed to address this type of information need and can be used to support the development of preventive policies and measures. For these reasons the Ministry of Health decided to go ahead with developing the necessary administrative capacity to collect such data according to the IDB guidelines and standards.

Our participation in the IDB project is

3


considered to be extremely useful for our country. It has helped initiate and establish a sound and sustainable mechanism of all injury data collection and surveillance. The intention of the Ministry is to continue to maintain and improve the existing structure of data collection. Our participation as associated partners in the JAMIE Joint Action is expected to further strengthen the existing capacity and enhance the quality of the data collected.


pursued in EDs in past three years – e.g. with focus on home and leisure accidents, external causes of injuries, or product related injuries? (e.g. IDB, EHLASS, EPAC, LIS, AWISS)

2008-2010: Yes. IDB – since 2006 in one General Hospital.

2011-2014: Yes, FDS in Nicosia General Hospital. 2013-2014: Yes, MDS in Limassol, Larnaka, Pafos, Kyperounta and Polis Hospital EDs with varying degrees of implementation and completeness of data entry.


In 2006, the Ministry of Health began collecting data on injury cases attending the Accident and Emergency Departments of two out of five state General Hospitals, i.e. the Nicosia General Hospital and the Ammochostos General Hospital. Our sources are the.

A paper form is filled in with this data and then it is recorded using the IDB coding software. This work is done by a dedicated clerk employed specifically for this purpose. She has received training on how to use the

In 2013 we installed a homemade software within the existing hospital information systems in order to record injuries using the MDS developed by the JAMIE joint action. EDs registrars were given basic training in recording all injury and poisoning cases attending the EDs. This has had variable success in the degree of implementation. Budgetary austerity measures and limitations in staff-time availability are creating difficulties in improving the system. Efforts are being

4


coding manual and how to enter the data into the electronic system. She is supervised by the Director of the Accident and Emergency Department.

The database is managed by the information technology officers of the health monitoring unit who perform quality checks regularly and the data are analysed by the statisticians of the Unit. Data are sent to the DG SANCO IDB database and some local reports comparing Cyprus data with European data have been prepared.

The system produces useful information on injuries, product-related injuries in particular, that is suitable both for statistical, research and injury prevention purposes.

The Accident and Emergency Department of Nicosia General Hospital is the central point of data collection and entry. A trained clerk is dedicated to this task and works full time at the department. She only works during normal working hours from 7:30 a.m. till 2:30 p.m. excluding Saturdays, Sundays and holidays. On Thursdays she works from 7:30 am till 6:00 pm except for July and August.

She collects information by interviewing patients and or relatives who attended the

made in order to increase the completeness and quality of recording.

5


department for management of injuries. patient records, emergency medical services records (i.e. ambulance services), emergency department records, outpatient/ambulatory care records, medical examiner/coroner reports and in-person interviews of the patients themselves She fills in a specially designed form and coded the data elements. The form includes spaces for free text descriptions of the injury variables that requires a lower level (finer detail) coding. She then entered the data in the IDB software. During her normal working hours nearly all injuries attending the emergency department are interviewed and recorded. A few injured patients attending at hours outside the clerk’s working hours are recorded by medical personnel in forms and the data are later entered in the software.

The pilot data collection begun on 9th February 2006 in Nicosia General Hospital and on 12th March 2006 in Paralimni Rural Hospital.

Nicosia: The “catchment” population of Nicosia General Hospital, in 2005, is assumed to be the estimated total population in the District Nicosia which is 302 600 inhabitants. The total number of arrivals at the Nicosia Accident and Emergency Department in 2004

6


was 128 435 (36.8% of all arrivals at Government General Hospital emergency departments which were a total of 348 584).

It is recognized that there are inherent problems in the selection of the sample of injuries introducing biases and limiting the representativity of the sample. Despite these limitations, we believe it is possible to analyze and use these data constructively.

The main factors affecting comparability are the sampling methodology, the correct definition of the catchment population, the completeness of the information collected and the quality of coding.

All efforts are being made to ensure the quality of data by correct application of the IDB coding manual which has been translated into Greek.

The progress of IDB in Cyprus, so far, provides evidence to suggest that the system is sustainable.


The monitoring system is an initiative by the Ministry of Health and is based on the IDB guidelines. There is no national legal basis. As from 2008 we have the EU framework Regulation 1338/2008.

3.4. Who provides the funding for data The Ministry of Finance through the Ministry

7


collection, handling and reporting? of Health. 3.5. Who is responsible for dealing with ED

injury data? (Please provide institution, unit, address, name of responsible person)

Health Monitoring Unit, Ministry of Health, 1 Prodromou & 17 Chilonos Street, 1448 Nicosia, Cyprus. Responsible: Dr Pavlos Pavlou.


We are the responsible organization for maintaining the database.


IDB-All injuries coding manual FDS for Nicosia MDS for other hospitals


One clerk dedicated to the IDB. Her duties are described above.

The clerks/registrars in EDs in all the hospitals using the MDS collect the data.


One central hospital. There are some problems with national representativeness but efforts are being made to improve this. They are described above. The representativeness of the data seems to have improved in years 2009-2010 but no formal evaluation has been carried out.

The completeness of case and data items recording is variable due to staff limitations.


Random cases attending ED are registered. When the clerk is absent from work, the registration is not complete.

3.11. How is data entry been done? (paper/pencil or tablet-PC with special data entry software, data linked with internal

Desktop computer with the IDB coding software installed. Version 3.4. (Data dictionary v.1.1, June 2005).

8


hospital system etc.) 3.12. What kind of quality control measures

are in place to ensure accuracy, reliability, coherence and comparability (what procedures, tools are applied)?

Quality control measures for duplicates, for inconsistencies between data elements (e.g. age and activity when injured) and for properly completed modules (admission, violence, intentional self-harm, transport and sports) when applied.


2010: One. Dr Costas Antoniades, Accident and Emergency Department, Nicosia General Hospital, 215 Old Nicosia-Limassol Road, 2029 Nicosia, Cyprus. http://www.moh.gov.cy/ngh

2013-2014: Nicosia GH - FDS Limassol GH - MDS Larnaka GH - MDS Pafos GH - MDS Kyperoynda Rural H - MDS Polis Rural H - MDS Dr. Pavlos Pavlou, Ministry of Health.


2010: 1,670 2013: Nicosia FDS: 381 cases

Hospital Data Set Total

Nicosia FDS 381

Limassol MDS 14575

Larnaka MDS 3399

Polis MDS 248

Kyperounda MDS 85

Total 18307

3.15. What is the average production time for Approximately six months from end of the

http://www.moh.gov.cy/ngh

9


data release? year. 3.16. Were (national) incidence rates for

home, leisure and school injuries derived? What method was used?

No


Not an official one but we have published some data on our website based on the model of EU reports

A report on fatal injuries is being prepared for data 2004-2012

3.18. Please check what has been done with the opportunities you identified earlier in 2011. Please describe briefly (500-700 words) current opportunities for optimizing the system (e.g. new IT developments, re-organisation of health information, demands for more effective prevention)

Better training of data entry staff, expansion to other hospitals and better national ED statistics.

No further training was possible due to staff limitations except for new staff collecting MDS. The data collection was expanded to all the remaining state hospitals in Cyprus using MDS.


The threat of staff loss. Recent budget cuts and staff limitations reduce the capability of maintaining, expanding and improving the systems of data collection.

4. National injury reporting 4.1 Please quote recent publications using your

IDB data (0r provide a web-link) 2008-2010: 2011-2014:

4.2. Is there a comprehensive reporting on accidents/injuries available, comprising home, leisure, road, and workplace injuries

There is no comprehensive report. There is intention to produce such a report

10


at various levels of severity (deaths, hospitalizations, ambulatory treatments) – or is there any intention to produce such report? (Please provide link to the website or attach the report)

when all the data are available.


N/A



The Health Monitoring Unit of the Ministry of Health.


Mr Dionisis Mavronikolas, Permanent Secretary of the Ministry of Health, 1 Prodromou & 17 Chilonos Street, 1448 Nicosia, Cyprus.

Ms Christina Yiannaki, Acting Permanent Secretary of the Ministry of Health, 1 Prodromou & 17 Chilonos Street, 1448 Nicosia, Cyprus.

5.3. Which authority (most probably in the Ministry of Consumer Affairs) is competent for the safety of consumer products? (please provide unit, addresses, name of responsible person)

Competition and Consumer Protection Service of the Ministry of Commerce Industry and Tourism, Consumer Policy. http://www.mcit.gov.cy/mcit/mcit.nsf/dmlprotection_en/dmlprotection_en?OpenDocument

5.4. Which unit in the national bureau of statistics is responsible for health statistics as mortality and hospital discharge

Division of Demography, Social Statistics and Tourism,Ms Dora Kyriakides, [email protected]

http://www.mcit.gov.cy/mcit/mcit.nsf/dmlprotection_en/dmlprotection_en?OpenDocument

http://www.mcit.gov.cy/mcit/mcit.nsf/dmlprotection_en/dmlprotection_en?OpenDocument


11


statistics? (please provide unit, addresses, name of responsible person)

http://www.mof.gov.cy/mof/cystat/statistics.nsf/populationcondition_23main_en/populationcondition_23main_en?OpenForm&sub=3&sel=1


There is no national public health institute as such. Some of these functions are carried out by the Ministry of Health. Dr Olga Kalakouta, Advisory Committee for

the Prevention of Childhood Injuries, Ministry of Health, 1 Prodromou & 17 Chilonos Street, 1448 Nicosia, Cyprus. Dr Pavlos Pavlou, Health Monitoring Unit, Ministry of Health, 1 Prodromou & 17 Chilonos Street, 1448 Nicosia, Cyprus.


5.7. Is there any (other) relevant institute with research interest in home and leisure injury prevention? (If yes, please provide unit, addresses, name of responsible person)

5.8. Is there a more or less formalized




12


collaboration of these key stakeholders? (If yes, please characterize)


6. Signature 6.1. Place, date 16.05.2011 23.07.2014

6.2. Signature

6.3. Name, function Dr Pavlos Pavlou

Health Monitoring Unit

Ministry of Health

Dr Pavlos Pavlou

Health Monitoring Unit

Ministry of Health

1


Country: CZECH REPUBLIC


1. Respondent 1.1. Name, title Prof.Planka Ladislav, MD., PhD. 1.2. Function Head of education 1.3. Affiliation, address Clinic of paediatric surgery and traumatology,

Faculty hospital Brno

1.4. Tel-nr., e-mail-address +420 732 234 234; [email protected] 1.5. Website www.detska-chirurgie.cz 2. Focus of your institution in injury

monitoring

2.1. Please describe briefly (300 – 500 words) why and for what purpose your institution handles or reports injury data, in particular data from emergency departments on home and leisure accidents – or how you plan to do it

Our clinic is one of eight pediatric trauma centers and is commissioned by the Czech Republic Ministry of health to create a national register of child injury according to foreign designs. We consider data collection as a key tool for preventing childhood injuries.

2




2008-2010: - It used our own national database for data collection - This database is compatible with IDB coding and every year all IDB codes of every case are sending to Injury Data Base.

2011-2014: Own IDB compatible data base on childhood injuries.


The central database is accessible through a

web interface. Access to each facility that cares

for injured patients. For each accident are

given basic characteristics, including data on

the mechanism, primary care, diagnosis,

treatment and its outcome. Assignment is also

part of the coding according to IDB.

All data are then accessible on-line for analysis

and are safely secured.


Implementation regulation by Czech republic Ministry of health


Czech republic Ministry of health European funds


Faculty hospital Brno Jihlavska 20, 625 00 Brno Czech Republic Prof. Petr Gal, Ph.D., M.D. Prof. Planka Ladislav, MD., PhD.

3.6. Does your organisation have access to this see above

3


data (if you are not the responsible organisation)?


full 3-digits V01-Y98 of ICD-10 and IDB-All injuries


Basic information – administrator Advance information – doctor


The injury data from all 14 trauma centres are sended, all injury levels and types are represented.


see above


Data are entered electronically through PC and a web interface in the central database in Brno.


- electronic control - feedback control of 10% cases by authorized officer


2010: 14 2013: 60

4



2010: 8 000 2013: 8 000


Data are on-line for the national users, IDB format is prepared in 1 month after deadline.


Yes, they were – according ICD and IDB code


Children injuries are on-line available (can be sort by season etc.), adult injuries are prepared as report every year in June.


- Data taking directly from IS - On-line data for adult injuries - Expansion to other hospitals outside trauma centres

- Expansion of children-FDS to other hospitals outside trauma centres – completed - MDS for all admissions, all age groups in all hospitals starts in 2015 (by law)


- lack of time for data entry in hospital - incomplete records of first and emergency aid

- lack of time for data entry in hospital: training and injury data entering technical staff - incomplete records of first and emergency aid: no problem for IDB


IDB data (0r provide a web-link) 2008-2010: None 2011-2014: 3

5



Yes it is, not on-line, in attach public report 2009, the 2010 is expected in a week.


Institute of biostatistics and analyses Kamenice 126/3, 625 00 Brno Czech republic Petr Brabec, M.Sc. - Deputy Director for Quality and Management, [email protected]



Department of Public Health and Preventive Medicine V Úvalu 84, Praha 5 150 06 ass. prof. Veronika Benesova, M.D., Ph.D. [email protected]


Department of Public Health and Preventive Medicine V Úvalu 84, Praha 5 150 06 ass. prof. Veronika Benesova, M.D., Ph.D. [email protected]

5.3. Which authority (most probably in the Ministry of Consumer Affairs) is competent for the safety of consumer products? (please provide unit, addresses, name of

Ministry of industry and trate: - Czech trade inspection - Czech Metrology Institute



6


responsible person) 5.4. Which unit in the national bureau of

statistics is responsible for health statistics as mortality and hospital discharge statistics? (please provide unit, addresses, name of responsible person)

Institut of health information and statistics of the Czech Republic Palackého nám. 4 , P.O.BOX 60, 128 01 Praha email: [email protected]


No


No institution, only interest groups and foundations.


No institution, only interest groups and foundations


Yes, creating a functional network (interconnection) preventive institution, completion planned for 2013.


Yes, it is. http://www.mzcr.cz/dokumenty/narodni-akcni-plan-prevence-detskych-urazu_1091_902_1.html


http://www.mzcr.cz/dokumenty/narodni-akcni-plan-prevence-detskych-urazu_1091_902_1.html



7

6. Signature 6.1. Place, date Brno, 30.06.2011 Brno, 29 August 2014

6.2. Signature

6.3. Name, function Prof. Ladislav Planka Prof. Ladislav Planka

1

National implementation Report June 2014

Country: GERMANY / BRANDENBURG


1. Respondent 1.1. Name, title Thomas Graf, Daniel Koster 1.2. Function Clerical assistant for health statistics 1.3. Affiliation, address Department of Health Brandenburg 1.4. Tel-nr., e-mail-address 00 49 / 2 28 – 9 96 43 81 69

[email protected] 0049 / 33702 -71138, [email protected]

1.5. Website www.destatis.de http://www.gesundheitsplattform.brandenburg.de

2. Focus of your institution in injury monitoring

2.1. Please describe briefly (300 – 500 words) why and for what purpose your institution

The official statistics in Germany do not have sufficient information on the circumstances


http://www.destatis.de/

2


handles or reports injury data, in particular data from emergency departments on home and leisure accidents – or how you plan to do it

and causes of injuries The hospital discharge register collects data on the diagnoses of injured patients but not

on the injury location, mechanism and circumstances

on injuries by violence and self-harm The road traffic statistics gather data only on traffic accidents registered by the police but

not on injury diagnoses

The criminal statistics collect data only on criminal acts registered by the police, but not

on injury diagnoses and on the context of violence



2008-2010: Yes, in Cottbus (all years), Eisenhüttenstadt 2008 and Chemnitz 2010 (IDB-FDS)

2011-2014: Yes, in Cottbus (all years). In 2014 the MDS of IDB has been established in the Hospital of Delmenhorst.



Public Health Service


Voluntary funding is covered by involvement of the Department of Health of Brandenburg

3



NDA: Dr. Gabriele Ellsäßer, Abteilungsleiterin Gesundheit, Landesamt für Umwelt, Gesundheit und Verbraucherschutz , Wünsdorfer Platz 3, 15806 Zossen.



IDB-All injuries


nurses or doctors interview patients


Hospitals are recruited through personal contacts, according to their willingness to collect IDB data voluntarily. Cottbus: admitted patients: daily; patients treated in the ED: one day (24 hours) per week Leipzig: admitted patients & ED patients: one day (24 hours) a week Eisenhüttenstadt: admitted patients: daily; patients treated in the ED: one day (24 hours) per week / data only for 2009 sample size: 842 cases; finished in 2010 Chemnitz: admitted patients: daily; patients treated in the ED: one day (24 hours) per week / only 2011 sample size: 1263 cases; finished in 2012

In Delmenhorst since June 2013 all admitted patients and patients treated in the ED. ED patients limited to children < 18 years. MDS interface integrated in the hospital documentation system. Chemnitz finished in 2012

4


The representativeness been ensured by expertises of extern statistic services and intern quality checks.



Tablet-PC with special data entry software


Standard-data-checks with SPSS NDA check for unclear reported cases Comparison with HDR-Data


2010: Cottbus (Carl-Thiem-Klinikum), Dr.

Thomas Erler: http://www.ctk.de/Kinder-und-Jugendmedizin.0.61.1.html

Leipzig (Universitätsklinikum Leipzig), Dr.

Woller: http://kinderchirurgie.uniklinikum-

leipzig.de/kindck.site,postext,fachaerzte-

und-

assistenten.html?PHPSESSID=8om8avvj3s

mqrdmek3hjkdooa2

Chemnitz: (Klinikum Chemnitz), Dr.

Martin Herbst:

2013: - Cottbus, Leipzig - Delmenhorst (Klinik für Kinder- und

Jugendmedizin), Dr. Johann Böhmann:

http://www.klinikum-

delmenhorst.de/Kliniken_Zentren/Kinder_+un

d+Jugendmedizin.html

http://www.ctk.de/Kinder-und-Jugendmedizin.0.61.1.html

http://www.ctk.de/Kinder-und-Jugendmedizin.0.61.1.html

http://kinderchirurgie.uniklinikum-leipzig.de/kindck.site,postext,fachaerzte-und-assistenten.html?PHPSESSID=8om8avvj3smqrdmek3hjkdooa2





http://www.klinikum-delmenhorst.de/Kliniken_Zentren/Kinder_+und+Jugendmedizin.html



5


http://www.klinikumchemnitz.de/mp/click

.system?s=Zuweiser/

/Mitarbeiter&menu=41&nav=107&navid=7

81&pid=781&sid=1


2010: 4700 2013: 4500


Approximately 1 minute per cases


Incidence rates for Brandenburg are build with data from IDB Cottbus (HDR based extrapolation & by catchment area population)

Incidence rates for Brandenburg are build with data from IDB Cottbus (HDR based extrapolation & by catchment area population)

reference population for Brandenburg (based only on admitted patients!)

Correct incidence rates can’t be build on IDB data because admitted & ED cases have to be extrapolated!


http://www.gesundheitsplattform.brandenburg.de

3.18. Please check what has been done with the opportunities you identified earlier in 2011. Please describe briefly (500-700 words) current opportunities for

Establish a higher rate of data collection Cooperation planned with another Brandenburg hospital in 2014

http://www.klinikumchemnitz.de/mp/click.system?s=Zuweiser/

http://www.klinikumchemnitz.de/mp/click.system?s=Zuweiser/

6


optimizing the system (e.g. new IT developments, re-organisation of health information, demands for more effective prevention)


The public health sector must be included and a sustainable partner

IDB is an integral part of the injury monitoring system in Brandenburg




“Unfälle, Gewalt, Selbstverletzung bei Kindern und Jugendlichen“ 010. http://www.destatis.de/jetspeed/portal/cms/Sites/destatis/Internet/DE/Content/Publikationen/ Fachveroeffentlichungen/Gesundheit/Gesundheitszustand/UnfaelleGewaltKinder, templateId=renderPrint.psml

Ellsäßer G (2014) Unfälle, Gewalt, Selbstverletzung bei Kindern und Jugendlichen 2013. Ergebnisse der amtlichen Statistik zum Verletzungsgeschehen 2011. Fachbericht. Statistisches Bundesamt (Hrsg.), Wiesbaden


Statistisches Bundesamt(Hrsg.) - Thomas Graf Landesamt für Umwelt, Gesundheit und Verbraucherschutz Brandenburg, Abteilung Gesundheit.

http://www.destatis.de/jetspeed/portal/cms/Sites/destatis/Internet/DE/Content/Publikationen/

http://www.destatis.de/jetspeed/portal/cms/Sites/destatis/Internet/DE/Content/Publikationen/

7


-Dr. Gabriele Ellsäßer 5. Key stakeholders (main data users 5.1. Which is the competent authority (most


Ministry of Health Rochusstr. 1, 53123 Bonn


Ministry of Health Rochusstr. 1, 53123 Bonn


Federal Ministry of Food, Agriculture and

Consumer Protection (BMELV)

Wilhelmstraße 54, 10117 Berlin

See also:

Federal Institute for Occupational Safety and

Health (BAuA)

Friedrich-Henkel-Weg 1-25

D-44149 Dortmund

Isabell Bentz

Tel. 0231/9071-2064

5.4. Which unit in the national bureau of statistics is responsible for health statistics as mortality and hospital discharge statistics? (please provide unit, addresses,

Statistisches Bundesamt H101 Graurheindorferstr. 198 53117 Bonn

8


name of responsible person) Thomas Graf Sabine Nemitz






6. Signature 6.1. Place, date Zossen, 29.06.2011 Zossen, 23 July 2014 6.2. Signature

9


6.3. Name Daniel Koster Daniel Koster

1


Country: DENMARK


1. Respondent 1.1. Name, title Bjarne Laursen, ph.d. 1.2. Function Senior researcher 1.3. Affiliation, address National Institute of Public Health, University

of Southern Denmark

1.4. Tel-nr., e-mail-address +45 3920 7777; [email protected] 1.5. Website www.si-folkesundhed.dk 2. Focus of your institution in injury

monitoring


NIPH host the Danish injury register until 2010 and reports data from this during newsletters, website and research papers. Our primary focus is home and leisure injuries. From 2010 the injury registration is hosted at the National board of Health as a part of the national patient

2


register. The role of NIPH in relation to reporting of injuries in the future is not decided yet. Contact at the national board of Health: Ditte Andreassen, [email protected]

Ditte Andreassen is not employed at NBOH anymore; the contact person is now Marianne Lundkjær Gjerstorff ([email protected])



2008-2010: Yes, three registrations:

1) IDB registration, based on hospitals in Glostrup, Frederikssund, Esbjerg, Randers. Period until 2010.

2) Accident analysis group, Odense Hospital. Ongoing.

3) National board of health, 2010-2011 (may be continued). Hospitals in Glostrup, Odense, Aarhus.

All of the above include product registration, and for all injuries including home and leisure and violence.

2011-2014: Yes, one registration of (nearly) Full data set:

1) Accident analysis group, Odense Hospital. Ongoing. Does only include coding of product and sport as text

The above registrawtion covers all injuries including home and leisure, suicide attempts and violence.


All are based on NOMESCO version 4 (from 2008 onwards) in almost the full detail.

1) Uses the full product list (2000+ products) while

2) 2) and 3) used a reduced product list (300 products). However, 2) includes all

The registration is based on NOMESCO version 4 in almost full detail. However, products are recorded as text in a specific text fiels; sports are recorded in a test field describing the activity. Recently, an algorithm has been developed extraction product and

3


products in text, but not coded sports codes from these text fields. 3.3. What is the formal status of this monitoring

system? (e.g. based on law, implementation regulation, guideline, initiative by an authority, private initiative)

1) Based on external funding, which ceases by 2010

2) Based mainly on regional and municipality funding.

3) Based on cross-sectoral governmental project funding (ends in 2011)

The registration is based on regional and municipality funding.


1) Funding ceases 2010 – our institute pays for reporting in 2011

2) The core data collection is mandatory – the extra costs due to the detailed collection is paid by regional and municipalities, and authorities that use the data

The core data collection is mandatory – the extra costs due to the detailed collection is paid by regional and municipalities, and authorities that use the data


1) National Institute of Public Health, University of Southern Denmark Øster Farimagsgade 5, DK-1353 København K Bjarne Laursen [email protected]

2) Accident analysis group, Odense University Hospital Sdr. Boulevard 29, DK-5000 Odense C Jens Lauritsen

3) National Board of Health (Sundhedsstyrelsen)

Islands Brygge 67,DK-2300 København S Ditte Andreassen, [email protected]

Accident analysis group, Odense University Hospital Sdr. Boulevard 29, DK-5000 Odense C Jens Lauritsen www.uag.dk


http://www.uag.dk/

4


1) www.niph.dk 2) www.uag.dk 3) www.sst.dk


Yes, to 1) and 3) Only by request and permission. A subset without the text fields is available through the “Statens Serum Institut”


NOMESCO version 4 (nearly full detail) http://www.sst.dk/~/media/Indberetning%20og%20statistik/Patientregistrering/klassifikationslister_skaderegistrering_2008_v1-2_jan2009.ashx

No change


Medical secretaries collect and code the data on external causes by interview when the patient arrive.

No change


No formal sampling. The hospitals in 1) were chosen in order to have hospital spread over the country. In 3) hospitals in three of the five regions were chosen. Two of the three hospitals are trauma centres, receiving also the most severely injured patients. The third hospital is a local hospital.

No formal sampling – there is only one hospital


All cases are recorded in 2) and 3). For 1) a selection scheme was introduced 2009 including only 50% of the cases at the hospital in Glostrup. Due to the close down, this was introduced in the other hospitals during 2010. The 50% was chosen as patients born the 1-15th in each month (based on the person number)

All cases are recorded.

http://www.niph.dk/

http://www.uag.dk/

http://www.sst.dk/

http://www.sst.dk/~/media/Indberetning%20og%20statistik/Patientregistrering/klassifikationslister_skaderegistrering_2008_v1-2_jan2009.ashx




5



1) PC software developed to this purpose 2) And 3) By the patient administrative

system at the hospital

By the patient administrative system at the hospital.


In general: - Teaching, instructions - Secretary meetings - Supervision of new employees (at

hospital) - Random sample control (at hospital) - Central quality control based on

statistics & feedback to hospitals

- Teaching, instructions - Supervision of new employees (at

hospital) - Random sample control (at hospital)

3.13. How many hospitals (ED) have been involved in the last year (2010)? (Please provide a list of involved hospitals if possible, addresses and names of contact persons: link or attachment)

2010: See 3.1 2013: Odense Hopispital; see 3.1 for contact information

3.14. Approx., how many cases have been collected in the last year (2010)?

2010: 1) 50,000 2) 40,000 3) 100,000

2013: 32,000


1) Normally 3-4 months 2) About 3-6 months 3) About 3-6 months

About 6 months


1) Yes, based on national population, national ED cases, sample ED cases in 5-years age groups and gender.

2) No 3) Probably as in 1) but not decided yet.

No

6



1) No – statistics is published on website 2) No annual report since 2004

1) http://www.si-folkesundhed.dk/Statistik/Ulykkesstatistik.aspx?lang=en

2) Reports: http://www.teamtext.dk/uag/aarsrap.php

No annual reports since 2004; previous reports, see http://www.teamtext.dk/uag/aarsrap.php


Due to lack of funding in the future the following topics are considered making the injury data collection more cost-efficient:

1) Slimming of the classification, both for the detailed registration (3) and for the general registration

2) Introduction of automatic coding of products based on text

3) Obtaining industry information for work injuries by connecting to national employment registers instead of obtaining the information from the patient

1) The classification has been reduced by January 1, 2014 (both for minimum and full registration) 2) Automatic coding of test (product and sport) has been used for 2013 data from Odense

3.19. Please check what has been done with the challenges you identified earlier in 2011. Please describe briefly (500-700 words) challenges to the system (e.g. reorganization of lead agency, severe budget cuts, decisions on reducing the

The primary challenge is funding. We are at this moment seeking funding for continuing 3)

No external funding has been obtained

http://www.si-folkesundhed.dk/Statistik/Ulykkesstatistik.aspx?lang=en



http://www.teamtext.dk/uag/aarsrap.php



7


scope) 4. National injury reporting 4.1 Please quote recent publications using your

IDB data (0r provide a web-link) 2008-2010: 2011-2014: None


At NIPH/SDU we are working on a comprehensive report for the period 1990-2010 including all sources of injury information in Denmark. It is expected finished during 2011. This is not expected to be repeated the following years

The report has been published March 2012: http://www.si-folkesundhed.dk/upload/ulykker_i_danmark1990-2009(rettet)-.pdf


For the time being, no institution is responsible for injury reporting.

No change.



The responsible for hospital injury statistics is the National board of health National Board of Health (Sundhedsstyrelsen) Islands Brygge 67,DK-2300 København S Ditte Andreassen, [email protected] www.sst.dk

The responsible for hospital injury statistics is “Statens Serum Institut” Artillerivej 5, DK-2300 Copenhagen S Responsible for injury data: Kristian Nielsen ([email protected]) or Erik Villadsen ([email protected]) www.ssi.dk

5.2. Which authority or agency (Ministry of health, Health Council) is competent for funding injury prevention (home and leisure) and prevention research? (please

Injury prevention is (should be) funded locally at the municipality level. There is no one responsible for prevention research.

No change.

http://www.si-folkesundhed.dk/upload/ulykker_i_danmark1990-2009(rettet)-.pdf





8


provide unit, addresses, name of responsible person)


Sikkerhedsstyrelsen (The Danish Safety Technology Authority), Department of product safety. Nørregade 63, DK-6700 Esbjerg Contact e.g. Ulla Hansen www.sik.dk

Contact, also Lone Brose ([email protected])


Statistics Denmark Health section Sejrøgade 11, DK-2100 København Ø Att. Kamilla Heurlen ([email protected]) www.dst.dk

No change.


National Institute of Public Health, University of Southern Denmark Øster Farimagsgade 5, DK-1353 København K Hanne Møller ([email protected])

No change.


No No change.


Odense Universitetshospital (Accident analysis group)

No change.


9



Sdr. Boulevard 29, DK-5000 Odense C Jens Lauritsen www.dst.dk


No formal, but there are network meetings and common projects.

No change.


There are general health plans including injuries, but no specific plan for injury prevention

No change.

6. Signature 6.1. Place, date Copenhagen 18.05.2011 Copenhagen 30.07.2014

6.2. Signature

6.3. Name, function Bjarne Laursen Bjarne Laursen

1


Country: Estonia


1. Respondent 1.1. Name, title Liis Rooväli 1.2. Function Head of Health Information and Analysis

Department

1.3. Affiliation, address Ministry of Social Affairs of Estonia, Gonsiori 29, 15027 Tallinn, Estonia

1.4. Tel-nr., e-mail-address +372 626 9158, [email protected] 1.5. Website www.sm.ee 2. Focus of your institution in injury

monitoring


Ministry of Social Affairs is responsible for organisation of any health data collection in Estonia (via surveys, registries, reports from health care providers etc). The Estonian Causes of Death registry is located under the Ministry

2


plan to do it of Social Affairs. Also the health care institutions have to send aggregated reports about different health care services provided (incl in ED) etc. to National Institute for Health Development that is located under the Ministry of Social Affairs. The National Institute for Health Development provides statistic about different health care services use etc. to different institutions in WHO, EC etc.



2008-2010: No.

2011-2014: No, but data at MDS level could be extracted from existing HIS, and has been provided for the years 2012 and 2013.





3.6. Does your organisation have access to this data (if you are not the responsible

3


organisation)? 3.7. Which coding system (for external causes)

is used in the ED based monitoring? (e.g. only 2-digits V01-Y98 of ICD-10, IDB-All injuries, ICECI, NOMESCO)







2010: 2013: In 2013, about 83000 cases from 32 hospitals.

3.14. Approx., how many cases have been 2010: 2013: In 2013, about 83000 cases from 32

4


collected in the last year? hospitals. 3.15. What is the average production time for

data release?




Estonia is currently developing nationwide e-health system and all health care providers are/will send individual reports to that system. No new data collection on paper basis will not introduced any more, everything would be integrated to the e-health system. Statistical module for e-health was established in 2013. This was the basis to provide MDS (ICD-10 + some SES data) for 2012 and 2013. This would remain the source for data in the future, improvement of data coverage is foreseen. development. In 2014 development of e-ambulance should be finished, it may improve the quality of injury data somehow. The demand for injury data to provide more effective injury prevention exists already now.

3.19. Please check what has been done with the challenges you identified earlier in

There is clear agreement that health care providers (hospitals) do not do not collect

5


2011. Please describe briefly (500-700 words) challenges to the system (e.g. reorganization of lead agency, severe budget cuts, decisions on reducing the scope)

information not directly needed for provision of medical care, so the future data collection is basing only on ICD-10 and ICD-11 possibilities.




We made few Years ago an overview of injuries in Estonia, Estonian Road Administration makes an overview about road traffic accidents (Traffic Safety Programme) http://www.sm.ee/fileadmin/meedia/Dokumendid/V2ljaanded/Toimetised/2009/series_20095eng.pdf http://www.mnt.ee/index.php?id=12620

National Institute for Health Development reports external causes of injuries in their database http://pxweb.tai.ee/esf/pxweb2008/Database_en/Morbidity/01Registered%20incidence/01Registered%20incidence.asp


Estonian Road Administration is responsible for data reporting on road traffic accidents. Ministry of Social Affairs is responsible for the comprehensive reporting of all health information: data from regular surveys, registries, reports provided by health care providers. Several of them include some type of injury data. There is no other regular special injury data reporting system, special overviews are provided by demand and according to existing resources.

National Institute for Health Development belongs under the Ministry of Social Affairs. They collect and report injury data from health care providers.

5. Key stakeholders (main data users) 5.1. Which is the competent authority (most Ministry of Social Affairs, Health Information

http://www.sm.ee/fileadmin/meedia/Dokumendid/V2ljaanded/Toimetised/2009/series_20095eng.pdf



http://www.mnt.ee/index.php?id=12620

http://pxweb.tai.ee/esf/pxweb2008/Database_en/Morbidity/01Registered%20incidence/01Registered%20incidence.asp



6



and Analysis Department, Liis Rooväli


Injury prevention funding and planning - Ministry of Social Affairs, Public Health Department, Head of Department Katrin Karolin Injury prevention research – we do not provide centrally such resources.


The Consumer Protection Board, Rahukohtu 2, 10130 Tallinn, Estonia, Director Andres Sooniste, [email protected]


The Estonian National Institute for Health Development, Causes of Death Registry (Gleb Denissov) and Department of Health Statistics (Natalja Eigo)

Natalja Eigo is currently on maternity leave, Mare Ruuge is replacing her


Estonian National Institute for Health Development is dealing with injury prevention but not with such data separately

5.6. Is there any (other) relevant body (agency) for the prevention of home and leisure accidents (e.g. for campaigning)? (If yes, please provide unit, addresses, name of responsible person) If there are more than

Estonian Health Insurance Fund, Health Care Department, Sirje Vaask

7


one, please provide information on the most important ones


University of Tartu, Department of Public Health, Diva Eensoo


Injuries and mental health working team which is one of the sub-groups on National Health Plan


National Health Plan 2009-2020 http://www.sm.ee/eng/activity/health/national-health-plan-2009-2020.html

6. Signature 6.1. Place, date Tallinn, 09.09.2011 Tallinn, 18.07.2014

6.2. Signature

6.3. Name, function Liis Rooväli Liis Rooväli

http://www.sm.ee/eng/activity/health/national-health-plan-2009-2020.html

http://www.sm.ee/eng/activity/health/national-health-plan-2009-2020.html

1


Country: GREECE


1. Respondent 1.1. Name, title Prof. Dr. Vassilios Makropoulos,

Thanasias Efthimios M.D. – (assistant)

1.2. Function Professor of the National School of Public Health (Dept. of Occupational and Industrial Hygiene )

1.3. Affiliation, address L. Alexandras 196, ATHENS, GREECE, 11521

1.4. Tel-nr., e-mail-address + 30 697 721 75 99 [email protected] Dr. Efthimios: +30 2132010340, [email protected]

1.5. Website http://www.nsph.gr/


2



24 HOURS INJURY ACCIDENTS MONITORING IN THE EMERGENCIES OF ONE UNIVERSITY HOSPITAL IN ATHENS (KAT). THERE WILL BE 2 ASSISTANTS (full time) FOR ENTERING THE DATA INTO THE SPECIAL FORM “KAT” IS A SPECIALISED UNIVERSITY HOSPITAL (THE BIGGEST OF IT’S KIND) ON ACCIDENTS, INJURY AND ORTHOPEDICS IN GREECE. IT’S “TARGET” POPULATION EXEEDS 5.000.000



2008-2010: NO

2011-2014:




3.5. Who is responsible for dealing with ED injury data? (Please provide institution,

3


unit, address, name of responsible person) 3.6. Does your organisation have access to this








3.13. How many hospitals (ED) have been involved in the last year? (Please provide a list of involved hospitals if possible,

2010: 2013:

4


addresses and names of contact persons: link or attachment)


2010: 2013:






4. National injury reporting

5


4.1. Please quote recent publications using your IDB data (0r provide a web-link)

2008-2010: 2011-2014:


ONLY ACCIDENTS IN WORKPLACE AND CAR ACCIDENTS. HELLENIC STATISTICAL AUTHORITY (EL.STAT) http://www.statistics.gr (0030) - 213 1352022, 213 1352307, 213 1352346, 213 1352310-11 Fax: 213 1352312 E-Mail [email protected] [email protected] [email protected] http://www.statistics.gr/portal/page/portal/ES

YE/PAGE-themes?p_param=A2102


MINISTRY OF HEALTH, EL.STAT http://www.yyka.gov.gr/ 210-5232-821/9, 210-5249-011


probably in the Ministry of Health) for injury statistics, in particular on and home and leisure accidents? (please provide unit,

MINISTRY OF HEALTH, http://www.yyka.gov.gr/

http://www.statistics.gr/

mailto:%20%[email protected]


mailto:%[email protected]



http://www.yyka.gov.gr/


6


addresses, name of responsible person) 210-5232-821/9, 210-5249-011 5.2. Which authority or agency (Ministry of

health, Health Council) is competent for funding injury prevention (home and leisure) and prevention research? (please provide unit, addresses, name of responsible person)

MINISTRY OF HEALTH, http://www.yyka.gov.gr/ (0030) 210-5232-821/9, 210-5249-011


MINISTRY OF ENVIRONMENT, ENERGY AND CLIMATE CHANGE Address 17 Amaliados str. 115 23 Athens Greece

Telephone: 213 15 15 000 Fax: 210 64 47 608 International calling code for Greece is +30


HELLENIC STATISTICAL AUTHORITY (EL.STAT) http://www.statistics.gr (0030) - 213 1352022, 213 1352307, 213 1352346, 213 1352310-11 Fax: 213 1352312 E-Mail [email protected] [email protected] [email protected]

5.5. Is there a national public health institute, HELLENIC STATISTICAL AUTHORITY








7


which is dealing with injury data? (If yes, please provide unit, addresses, name of responsible person)

(EL.STAT) http://www.statistics.gr (0030) - 213 1352022, 213 1352307, 213 1352346, 213 1352310-11 Fax: 213 1352312 E-Mail [email protected] [email protected] [email protected]


NO


KEPA. Ms, Petridou 0030 210 7462187 [email protected]


YES


YES http://www.yyka.gov.gr/articles/health/domes-kai-draseis-gia-thn-ygeia/ethnika-sxedia-drashs/95-ethnika-sxedia-drashs

6. Signature







http://www.yyka.gov.gr/articles/health/domes-kai-draseis-gia-thn-ygeia/ethnika-sxedia-drashs/95-ethnika-sxedia-drashs



8

6.1. Place, date Athens, 16.09.2011

6.2. Signature

6.3. Name, function VASSILIOS MAKROPOULOS VASSILIOS MAKROPOULOS

1


Country: SPAIN/ REGION NAVARRA

Question Status 2011(answers as in baseline report of 2011) Status 2014 (please report only changes)

1. Respondent 1.1. Name, title Maria Segui Gomez, MD, 1.2. Function PhD Professor 1.3. Affiliation, address European Center for Injury Prevention,

Universidad de Navarra Irunlarrea 1, Ed. Castaños S-200 Pamplona 30080, Navarra, Spain

1.4. Tel-nr., e-mail-address +34 948 425 600 ext 6575, [email protected] 1.5. Website www.unav.es/ecip 2. Focus of your institution in injury

monitoring

2.1. Please describe briefly (300 – 500 words) why and for what purpose your institution handles or reports injury data, in particular

University- based center focusing on research and teaching relating to injury prevention and control. Activities focus around the public

2


data from emergency departments on home and leisure accidents – or how you plan to do it

health model of measuring burden, identifying risk factors, designing and evaluating interventions and promoting implementation of efficient ones. The first one, measurement of burden, implies using and advancing information systems and injury descriptors.



2008-2010: No, not in ED

2011-2014:






3.7. Which coding system (for external causes) is used in the ED based monitoring? (e.g.

3


only 2-digits V01-Y98 of ICD-10, IDB-All injuries, ICECI, NOMESCO)







2010: 2013:


2010: 2013:


4








4.2. Is there a comprehensive reporting on accidents/injuries available, comprising home, leisure, road, and workplace injuries at various levels of severity (deaths,

Not officially, not periodically, but there have been several publications and book chapters on this matter. A list of publications that cover a wide range of injury mechanism is provided in

5


hospitalizations, ambulatory treatments) – or is there any intention to produce such report? (Please provide link to the website or attach the report)

the baseline questionnaire.


Nobody. We, at ECIP do it as part of our mission.



For home and leisure accidents, the most competent authority is the Ministry´s of Health “Instituto Nacional del Consumo” c/ Principe Vergara 54, 28071


Same as above


Same as above

5.4. Which unit in the national bureau of statistics is responsible for health statistics as mortality and hospital discharge statistics? (please provide unit, addresses,

As stated in previous section, this is the competency of the Ministry´s of Health Information Systems Division

6


name of responsible person) 5.5. Is there a national public health institute,


No. No government funded body deals exclusively with this issue for the whole country. Some autonomous public health departments do some activities, but they do not do this comprehensively neither.


Not really


Also within the Ministry of Health, but under a separate “Directorate” sits the division of Epidemiology and Health Promotion


The “Instituto Nacional del Consumo” is part of the Ministry of Health and they collaborate with the Information systems and the Epidemiology and Health Promotion “division”


There are some sections, for example when it comes to child safety, the Ministry´s of Health “Health Epidemiology and Promotion” division has led some initiatives such as the one related to drowning http://www.msps.es/profesionales/saludPublica/prevPromocion/Lesiones/docs/guiaSegurida

http://www.msps.es/profesionales/saludPublica/prevPromocion/Lesiones/docs/guiaSeguridadAgua.pdf


7


dAgua.pdf

6. Signature 6.1. Place, date Pamplona, June 30th, 2011

6.2. Signature

6.3. Name, function Maria Segui-Gomez


1


Country: FINLAND


1. Respondent 1.1. Name, title Kari Haikonen, mr. Antti Impinen, Dr. 1.2. Function Researcher Senior Researcher 1.3. Affiliation, address Injuries and functional capacity unit,

National Institute for Health and Welfare, Mannerheimintie 164a, Postal address: P.O. Box 30, FI-00271 Helsinki, FINLAND

Injury Prevention Unit, National Institute for Health and Welfare, Mannerheimintie 168a, Postal address: P.O. Box 30, FI-00271 Helsinki, FINLAND

1.4. Tel-nr., e-mail-address +358 20 610 8433 [email protected]

+358-29-5248615 [email protected]

1.5. Website http://pistetapaturmille.thl.fi/fi_FI/web/pistetapaturmille-fi/etusivu

http://www.thl.fi/en/web/thlfi-en


2.1. Please describe briefly (300 – 500 words) We are producing statistical information about



http://www.thl.fi/en/web/thlfi-en

2


injuries for supporting decision making, for researchers and for preventive work. There is also obvious need for having the system monitoring injuries (especially home and leisure time) which are not core interest of working with road safety or occupational health issues and are therefore not reported or researched by them.



2008-2010: Yes, there is one local project (Safe Community) going on in Kouvola region in Finland. There comprehensive data collection for local injury prevention practices includes, in addition to in-patient and out-patient treated injuries, also day care and elderly care under social welfare services. At national level THL is responsible for the development of injury monitoring.

2011-2014: Basic data on inpatient admissions and outpatient visits on secondary or tertiary care are collected regularly on national level. Information on outpatient visits to primary care remains scarce. There have been single short projects performing additional injury monitoring locally but none on the constant basis. Project in Kouvola region came to end on Oct. 2013.


There is a poster online describing the system: http://www.tapaturmahanke.fi/images/stories/englanninkielinen%20start-posteri.pdf There’s also a slideshow online: http://www.tapaturmahanke.fi/images/stories/kansainvaliset/centre%20for%20injury%20and%20violence%20prevention%2020.5.2010.pdf

National Care Registers gathers all inpatient admissions and outpatient visits on secondary and tertiary care including public and private hospitals. Currently we have no knowledge of ongoing surveillance systems. Project in Kouvola region came to end on Oct. 2013.

3.3. What is the formal status of this monitoring system? (e.g. based on law, implementation

Pilot, research, Safe Community (without a permanent funding).

National care register is based on legislation

http://www.tapaturmahanke.fi/images/stories/englanninkielinen%20start-posteri.pdf

http://www.tapaturmahanke.fi/images/stories/englanninkielinen%20start-posteri.pdf

http://www.tapaturmahanke.fi/images/stories/kansainvaliset/centre%20for%20injury%20and%20violence%20prevention%2020.5.2010.pdf



3

regulation, guideline, initiative by an authority, private initiative)


According to the website of the project it is funded by government’s National Development Programme for Social Welfare and Health Care (75%) and by the city of Kouvola (25%).

Care Register: Core functions of THL Injury reporting done in Injury Prevention Unit


Some (if not all) of the START – center personnel. Contact information here: http://www.tapaturmahanke.fi/index.php?option=com_content&view=article&id=18&Itemid=18&lang=fi Unfortunately no translations available, only in Finnish language.

Care Register: Injury Prevention Unit


No. Yes


ICD 10, Finnish version, in-addition fields for alcohol test results and for sport injuries specific type of sport classification and field for protective equipment use.

ICD 10, Finnish version


By staff as part of their regular duties - not a sample data, by intended to collect data on all injury cases.

Information coded on all patients. No separate injury data collection except related IC-10 codes on external cause and type of injury.


Includes only Kouvola region, but all hospitals there.

Care Register is nationwide. For IDB a 10% direct sample of all patients was drawn from a large data. Thus the hospitals within sample are representative.

3.10. How is the sampling of cases within hospitals been done (How was the

No sampling In register all cases within scope are covered. In IDB sample only a direct 10% sample of

http://www.tapaturmahanke.fi/index.php?option=com_content&view=article&id=18&Itemid=18&lang=fi



4

representativeness of the samples in hospitals ensured)?

patients was drawn. (No 2-stage sample)


PC, data entered directly into the electronic patient journals.


Regular training of the staff, active use of data. For research and other reports parts of the data has been verified by a physician using the narratives in the electronic patient journals.


2010: 2013: Annually around 200 hospitals within sample


2010: No data collection in 2010 due to renewal of the electronic patient journal soft ware – continuation of data collection expected to start January 2012.

2013: In register: Approximately 150,000-200,000 cases eligible for IDB sampling Sample: 10 %


Varies… for some parts real time statistics are available.

Data for the previous year are ready to use typically in autumn of each year. (2013 data available in autumn 2014)


National figures not based on this data. Directly: sampled 10% of cases / 10% of population


See FINJURY above. Key figures are published but no regulated system or platform for this exists.

3.18. Please check what has been done with Next steps nationally: to improve the quality National outpatient data is now available for

5

the opportunities you identified earlier in 2011. Please describe briefly (500-700 words) current opportunities for optimizing the system (e.g. new IT developments, re-organisation of health information, demands for more effective prevention)

and representativeness of nation-wide out-patient treated injury data. Emphasize on improving the practical characteristics, accessibility and use of already existing data at local and at national level.

secondary and tertiary care. Wider utilization of the injury data is still being less effective but hoped to improve soon as the data quality improves. Dissemination of information is slowly being transformed from using stable reports only towards more interactive systems based on open data principles (while individual information remaining classified) Later on both static and dynamic reporting will exist. Sports classification is being introduced while bringing it to national registers may take some time.


At national level: lead agency exits, major challenges in convincing and training of the personnel in the hospitals. At Kouvola region: budget for a sustainable registration system.

On national level: there will be budget cuts for the work of THL. Data collection is secured but data utilization and dissemination of results might be affected in near future Kouvola Region: Local project came to end on Oct 2013. Similar projects have difficulties on finding steady funding.




The closest thing to comprehensive reporting is, I believe, the website about injuries and injury prevention on behalf of Injuries and functional capacity unit in National Institute for Health and Welfare: http://www.thl.fi/fi_FI/web/pistetapaturmille-fi where many kinds of statistics, themes and even some (small) area reports on injuries have

http://www.thl.fi/fi_FI/web/pistetapaturmille-fi

6

been gathered. Unfortunately no English language is available at the moment.




Ministry of Social Affairs and Health/ Ms. Merja Söderholm Ministry of employment and the economy/Mr. Tomi Lounema (tomi.lounema(at)tem.fi, responsible for Consumer safety, Safety of services) Ministry of Interior/Rescue services/Mr. Hannu Olamo (hannu.olamo(at)intermin.fi)

Ministry of Social Affairs and Health/ Mr. Kari Paaso Ministry of employment and the economy/Mr. Tomi Lounema (tomi.lounema(at)tem.fi, responsible for Consumer safety, Safety of services) Ministry of Interior/Rescue services/Mr. Hannu Olamo (hannu.olamo(at)intermin.fi)


Ministry of Social Affairs and Health/ Ms. Merja Söderholm Ministry of employment and the economy/Mr. Tomi Lounema (tomi.lounema(at)tem.fi, responsible for Consumer safety Ministry of Interior/Rescue services/Mr. Hannu Olamo (hannu.olamo(at)intermin.fi) Several Foundations, Finnish Academy of Sciences, The Finnish Funding Agency for Technology and Innovation (has currently a Safety Promotion/injury Prevention Funding programme – also Funding available for applied HLA injury research)

7


TUKES – Finnish Safety and Chemical Agency, please see http://www.tukes.fi/en/


Mortality statistics are administrated by Statistics Finland (http://www.stat.fi/til/ksyyt/index_en.html) National Institute for Health and Welfare (THL) is responsible for Hospital Discharge statistics.


National Institute for Health and welfare, Injuries and functional capacity unit, Anne Lounamaa (head of unit, senior researcher)

National Institute for Health and welfare, Injury prevention unit, Pirjo Lillsunde (head of unit)


UKK institute (Sports injuries), several Universities have research and developmental work specially on the field of elderly falls, several NGOs

UKK institute (sports injuries), rescue services (fires, drownings, ambulance services), TUKES (consumer safety), NGOs (Red Cross etc.)


As above

5.8. Is there a more or less formalized collaboration of these key stakeholders? (If

Yes and No Ministry of social affairs and health is organizing the meetings for the coordination

http://www.stat.fi/til/ksyyt/index_en.html

8

yes, please characterize) group of home and leisure injury prevention 5.9. Is there a national action plan for (home

and leisure) injury prevention? (If yes, please provide a link or document)

Not a comprehensive Target Programme for the Prevention of Home and Leisure Accident Injuries 2014-2020 http://www.stm.fi/julkaisut/nayta/-/_julkaisu/1867344

6. Signature 6.1. Place, date Helsinki, 16.05.2011 Helsinki 25.7.2014

6.2. Signature

6.3. Name, function Kari Haikonen Antti Impinen, Senior Researcher

http://www.stm.fi/julkaisut/nayta/-/_julkaisu/1867344

http://www.stm.fi/julkaisut/nayta/-/_julkaisu/1867344

1


Country: HUNGARY


1. Respondent 1.1. Name, title Maria Benyi MD Péter Varsányi MD 1.2. Function Leader of department medical expert 1.3. Affiliation, address Department of Health Monitoring and

Epidemiology of Noncommunicable Diseases National Health Development Institute (OEFI) H-1092 Budapest, Gyáli út 2., Hungary

National Institute for Health Development H-1096 Nagyvárad tér 2.

1.4. Tel-nr., e-mail-address +36 1 476-6416 [email protected]

+36 1 4288 250 [email protected]

1.5. Website balesetmegeloz.atw.hu www.oefi.hu

www.oefi.hu



Our institute manage injuries as a group of non-communicable diseases. It collects and

2



processes data, coordinates the good practices and took part in EU- and WHO-supported projects (EUNESE, APOLLO, AdRisk).



2008-2010: No. But we had E-HIS (European Health Interview Survey) Questions for 4 kind of injuries (workplace, home, leisure time and school accidents), ambulatory and hospital attendance.

2011-2014: Occasional: IDB FDS was collected in one reference hospital for a one-year-period during JAMIE project. Regular: ICD-10 is used in all hospitals in Hungary. ICD-10 has unique codes for the External causes of morbidity and mortality covering the main types of injuries.


See Balesetek Hu.pdf It will be published by HCSO.

Occasional: The reference hospital’s trauma unit serves a catchment area of 577000 residents for all type of injuries except burn and child care. Every 7th case was covered between 20130301 – 20140228. The data collection was carried out by administrators who subtracted the data from hospital records. Data entry was processed via EpiData software prepared by the National Institute for Health Development according to the IDB coding manual. Regular: ICD-10 coding is mandatory in all in- and out

3


patient hospitals, who have to report the collected data to the National Health Insurance Fund Administration because of financial purposes.


Based on law. Occasional: The IDB FDS data collection was only implemented as part of the JAMIE project and it is only lasted for a one-year period. Regular: The ICD-10 coding is based on law.


EU and HCSO. EU and the Government.


National Center for Health Care Audit and Inspection Hungary (OszMK) – in the past. It is changing now.

Occasional: National Institute for Health Development Health Monitoring Unit Péter Varsányi MD H-1096 Budapest Nagyvárad tér 2. Regular: National Health Insurance Fund Administration H-1139 Budapest, Váci út 73/A


Our department coordinated it. Occasional: Our department coordinated the IDB FDS data collection. Regular: We have limited access to the ICD-10 codes collected by the National Health Insurance Fund Administration.

4



No coding system. The questions were related with the level of care.

Occasional: IDB Regular: only 2-digits V01-Y98 of ICD-10


Occasional and regular: nurses and doctors interview patients


Occasional: one reference hospital was chosen, with a catchment area big enough to provide the minimum case number Regular: every hospital collects ICD-10


Occasional: Every 7th case was covered between 20130301 – 20140228. Regular: no sampling for ICD-10


Occasional: Data entry was processed via EpiData software prepared by the National Institute for Health Development according to the IDB coding manual. Regular: Data entry is performed via special data entry software.

3.12. What kind of quality control measures are in place to ensure accuracy, reliability, coherence and comparability (what

Occasional: A manual, a training session and regular quality checks were maintained during the

5


procedures, tools are applied)? data collection. Quality control features were also included in the special data entering software. During the uploading process to IDB database a quality check was performed by the clearing house. Regular: no information


2010: - 2013: Occasional: one reference hospital Regular: all hospitals


2010: 5400 2013: Occasional: approx. 3100 Regular: approx. 1300000


- no information


See doc. attached.

no incident rates


It will be published by HCSO. There is no annual report about the findings of ED based injury data.

3.18. Please check what has been done with the opportunities you identified earlier in 2011. Please describe briefly (500-700 words) current opportunities for optimizing the system (e.g. new IT

There is a legislative procedure started which aims that all the hospitals should collect injury data on MDS level. It won’t be a new data collection system, only a rearrangement of the one that is in operation nowadays, with some

6


developments, re-organisation of health information, demands for more effective prevention)

new aspects. Injury prevention became really important for the government in the last years. Therefore an Injury Prevention Action Plan has been prepared for the next 2 years in which injury data collection got a highlighted role.


There is no change in the challenges: limited budget for injury prevention data collection, the nurses and doctors have so much administrative work in the hospitals that it is hard to implement a new data collection system.

4. National injury reporting 4.1 Please quote recent publications using your

IDB data (0r provide a web-link) 2008-2010: 2011-2014: there is no publication yet


Attached ad “injury prevention Hu.pdf”; or can be downloaded from http://balesetmegeloz.atw.hu/ (In “Letöltések”, “Injury prevention draft”)

no up-dated report


Officially nobody, but our department works on it.

Officially nobody.

5. Key stakeholders (main data users)

http://balesetmegeloz.atw.hu/

7


5.1. Which is the competent authority (most probably in the Ministry of Health) for injury statistics, in particular on and home and leisure accidents? (please provide unit, addresses, name of responsible person)

-- Hungarian Central Statistical Office Healthcare and injuries Bartháné Kuti Éva [email protected]


-- Ministry of Human Resources State Secretariat for Healthcare


Hungarian Authority for Consumer Protection www.nfh.hu Csákiné Dr. Gyuris Krisztina +36 1 459 4840

Hungarian Authority for Consumer Protection Department of Strategy and International Affairs Péter Aranyi [email protected]


Hungarian Central Statistical Office (www.ksh.hu) Bartháné Kuti Éva – Healthcare and injuries (+36-1) 345-6017 [email protected]

Hungarian Central Statistical Office Healthcare and injuries Bartháné Kuti Éva [email protected]


Yes, us (see point 1.) Yes National Institute for Health Development Péter Varsányi MD [email protected]

5.6. Is there any (other) relevant body (agency) for the prevention of home and leisure

For children: National Child Health Institution (http://www.ogyei.hu/, Gabriella Pall MD.)

National Institute for Child Health Dóra Várnai


http://www.nfh.hu/


http://www.ksh.hu/




http://www.ogyei.hu/

8


accidents (e.g. for campaigning)? (If yes, please provide unit, addresses, name of responsible person) If there are more than one, please provide information on the most important ones

For elderly: Hungarian Malthese Charity Service (http://www.maltai.hu/)

[email protected] Association of Public Health Education and Research Units Prof. Róza Ádány MD [email protected]


No information. no information


In the field of child injury prevention. No else. Yes, in the field of child injury prevention.


There were no action plan for the entire population. For elderly: there were actions, but not formalized. For children: http://www.childsafetyeurope.org/europe/info/hungary/hungary-planning-document-en.pdf

There is an Action Plan of Injury Prevention and a specific one for child injury prevention (http://www.childsafetyeurope.org/europe/info/hungary/hungary-planning-document-en.pdf)

6. Signature 6.1. Place, date Budapest, 15. 06.2011 Budapest, 21.07.2014.

6.2. Signature

6.3. Name, function Maria Benyi MD Péter Varsányi MD

http://www.maltai.hu/



1


Country: IRELAND


1. Respondent 1.1. Name, title Eve Griffin, PhD 1.2. Function Manager, National Registry of Deliberate Self-

Harm 1.3. Affiliation, address 1 Perrott Avenue, College Rd, Cork, Ireland. 4.28 Western Gateway Building, University

College Cork, Ireland 1.4. Tel-nr., e-mail-address 00353 21 4277499 00 353 21 420 5551 1.5. Website www.nsrf.ie www.nsrf.ie 2. Focus of your institution in injury

monitoring


The aim of the National Suicide Research Foundation (NSRF) is to produce an internationally recognised body of reliable knowledge from a multidisciplinary perspective. The implementation of the pilot

2


plan to do it Injury DataBase (IDB) with data collection, injury surveillance and evaluation is the beginning of steps being taken towards injury prevention. The unit has been recognised as a Centre of Excellence and the Irish focal point for information regarding suicide and its prevention by the WHO. For more then a decade the NSRF has carried out work on

(i) the incidence and determinants of

deliberate self harm in the population

(ii) the analysis of trends in suicide

mortality in Ireland, and

(iii) the extent and determinants of suicide ideation in the population.

With unit grant funding from the Health Research Board, the Foundation established the first Irish monitoring study of hospital treated cases of deliberate self harm based on a geographically defined catchment area (the Southern and Mid-Western Health Boards). In 2000, this work was extended to establish a National Registry of Deliberate Self Harm (NRDSH), the first of its kind in the world, with funding from the Department of Health and Children. Under the directorship of Professor Ivan J. Perry, University College Cork, the NRDSH is currently operating in all

3


general Irish hospital emergency departments collecting data on socio-demographic and behavioural features of cases of deliberate self harm (DSH). The NSRF’s experience in establishing an internationally acknowledged database of deliberate self harm has placed it in an excellent position to lead the task of recording injury related presentations to hospital



2008-2010: Data were collected from 3 Cork city ED’s for 010 for the EU project INTEGRIS

2011-2014: MDS data were collected from one Irish hospital ED in 2013, as part of the JAMIE project


The system is the INTEGRIS system which is a combination of the IDB AI system and data on hospital discharges.

All adult (16 years plus) emergency department presentations involving injuries within the calendar year of 2013 were included.


Pilot implementation. This is funded to date by the EU and the National Suicide Research Foundation.

Pilot implementation.


To date all funding has come from the EU and the NSRF

To date, this has been funded by the EU and the National Suicide Research Foundation

3.5. Who is responsible for dealing with ED Each individual hospital takes responsibility Each individual hospital takes responsibility

4


injury data? (Please provide institution, unit, address, name of responsible person)

for their data and are answerable to the health services executive however no annual statistics for injury data are released aside from presentation numbers.

for their data and are answerable to the Health Services Executive. Data collection is co-ordinated by the National Suicide Research Foundation


To date the NSRF has gained access to this data for 2010 data.

To date the National Suicide Research Foundation has gained access to this data for 2013 data.


IDB All Injuries IDB-All injuries (minimum dataset)


The form is initially filled in by the receptionist. Then the patient is interviewed by the triage nurse and following from this the doctor interviews the patient and the form is updated by each staff member who is in contact with the patient.

The form is initially filled in by the receptionist. Then the patient is interviewed by the triage nurse and following from this the doctor interviews the patient and the form is updated by each staff member who is in contact with the patient.


To date the hospital providing IDB data are from Cork City. To ensure the representativeness of the data it is cross-checked with data from the NSRF’s deliberate self harm registry which collects intentional self harm injury data from all emergency departments in Ireland.

In 2013, the hospital providing IDB data is based in Dublin. The hospital is the largest ED in the country, treating 4% of all ED presentations in Ireland.


A sample of 1 day in 8 was undertaken in all three hospitals.

All presentations involving injuries for the full calendar year 2013 to this hospital ED were included in the sample.

3.11. How is data entry been done? All three hospitals collect the data differently. In Tallaght ED, hospital attendance records are

5


(paper/pencil or tablet-PC with special data entry software, data linked with internal hospital system etc.)

However the predominant method of collection is that the records are created electronically and duplicated with a paper copy. In one hospital all information is recorded electronically with a paper record for back up. However in the other two hospitals data from the registration desk, triage nurse and exiting diagnosis are recorded on the electronic system. Any additional information on the injury event is kept in paper format.

created electronically and duplicated with paper copies. The IT department in the hospital produces an electronic file of all hospital attendances as part of the data collection, and from this file injury presentations are identified.


Data recorded for injury surveillance use the IDB AI data entry system and its quality checks. The data are also compared to another data source – The national registry of deliberate self harm – to ensure the accuracy of the data collection.

Data recorded for injury surveillance use the IDB AI data entry system and its quality checks. Injury-related presentations are identified by their accompanying ICD-10 code. In addition, keyword searches of the narrative field are performed to identify injury presentations which are missing an ICD-code.


2010: 3 Cork City Hospitals were involved in 2010 Cork University Hospital, Wilton, Cork, Ireland http://www.cuh.hse.ie/

2013: One Dublin Hospital provide data for the year 2013. The Adelaide and Meath Hospital, Dublin (inc. the National Children’s Hospital), Tallaght, Dublin 24. http://www.amnch.ie/

http://www.cuh.hse.ie/

http://www.amnch.ie/

6


Mercy University Hospital, Glenville Place, Cork, Ireland http://www.muh.ie/ South Infirmary Victoria University Hospital Old Blackrock Road, Cork Ireland http://www.sivuh.ie/


2010: 6000 2013: 13,132


4 months 3 months


Incidence rates are to be released in September. The anonymisation of the data means that only event rates can be calculated. Two types of rates will be calculated. 1) Crude and age specific rates per 100,000 population were calculated. These rates will be calculated by dividing the number of injury events by the appropriate population, which will be broken into six age groups. 2) European age standardised rates will be

National incidence rates for 2013 were calculated based on national figures of injury-related hospital discharges. This hospital discharge data was provided, for the most recent year, from the Hospital Inpatient Enquiry (HIPE) Department of the Irish Health Service Executive.

http://www.muh.ie/

http://www.sivuh.ie/

7


calculated. Age-standardisation allows for comparisons across areas by allowing and adjusting for variations in the age distribution of the local population.


The last report released in relation to injuries in Ireland was based on 2005 data. http://www.nsrf.ie/reports/CurrentStudies/PIReport-EU-IDB-2005.pdf

It is proposed that a national report on injury presentations to ED in Ireland (using 2013) will be prepared in Autumn 2014.


A new government has recently been elected and are currently reviewing the health systems. This new government is committed to restructuring the health service in order to make it more effective and also more cost efficient. Medical consultants across Ireland have clearly outlined their support for an injury surveillance system. Efforts also made by organisations such as the Injury Observatory for Britain and Ireland to promote the work and efforts currently undertaken by various individuals and agencies in relation to injury prevention and injury surveillance in Ireland. In doing so the observatory have highlighted the need of such a system to collect regular data in relation to injury. It is hoped that due to both this demand and

There are a number of opportunities which may ensure the sustainability and optimization of the Irish system for monitoring injuries. Data capture has been identified as one of the pillar stones in the Irish Government’s Healthy Ireland’ Framework, and specifically

injury prevention is mentioned as a component of this framework. In January 2014 a Special Interest Group was established for unintentional injury prevention in children, with representatives from the Department of Health, Department of Children and Youth Affairs and the Institute of Public Health. The Group advocates the JAMIE minimum dataset as an injury monitoring system, and supports its continuation. There may also be potential to link with existing monitoring systems (e.g. Irish

http://www.nsrf.ie/reports/CurrentStudies/PIReport-EU-IDB-2005.pdf

http://www.nsrf.ie/reports/CurrentStudies/PIReport-EU-IDB-2005.pdf

8


the obvious burden of injuries on the health system that the government will take the implementation of an injury surveillance system into serious consideration.

National Registry of Deliberate Self-Harm; TARN – The Trauma Audit & Research Network).


To date there has been a lack of interest from stakeholders in relation to injury surveillance. On page 64 of the last health strategy which was published by the Department of Health and Children in 2001 it outlined that a national injury prevention strategy would be prepared. It called for a co-ordinated approach across many sectors however to date this has not occurred. The Department of Health and Children have been supportive of the work undertaken for the IDB but have not provided funding due to severe budget cuts across the whole of the health service. http://www.dohc.ie/publications/pdf/strategy.pdf?direct=1

While the Irish government recognises the value of this data, there is no legal basis for this monitoring and no government mandate. In addition there is no national strategy for injury prevention in Ireland. Another challenge is the current status of recording data in Irish EDs. Not all EDs capture data electronically, and so extracting relevant information can be expensive and time-consuming. Without sufficient funding on an on-going basis, it will be a challenge to expand the current dataset to FDS or to include additional hospitals.




A comprehensive report for 2010 is due out in September. In relation to deaths and discharges the information is available to date for 2009.

The 2012 report for national hospital discharge data is available for the year 2012: http://www.hpo.ie/latest_hipe_nprs_reports/H

http://www.dohc.ie/publications/pdf/strategy.pdf?direct=1

http://www.dohc.ie/publications/pdf/strategy.pdf?direct=1

http://www.hpo.ie/latest_hipe_nprs_reports/HIPE_2012/HIPE_Report_2012.pdf

9



http://www.esri.ie/health_information/latest_hipe_nprs_reports/2009_hipe_report/index.xml

IPE_2012/HIPE_Report_2012.pdf


Department of Health and Children Hawkins House, Hawkins Street, Dublin 2, Ireland Health Services Executive Dr. Steevens' Hospital, Dublin 8, Ireland Healthcare Pricing Office ESRI Building Whitaker Square Sir John Rogerson’s Quay Dublin 2 Ireland

Department of Health Hawkins House, Hawkins Street, Dublin 2, Ireland Health Services Executive Dr. Steevens' Hospital, Dublin 8, Ireland Healthcare Pricing Office ESRI Building Whitaker Square Sir John Rogerson’s Quay Dublin 2 Ireland



Department of Health and Children Hawkins House, Hawkins Street, Dublin 2, Ireland

Department of Health Hawkins House, Hawkins Street, Dublin 2, Ireland



http://www.hpo.ie/latest_hipe_nprs_reports/HIPE_2012/HIPE_Report_2012.pdf

10



Department of Health and Children Hawkins House, Hawkins Street, Dublin 2, Ireland

Department of Health Hawkins House, Hawkins Street, Dublin 2, Ireland


Department of Jobs, Enterprise and Innovation, 23 Kildare Street, Dublin 2. http://www.djei.ie/contact/index.htm

Department of Jobs, Enterprise and Innovation, 23 Kildare Street, Dublin 2. http://www.djei.ie/contact/index.htm


Healthcare Pricing Office ESRI Building Whitaker Square Sir John Rogerson’s Quay Dublin 2 Ireland www.hpo.ie Health Research and Information Division Head of Division Professor Miriam Wiley [email protected] Manager HIPE & NPRS Unit Deirdre Murphy

1) Mortality data Vital Statistics, Central Statistics Office Skehard Road, Cork, Ireland. LoCall: 1890 313414 Phone: +353-21-4535000 or 353-1-4977144 Email: [email protected] www.cso.ie

2) Discharge data Healthcare Pricing Office

http://www.djei.ie/contact/index.htm

http://www.djei.ie/contact/index.htm

http://www.hpo.ie/


http://www.cso.ie/

11


[email protected] ESRI Building Whitaker Square Sir John Rogerson’s Quay Dublin 2 Ireland www.hpo.ie Health Research and Information Division, ESRI Head of Division Professor Miriam Wiley [email protected] Manager HIPE & NPRS Unit Deirdre Murphy [email protected]


Institute of Public Health which has close links with the injury observatory for Britain and Ireland. http://www.publichealth.ie/

Institute of Public Health which has close links with the Injury Observatory for Britain and Ireland. http://www.publichealth.ie/

5.6. Is there any (other) relevant body (agency) for the prevention of home and leisure accidents (e.g. for campaigning)? (If yes, please provide unit, addresses, name of responsible person) If there are more than one, please provide information on the

No

http://www.hpo.ie/


http://www.publichealth.ie/

http://www.publichealth.ie/

12


most important ones 5.7. Is there any (other) relevant institute with

research interest in home and leisure injury prevention? (If yes, please provide unit, addresses, name of responsible person)

Injury Observatory for Britain and Ireland http://www.injuryobservatory.net/

Injury Observatory for Britain and Ireland http://www.injuryobservatory.net/


Yes. In January 2014 a Special Interest Group was established with a focus on unintentional injury prevention among children in Ireland. This group involves stakeholder from governmental agencies (Department of Children and Youth Affairs), The Institute of Public Health, The National Paediatric Mortality Register, The National Suicide Research Foundation, and Irish Water Safety.


There is no national strategy for injury prevention in Ireland. However injury prevention is mentioned as a component in the government’s Healthy Ireland’ framework. http://www.dohc.ie/publications/Healthy_Ireland_Framework.html

6. Signature 6.1. Place, date Cork, 16.08.2011 Cork, 21.07.2014

http://www.injuryobservatory.net/


http://www.dohc.ie/publications/Healthy_Ireland_Framework.html

http://www.dohc.ie/publications/Healthy_Ireland_Framework.html

13

6.2. Signature

6.3. Name, function Eve Griffin Eve Griffin, Manager National Registry of

Deliberate Self-Harm

1

National Implementation Report July 2014

Country: ICELAND


1. Respondent 1.1. Name, title Svanhildur Thorsteinsdottir, Ms. Gudrun Kr. Gudfinnsdottir, Ms 1.2. Function Project Manager, Division of health statistics Project Manager,

Division of Health Information 1.3. Affiliation, address The Directorate of Health, Austurströnd 5, 170

Seltjarnarnes, Iceland The Directorate of Health, Barónsstígur 47, 101 Reykjavík, Iceland

1.4. Tel-nr., e-mail-address +354 5101900 1.5. Website www.landlaeknir.is 2. Focus of your institution in injury

monitoring

2.1. Please describe briefly (300 – 500 words) why and for what purpose your institution handles or reports injury data, in particular data from emergency departments on

The Directorate of Health is required by law to

collect data and produce statistics on health and

health care services in Iceland.

Reference to law 41/2007:

http://eng.velferdarraduneyti.is/media/acrobat-

enskar_sidur/Act_on_the_Medical_Director_of

http://www.landlaeknir.is/

2


home and leisure accidents – or how you plan to do it

In accordance with this law the Directorate of

Health maintains the Icelandic Accident

Register which is a database on all accidents in

Iceland. It covers not only information from

emergency departments but also information

from insurance companies, the police, health

care centres and the Administration of

Occupational Safety and Health. The

information is not detailed and the purpose of it

is only to provide an overview of accident

statistics.

The Directorate of Health is also, by the

aforementioned law, required to maintain the

Hospital Discharge Register. Detailed data on

discharges from all hospitals in the country is

collected into this database, among other ICD-

10 data. The 2 major emergency departments in

the country do, however, not record data on the

external cause of injury according to the 20th

chapter of ICD-10. They register information

on accidents in a more detailed way according

to the NOMESCO Classification of External

Causes of Injuries. This information has as of

yet not been collected by the Directorate of

Health as part of its regular data collection from

health care institutions.

The Directorate plans to approach one or both

hospitals on the matter of delivering this data to

the IDB. Seeing that Nomesco can be

transcoded into IDB this should not be difficult.

_Health_and_Public_Health_as_amended.pdf

Data from the emergency department of

Landspitali - The National University Hospital

of Iceland was collected specifically for the

JAMIE joint action. This particular hospital

covers approximately 70% of all inpatient

discharges in Iceland.

Before submission to the IDB the data was

converted to the standard IDB data format

(IDB-MDS) by the Directorate of Health. Data

was submitted for years 2010-2013.

3


The plan is to obtain the NOMESCO data and

transcode it. Whether the transcoding will take

place at the Directorate is not yet certain.



2008-2010: Data on accidents (not all injuries) from almost all hospitals in the country is sent to The Icelandic Accident Register, a central database on accidents in Iceland - maintained by the Directorate of Health. http://landlaeknir.is/Heilbrigdistolfraedi/Slysaskra But this however is not a specific injury surveillance system. Most of the questions below do not apply. However I describe the system in 6.2 and answer some of the questions that apply.

2011-2014: No change. New link with description of the Icelandic Accident Register (only in Icelandic): http://www.landlaeknir.is/tolfraedi-og-rannsoknir/gagnasofn/gagnasafn/item12461/Slysaskra-Islands


The Icelandic Accident Register (IAR) is kept and maintained by the Directorate of Health in Iceland. It contains information on accidents (not all injuries – not violence and self-harm, i.e. only unintentional injuries). The register is not yet complete, i.e. not all accidents are registered into the database. You can see statistics for 2002-2009 (2010 will be published this month) on our website: http://landlaeknir.is/Heilbrigdistolfraedi/Slysaskra. At the bottom of each page you can see which parties registered each year. Because the

New link to IAR tables covering years 2002-2012 (only in Icelandic): http://www.landlaeknir.is/tolfraedi-og-

http://landlaeknir.is/Heilbrigdistolfraedi/Slysaskra




4


number of those registering has been increasing care needs to be taken when comparing data between years. Those that register accidents are both within and outside the health care sector: Hospital emergency departments (almost all), health care centers (almost all), one of four insurance companies, The Administration of Occupational Safety and Health, The National Commissioner of the Icelandic Police. The Accident Register is a central database on accidents and those injured (also on motor vehicle accidents where no one was injured – data from one insurance company). The data only contains information on a minimal set of variables. On the accident: -date -time -type of accident (traffic accident, occupational accident, domestic and leisure accident, aircraft accident, marine accident, sports accident, other accidents) -municipality -street and house number (not required) -the scene of the accident (26 categories, e.g. sidewalk, school area, sea)

rannsoknir/tolfraedi/heilsa-og-lidan/slys/

5


-GPS coordinates (only from the national commissioner of the Icelandic police) On the injured -personal number (coded) -sex -severity of injury (not required and therefore the coverage is not good) -severity of vehicle damage The abovementioned parties can register data through a website but more commonly they register data in a more detailed way in their own registers (e.g. hospital register at the University hospital) and then only the above variables are projected into the Accident Register. When the accidents are registered in the Accident Register a unique number is attached to it and the same number is attached to the accident in the various registers of those registering. This allows for the extraction of further information on the accident, if needed later on.


In the beginning a joint agreement between both public and private parties. With an amendment to the law on the director of health in 2007 all health care workers were required to register accidents into the IAR. This led to an expansion of the IAR with more health care

Legal base ensured via the Medical Director of Health and Public Health Act no. 41/2007, (in English, see http://eng.velferdarraduneyti.is/media/acrobat-enskar_sidur/Act_on_the_Medical_Director_of_Health_and_Public_Health_as_amended.pdf)

6


centres sending information. as well as Regulation 548/2008 (only available in Icelandic). MDS extracted from available hospital data.


Run by the state (publically funded).


The Directorate of Health. Division of Health Statistics, Svanhildur Thorsteinsdottir project manager. Sigridur Haraldsdottir, head of division.

The Directorate of Health, Division of Health Information. Barónsstígur 47, 101 Reykjavík, Iceland. Head of Division Health Information: Ms Sigridur Haraldsdottir.


N/A The Directorate of Health is responsible for data in the IAR and therefore has access.


For IAR: See description of the IAR in 3.2, including variables recorded


Nurses and doctors collect data from patients. Medical secretaries responsible for submitting to the IAR.


For the IAR: The aim is obtain data from all health care institutions in the country. Participation has been gradually increasing since the inception of the IAR.

3.10. How is the sampling of cases within hospitals been done (How was the representativeness of the samples in

For IAR: All cases.

7


hospitals ensured)? 3.11. How is data entry been done?


Electronic linkage of local systems with the IAR.


Quality control at the Directorate of Health.


2010: See attached list of hospitals.

2013: See attached list of hospitals.


In 2010: about 34000 injured. 2012: Around 33000 injured.


4-6 months after end of year


Number of injured pr. 1000 inhabitants, by sex and 5 year age groups. Total number of injured pr 1000 inhabitants, as well as broken down by the following categories: traffic accidents, occupational accidents, domestic and leisure accidents, sports accidents and school accidents.

Number of injured pr. 1000 inhabitants, by sex and 5 year age groups. Total number of injured pr 1000 inhabitants, as well as broken down by the following categories: traffic accidents, occupational accidents, domestic and leisure accidents, sports accidents and school accidents.

3.17. Is there a national (annual) report about figures and findings of the ED based system? (Please provide link or file of last


Tables in Icelandic and English published annually on the Directorate of Health´s website, see



8


report) http://www.landlaeknir.is/tolfraedi-og-rannsoknir/tolfraedi/heilsa-og-lidan/slys/

3.18. Please check what has been done with the challenges you identified earlier in 2011. Please describe briefly (500-700 words) current opportunities for optimizing the system (e.g. new IT developments, re-organisation of health information, demands for more effective prevention)

The IAR needs to be updated in accordance with new IT developments. Also, to reorganize the way information is sent to the IAR. Instead leaving it up to each party to decide whether the accident and persons injured in question have been registered previously by another party, each party should send information on all injured (not accidents, i.e. the event) and then duplicates are systematically reviewed centrally at the Directorate of Health. This would improve the accuracy of the register and require less manpower on behalf of those parties that register. It would however require more manpower at the Directorate. Connections via unique identification numbers need to be reviewed so as to make it easier to gather more detailed information on those injured, e.g. ICD-10 codes and severity of injury.


Severe budget cuts halt further development of the IAR at the moment.

Uncertainty as regards further development of the IAR in near future due to financial constraints.

4. National injury reporting

9



2008-2010: 2011-2014:


The Directorate of Health: http://landlaeknir.is/Heilbrigdistolfraedi/Slysaskra The Road Traffic Directorate http://www.us.is/id/1001623 The Administration for Occupational Safety http://slysatolfraedi.ver.is/t%C3%B6lfr%C3%A6%C3%B0i.aspx

New link for The Directorate of Health: http://www.landlaeknir.is/tolfraedi-og-rannsoknir/tolfraedi/heilsa-og-lidan/slys/ The Road Traffic Directorate has been incorporated into the Icelandic Transport Authority. New link: http://www.icetra.is/ New name: The Administration for Occupational Safety and Health


The Directorate of Health, The Road Traffic Directorate, The Administration for Occupational Safety.

The Directorate of Health, Barónsstígur 47, 101 Reykjavík. http://www.landlaeknir.is/english/. The Icelandic Transport Authority, P.O. Box 470, 202 Kópavogur. http://www.icetra.is/. The Administration of Occupational Safety and Health, Bíldshöfdi 16, 110 Reykjavík http://www.vinnueftirlit.is/english

5. Key stakeholders (main data users) 5.1. Which is the competent authority (most The Directorate of Health, Svanhildur The Directorate of Health,



http://www.us.is/id/1001623

http://slysatolfraedi.ver.is/t%C3%B6lfr%C3%A6%C3%B0i.aspx

http://slysatolfraedi.ver.is/t%C3%B6lfr%C3%A6%C3%B0i.aspx

http://www.landlaeknir.is/tolfraedi-og-rannsoknir/tolfraedi/heilsa-og-lidan/slys/

http://www.landlaeknir.is/tolfraedi-og-rannsoknir/tolfraedi/heilsa-og-lidan/slys/

http://www.icetra.is/

http://www.icetra.is/

10



Thorsteinsdottir Project Manager Division of Health Statistics, Sigridur Haraldsdottir Head of Division of Health Statistics. [email protected]

Division of Health Information, Barónsstígur 47, 101 Reykjavík, Iceland. Head of Division Health Information: Ms Sigrídur Haraldsdóttir, [email protected]


Ministry of Welfare Hafnarhusinu við Tryggvagötu 150 Reykjavik Gunnar Alexander Ólafsson [email protected] Hafnarhúsinu við Tryggvagötu | 150 Reykjavík

Ministry of Welfare Department of Quality and Prevention, Hafnarhúsinu við Tryggvagötu, 150 Reykjavík, Iceland. Director General, Department of Quality and Prevention: Ms. Margret Björnsdóttir, [email protected].


The Consumer Agency, Safety Division Borgartún 21 105 Reykjavik

[email protected]

Website: http://www.neytendastofa.is/english/the-consumer-agency/


These statistics are at The Directorate of Health.

Responsibility for health statistics, including mortality and hospital discharges: The Directorate of Health, Division of Health Information, Barónsstígur 47, 101 Reykjavík, Iceland. Head of Division Health Information: Ms Sigrídur Haraldsdóttir,




11


[email protected] 5.5. Is there a national public health institute,


The Directorate of Health. The Public Health Institute was recently merged with The Directorate of Health. Svanhildur Thorsteinsdottir project manager Sigríður Haraldsdóttir Head of Division

The Directorate of Health, Division of Health Information, Barónsstígur 47, 101 Reykjavík, Iceland. Head of Division Health Information: Ms Sigrídur Haraldsdóttir, [email protected]


ICE SAR: http://www.icesar.com/category.aspx?catID=280 Forvarnahusid (no official translation found but House of Prevention is the direct one). Herdis L. Storgaard heads this agency (herdis[hjá]forvarnahusid.is) Kringlunni 1-3 103 Reykjavík

The Icelandic Association for Search and Rescue, ICE-SAR, Skógarhlíd 14, 105 Reykjavík. http://www.icesar.com/ Forvarnahúsid, Kringlunni 1-3, 103 Reykjavík http://forvarnahusid.is/ (in Icelandic only)


Same as in 9.6.


The Accident Prevention Council has been active up until recently. It was situated within the Public Health Institute which recently was merged with the Directorate of Health. The future of the council is not clear at the moment. But it had representatives from the ICE-SAR, The Administration for Occupational Safety and Health, The Directorate of Health, The

The Accident Prevention Council, formerly located at the Public Health Institute, was abolished with the merger of the Institute with the Directorate of Health and has not been re-established.

http://www.icesar.com/category.aspx?catID=280

http://www.icesar.com/category.aspx?catID=280


http://www.icesar.com/

12


Public Health Institute, Landspitali Hospital, Insurance Companies, the Ministry of Interior.


The National Health Plan till 2010. http://www.velferdarraduneyti.is/media/Skyrslur/htr2010.pdf This is currently being revised.

6. Signature 6.1. Place, date Seltjarnarnes, 23rd of June 2011 Reykjavík, Iceland, July 25th 2014

6.2. Signature

6.3. Name, function Svanhildur Thorsteinsdottir Gudrun Kr. Gudfinnsdottir

http://www.velferdarraduneyti.is/media/Skyrslur/htr2010.pdf

http://www.velferdarraduneyti.is/media/Skyrslur/htr2010.pdf

13

Health care facilities submitting data to the Icelandic Accident Register 2010 and 2013:

Landspítali University Hospital emergency department,

Akureyri Hospital

The Health Center of Western Iceland,

Health Center of Eastern Iceland,

The Health Center of Southern Iceland,

The Health Center of Thingeyjarsýslur, Húsavík

The Health Center of Sudurnes,

Patreksfjördur Health Center,

Blönduós Health Center,

Sauðárkrókur Health Center,

Siglufjördur Health Center,

Dalvík Health Center,

Vestmannaeyjar Health Center,

Primary health care center Lágmúli, Reykjavík

Primary health care center Salahverfi, Reykjavík (added in 2012),

Map of Health Regions and location of health care facilities in Iceland:

http://www.landlaeknir.is/utgefid-efni/skjal/item2223/Heilsugaeslustodvar-og-heilbrigdisumdaemi-a-Islandi

(use link on right hand side of page)

http://www.landlaeknir.is/utgefid-efni/skjal/item2223/Heilsugaeslustodvar-og-heilbrigdisumdaemi-a-Islandi

1


Country: ITALY


1. Respondent 1.1. Name, title Giuseppe Balducci, Dr.

Responsible of the Italian National of Institute of Health operative unit in the SINIACA-IDB project for the surveillance of injuries

Alessio Pitidis, Dr. National responsible of the SINIACA-IDB project for the surveillance of injuries

1.2. Function Researcher http://www.iss.it/site/attivita/ISSWEB_istituto/RicercaPersonale/dettaglio.asp? idAna=1714&lang=1

Director of the Environment and Trauma Unit Italian National Institute of Health

1.3. Affiliation, address Italian National Institute of Health – Environment and Trauma Unit, viale Regina Elena, 299 – P.O. box 00161, Rome Italy http://www.iss.it/site/attivita/ISSWEB_istituto/UO/index.asp?

Italian National Institute of Health Environment and Trauma Unit Department of Environment and Primary Prevention viale Regina Elena, 299 – P.O. box 00161, Rome Italy

http://www.iss.it/site/attivita/ISSWEB_istituto/RicercaPersonale/dettaglio.asp?idAna=1714&lang=1



http://www.iss.it/site/attivita/ISSWEB_istituto/UO/index.asp?idUO=1050&lang=1


2

idUO=1050&lang=1 1.4. Tel-nr., e-mail-address 0649902969 0649902493 1.5. Website www.iss.it www.iss.it 2. Focus of your institution in injury

monitoring


In Italy, Law 493/99 (Art. 4) has determined that a National Surveillance System on Home Accidents called SINIACA (Sistema Informativo Nazionale sugli Incidenti in Ambienti di Civile Abitazione - National Surveillance System on Home Accidents) was instituted in the National Institute of Health (ISS), in accordance with the regions. Although in its first part the Law outlines a system seemingly passive (i.e a mere collector of information provided by the regions), in the next paragraph it also suggests an active role, emphasizing the primary objectives (knowledge, prevention, evaluation). In developing the SINIACA the ISS always kept in mind the knowledge acquired from its Trauma Prevention and Control Unit in the injury prevention area since the early '80s and consolidated in the 90s. Therefore the general approach given in accordance with the regions, the information system and the same methodology of data collection (using computerized forms) comes from the experience we've acquired in the course of the first Italian study on accidents (Italian Study

In Italy, Law 493/99 (Art. 4) has determined a National Surveillance System on domestic accidents called SINIACA (Sistema Informativo Nazionale sugli Incidenti in Ambienti di Civile Abitazione - National Surveillance System on Accidents at Home) within the National Institute of Health (ISS), in collaboration with the Regional epidemiological observatories and the local health units. In 2004 was instituted within the ISS the unit "Environment and Trauma" so to formalize the activity of the internal working group dedicated to injuries prevention and control, since the early '80s. The methodology of surveillance was based on the experience acquired in the first Italian Study on Accidents (SISI) made by the Italian National Institute of Health in collaboration with the regions of Liguria, Marche and Molise in the early '90s. Currently the SINIACA surveillance, in addition to current HDR and mortality data, is based on a national sample of hospital emergency departments (ED). This


http://www.iss.it/

3

on Accidents - SISI) funded by the Ministry of Health and conducted in collaboration with the regions of Liguria, Marche and Molise, and that, in the early '90s, provided numerous epidemiological indications and useful insights on the problem and on prevention. Actually, the National Surveillance System on Home Accidents (SINIACA) has as main purpose to monitor accidents at home, for the formulation of prevention programs. The system was born from the need to obtain full information about the accident, the injuries caused by it and related care needs. The system is structured on 3 levels of severity of the injuries observed:

1) events detected in the ER; 2) events related to hospitalization; 3) deaths.

The data collected allow to characterize the domestic incident based on numerous variables and environmental health:

1) - Location of the incident (bathroom, kitchen, etc..);

2) The accident (fall, shock, poisoning, etc..);

3) Activity of the subject at the time of the accident (activities of daily living, housework, do-it-yourself, etc..);

4) Type of injury (poisoning, fractures, contusions, burns, etc..);

surveillance is pursuant to the WHO guidelines on injury surveillance. The main variables for the collected data are: 1) place of occurrence; 2) mechanism of injury; 3) activity of the injured person at moment of injury; 4) open description in natural language of the circumstances of the accident; 5) sex, age, citizenship and town (or foreign country) of permanent residence of the injured person; 6) main diagnosis; 7) treatment and follow-up. These data are sent periodically to the central system at ISS from various territorial units: independent and scientific hospitals, children's hospitals, regional hospitals or in direct management of the local units of the National Health Service (NHS), regional epidemiological observatories. With regard to road traffic accidents the ISS group on injury control and prevention, within a project for the Ministry of Transports and Infrastructures, has developed a minimum data set for recording road traffic injuries at hospital ED. With regard to road traffic accidents, the ISS group on injury control and prevention, within a project for the Ministry of Transports and Infrastructures, has developed a minimum data set for recording road traffic injuries at ED. This coding also, was in accord to the WHO guidelines on the surveillance of injuries.

4

5) Event severity (triage). These data are sent periodically to the system from various local territorial units (independent and scientific hospitals, hospitals in direct management of the local NHS unit, regional epidemiological observatories) and central institutions (National Institute of Statistics ISTAT, Ministry of Health). With regard to road traffic accidents, as early as 2000 to 2005 our group has conducted two projects (Datis 1 and 2) (Road Accident Data) funded by the Ministry of Transports and Infrastructures (MIT) under the Framework MIT / ISS. One of the objectives (LINE C: Monitoring the Emergency Departments) was to make reliable estimates of ED attendances for road traffic accidents and was also developing a minimum data set on the external cause of injuries usable in hospital ED’s in order to obtain information on all road accidents, not only on the ones verbalized by police forces. DATIS minimum data set on road traffic accidents is actually used in the pilot centers of ED in 4 Regions: Liguria, Umbria, Molise and Sardegna. In 2005, we have also participated in the EHLASS project for Italy with a network of 9 hospitals located in 7 different local NHS units well distributed throughout the country.

In 2005 the ISS also participated in the EHLASS project for Italy with a network of 9 hospitals located in 7 different local units of the NHS distributed throughout the country. The HLA v.2000 coding manual was adopted for the registration of home and leisure injuries. In 2010 within the EU-project INTEGRIS we have experimented the implementation of the violence modules (aggression and self-injury) of the IDB coding manual (All injuries: IDB-AI) and its integration with HDR data in 3 Italian hospitals sited respectively in Northern, Central and Southern Italy.

3. Systematic ED based injury surveillance

5

3.1. Has specific injury surveillance been pursued in EDs in past three years – e.g. with focus on home and leisure accidents, external causes of injuries, or product related injuries? (e.g. IDB, EHLASS, EPAC, LIS, AWISS)

2008-2010: In 2008-2009 we have conducted a National Surveillance on Home accidents compatible with IDB-Full Data Set (IDB-FDS), products excluded, in a sample of 20 Italian hospitals. In a sub-sample of 7 hospitals road traffic accidents also have been recorded with a national code compatible with IDB-FDS. Moreover, in 2010 within the EU-project INTEGRIS we have experimented the implementation of the IDB-All injuries (IDB-AI) FDS and its integration with HDR data in 3 Italian hospitals sited respectively in Northern, Central and Southern Italy.

2011-2014: In 2011 Italy adhered to JAMIE (Joint Action on Monitoring Injuries in Europe) and the ISS had a grant from the Ministry of Health for integrating the local surveillance of injuries into SINIACA and the coordination of the SINIACA and IDB surveillance in Italy according to the European recommendation of year 2007 on the prevention of injuries. The surveillance system in Italy has been named SINIACA-IDB. The Italian codes for the registration of injury are converted into IDB MDS or FDS ones. The IDB MDS coding is used for the "all-injuries" surveillance and the IDB FDS coding is used for the surveillance of: accidents at home and in road traffic, violent events, product related injuries. The surveillance of all injuries in all hospitals of entire regions in IDB MDS compatible format has been pursued in years 2011-2012 and is continuing. The surveillance of injuries in formats compatible with IDB FDS in the years from 2011 to 2013 was also possible and is continuing in a network of hospitals: the surveillance of home accidents has been conducted in up to 32 hospitals, the one for road traffic accidents was realized in up to 13 hospitals, the IDB FDS surveillance of

6

aggressions and self-injuries was implemented in up to 5 hospitals. Within this network, in the same period, the surveillance of product related injuries was implemented in up to 12 hospitals


We have selected a set of codes representative of the highest frequencies of injury types observed at ED which are compatible with the IDB-FDS. These data can be linked to the HDR, at national level, for inpatients, based on the patient’s admission code. The sample of 20 hospitals that we have included in the National Surveillance System of injury, it is a natural sample but well-distributed on the national territory (North, Centre and South) in urban, middle urban, rural, coastal and mountain areas. The catchment population of this network of hospitals (n = 20), represents more of 3% of the General Italian population (considering the IDB-FDS). Also, the age and sex distribution of the hospital catchment population in the sample is strictly concordant with the analogue distribution of the national population in Italy. There is, also, a subset of hospitals (actually 7 of 20 hospitals, but in the nearest future the number will be implemented) in which road traffic accidents, also, will be recorded. These 7 hospitals are sited in Northern, Central and Southern regions of Italy at urban, middle urban, rural

In Italy is mandatory since year 2012 for all the hospitals of the NHS an ED register compliant with a national minimum data set. Furthermore all regions must adopt a register for the interventions of health emergency rescue services (118 service, e.g. ambulances or helicopters) compliant to a national standard. They are called the EMUR registers (EMergency URgency). The coding manuals and data format of EMUR registers were analysed and it was possible to develop conversion procedures from national coding to the IDB MDS codes for those patients who arrived at ED by mean of the 118 service. With regard to diagnoses the ICD-9-CM coding is adopted in the Italian hospitals. They were developed conversion procedures into IDB MDS codes for nature of injury and body part, through the Barrel's matrix. Some regions started the EMUR registers several years before they were mandatory. Among them we choose Piedmont and Tuscany that were able to produce data from the year 2011 and Abruzzo was included since 2012.

7

and coastal level. Finally, in 3 hospitals (Galliera General Hospital in Genoa, Gaslini Paediatric Hospital in Genoa, Spoleto General Hospital in Umbria region) is been experimented the surveillance of violence events (assault and self-harm injuries), with the IDB-FDS coding system.

In these regions all the hospitals served by the 118 rescue service were included in the MDS surveillance. They are the largest hospitals representing almost all of the inpatients for injuries of these regions. The injury patients who arrived through the 118 service are around 13% of all injury patients observed in ED. Around 100 hospitals per year have participated in the MDS surveillance and all type of accidents or violent events have been included ("all-injury" coding). More then 140,000 ED attendances per year are recorded in the Italian IDB MDS surveillance. For the FDS surveillance a network of hospitals has been established through the integration at national level of the surveillances active at local level or by launching the national FDS surveillance in 9 Italian Regions (Piedmont, Aosta Valley, Trent province, Liguria, Emilia-Romagna, Umbria, Marche, Molise, Sardinia). They were included the home injuries and road traffic ones and the violent events for aggression or self-injury. Also the product-related injuries are recorded in a sub sample of hospitals. For home injuries and road traffic ones conversion procedures have been developed from national coding to the IDB FDS codes. The IDB modules for aggression and self-

8

injuries have been applied directly. For the registration of products has been selected a short list of codes representative of the products most frequently reported in ED. This short list has been used at the hospital. Then at central level in the ISS, during the data quality control, dedicated coders have completed the coding of products for the less frequent cases by reading the open description of accident. To

this purpose also software procedures have been developed for the recognition of products from the automatic reading of the textual description of accident in natural language. With regard to data in IDB-FDS format 32 hospitals distributed in the aforesaid 9 regions produce around 42,000 records/year of home injuries, 13 hospitals in 4 regions (Piedmont, Liguria, Umbria, Sardinia) record around 16,000 cases/year of ED attendances caused by road traffic injuries and 5 hospitals in 3 regions (Piedmont, Liguria, Emilia-Romagna) record around 1,600 cases/year of violence (aggression or self-injury). Within these FDS hospitals a subsample of 12 of them records also the object or the substance involved in injury (around 22,000 records/year).


In part, based on Law 493/99 (SINIACA -National Surveillance System on Home accidents ), in part for Initiative by an Authority (Ministry of Infrastructures and Transport - under the Framework Agreement

The surveillance of home injuries is based on the Law 493/99 (SINIACA - National Surveillance System on Home accidents). The initiative of the Ministry of Health granted a project to the Italian National Institute of

9

with the National Institute of Health – DATIS project). The surveillance of violence (assault and self arm) on the basis of EU-project INTEGRIS.

Health in order to extend the surveillance toward other type of accidents and violence (aggression or self-injury). Currently is under examination the proposal of a governmental decree for formalizing the SINIACA-IDB surveillance in Italy.


Actually there is no funding, but the Ministry of Health has approved the funding, for the years 2012-2013, of a project for the consolidation and the extension of the National Surveillance System on Home accidents (SINIACA) and its integration in the European IDB

Until year 2014 a project funding has been granted from the Ministry of Health for the consolidation of SINIACA and its integration in the European IDB. The National Prevention Plan (period 2014-2020) indicates that Regions in preventing accidents at their will may use the resources dedicated to prevention (5% of the National Health Fund) for maintaining or implementing the SINIACA-IDB surveillance.


Italian National Institute of Health SINIACA V.le Regina Elena 299 – 00161 Rome Dr. AlessioPitidis www.iss.it/casa


Y Y


National simplified Injury Coding System compatible with IDB (JAMIE-FDS)

The EMUR national standard for ED simplified coding system, compatible with IDB (JAMIE-MDS). National analytic coding system of home injuries and road traffic ones, compatible with IDB (JAMIE-FDS).

http://www.iss.it/casa

10

Directly IDB (JAMIE-FDS) for violence (aggression or self-injury).


ED operators (frequently nurses), during the TRIAGE.


The sample of 20 hospitals that we have included in the National Surveillance System of injury, it is a natural sample but well-distributed on the national territory (North, Centre and South) at urban, middle urban, rural, coastal and mountain level. The catchment population of this network of hospitals (n = 20), represents more of 3% of the General Italian population . Also, the age and sex distribution it is strictly concordant with the analogue distribution of the national population in Italy. There is, also, a subset of hospitals (actually 7 of 20 hospitals, but in the nearest future the number will be implemented) in which road traffic accidents, also, are recorded. These 7 hospitals are sited in Northern, Central and Southern regions of Italy at urban, middle urban, rural and coastal level. Finally, in 3 hospitals (Galliera General Hospital in Genoa, Gaslini Paediatric Hospital in Genoa, Spoleto General Hospital in Umbria region) is been experimented the surveillance of violent events (assault and self-inflicted injuries), with the IDB-FDS coding system.

For the IDB MDS surveillance they were selected three regions sited respectively in north (Piedmont), in centre (Tuscany) and in south (Abruzzo) Italy. These three regions represent 16% of the Italian population and have respectively at high, middle and low population density. There is a high concordance between the age-sex distribution of their population and national one (Kendall's tau >=0.88; p<0.0000) All the hospitals of these regions, that had patients transported by the 118 rescue service, participated in the MDS surveillance. They are the largest hospitals accounting for 89.1% of the whole inpatients for injuries in the 3 regions. The patients who arrived in ED by mean of the 118 service were included in the MDS surveillance. On average they are around 13% of all the ED attendances caused by injury and have an inpatient rate of around 20% compared to the 7% rate for all the injury patients observed in ED. As for FDS sampling, considering only hospitals that provided also the coding of

11

product-related injuries, there was a convenience sample of around 10 hospitals per year. For instance in 2013 they are 9 hospitals in 6 Italian Regions (Piedmont, Aosta Valley, Liguria, Umbria, Marche, Sardinia). So that 3 hospitals are in northern Italy, 2 in the centre and 1 in the south. A paediatric hospital also was included. The hospitals are distributed in: urban area (3), medium urban area (2) and rural area (4); coastal area (4), internal hill or flat area (4), mountain area (1) There is high concordance between the age-sex distribution of the catchment population of hospitals and the correspondent distribution of the Italian population. The sample size equal to 1,2% of the Italian inpatients for injury. Within the hospitals all cases of home injury have been recorded in all hospitals; all cases of road traffic injury in 6 hospitals, all assault or self-harm cases in 2 hospitals.


All ED attendances for injury are recorded in the system.

In all MDS hospitals all ED attendances for injury are recorded. Basically in all FDS hospitals all the cases of home injury are recorded; in a subsample of hospitals all road traffic injuries are also recorded; in a subsample of hospitals all product-related injuries are also recorded; in a subsample of hospitals all violent injuries (aggression or self-injury) are also recorded.

12


PC with special data entry modules included in the internal hospital IT system or PC with special data entry software


Reliability and comparability: a single record validation of codified data by means a comparison with the open text description of the accidental event. Coherence: QC Software.

Reliability and comparability: For each single record in FDS format the validation of codified data has been performed by means of comparison with the open text description of the accidental event. In the MDS data for each group of population and classification of the injury have been analyzed the number of missing or invalid data together with the analysis of the use of the codes: "other" or "unknown" . The proportions and incidences of type of injuries among territories have been also compared. Coherence: QC Software.


2010: Presidio Ospedaliero Vittorio Veneto (Treviso); Via Forlanini 71 - 31029 Vitt. Veneto (TV) http://www.ulss7.it/istituzionale/strutture-e-assistenza/ospedali/vittorio-veneto.html Presidio Ospedaliero Conegliano (Treviso); Via Brigata Bisagno 4 - 31015 Conegliano (TV) http://www.ulss7.it/magnoliaPublic/istituzionale/strutture-e-assistenza/ospedali/conegliano.html E.O Ospedali Galliera (Genova);

95 hospitals using MDS format have been involved in the year 2012. 9 hospitals using the FDS have been involved in the year 2013. List of FDS hospitals (2013): Ospedale Generale Regionale della Val d'Aosta

“U. Parini” (“U. Parini”, Regional General Hospital of Aosta Valley).

Ospedale S. Giovanni Bosco - Torino Nord

Emergenza ("St. Giovanni Bosco" General

Hospital - Turin North Emergency).

http://www.ulss7.it/istituzionale/strutture-e-assistenza/ospedali/vittorio-veneto.html

http://www.ulss7.it/istituzionale/strutture-e-assistenza/ospedali/vittorio-veneto.html

http://www.ulss7.it/magnoliaPublic/istituzionale/strutture-e-assistenza/ospedali/conegliano.html



13

Via Mura delle Cappuccine 14 – 16128 Genova http://www.galliera.it/

Istituto G. Gaslini (Genova); Via Gerolamo Gaslini 5 - 16147 Genova www.gaslini.org Ospedale S. Francesco (Nuoro); Via Mannironi – Nuoro http://www.aslnuoro.it/index.php?xsl=21&s=3&v=9&c=625&esn =Primo+piano&na=1&n=50 Polo Ospedaliero Spoleto(Perugia): Via Loreto 3 - 06049 Spoleto (PG) http://portale.asl3.umbria.it/MEDIACENTER/FE/media/ospedale-di-spoleto.html Ospedale Civile San Matteo degli infermi Via dell’ospedale – 06046 Norcia (PG) http://portale.asl3.umbria.it/MEDIACENTER/FE/media/ospedale-di-norcia.html Ospedale Civile di Norcia Via Giovanni XXIII – 06046 Cascia (PG) http://portale.asl3.umbria.it/MEDIACENTER/FE/media/ospedale-di-cascia.html Ospedale Santa Rita da Cascia

Ente Ospedaliero di rilievo nazionale e di alta

specializzazione Ospedali "Galliera" (Galliera's

Hospitals Group).

Istituto di Ricovero e Cura a Caratere

Scientifico "G. Gaslini" ("G. Gaslini" Institute).

Ospedale "San Giovanni Battista" di Foligno -

Polo Ospedaliero di Foligno ("St. John the

Baptist", Hospital - Hospital Centres of

Foligno).

Ospedale Civile "San Matteo degli Infermi "

Spoleto - Polo Ospedaliero di Spoleto ("St.

Matthew of the Sick", Civil Hospital - Hospital

Centres of Spoleto).

Ospedale “SS. Benvenuto e Rocco” di Osimo (“Sts. Benvenuto e Rocco” Hospital). Ospedale di Senigallia (Senigallia Hospital ).

Presidio Ospedaliero "S. Francesco" di Nuoro

("St. Francis" General Hospital of Nuoro).


17.629 cases collected in 2010. MDS format cases(year 2012): n. 140,370

http://www.galliera.it/

http://www.gaslini.org/

http://www.aslnuoro.it/index.php?xsl=21&s=3&v=9&c=625&esn%20=Primo+piano&na=1&n=50

http://www.aslnuoro.it/index.php?xsl=21&s=3&v=9&c=625&esn%20=Primo+piano&na=1&n=50

http://portale.asl3.umbria.it/MEDIACENTER/FE/media/ospedale-di-spoleto.html

http://portale.asl3.umbria.it/MEDIACENTER/FE/media/ospedale-di-spoleto.html

http://portale.asl3.umbria.it/MEDIACENTER/FE/media/ospedale-di-norcia.html

http://portale.asl3.umbria.it/MEDIACENTER/FE/media/ospedale-di-norcia.html

http://portale.asl3.umbria.it/MEDIACENTER/FE/media/ospedale-di-cascia.html

http://portale.asl3.umbria.it/MEDIACENTER/FE/media/ospedale-di-cascia.html

14

FDS format cases(year 2013): n. 22,305


Approximately 2 years due to the partially manual procedure of QC.

MDS data production time: 2 years FDS data production time: 1 year

3.16. Were(national) incidence rates for home, leisure and school injuries derived? What method was used?

Available only for home accidents: 1,700 cases x 100.000 inhab. on the basis of extrapolation of ED attendances by means of Hospital Catchment population (age and sex distribution strictly concordant with national population distribution).

MDS format data: Yes Population base method (catchment area), because all the hospitals (all specialisations) of entire regions are included in the surveillance so that the catchment area coincides with the resident population of the region FDS format data: Yes HDR based method


There is not a periodical report. Several reports have been published every time since data controlled for quality have been available. www.iss.it/casa

3.18. Please check what has been done with the opportunities you identified earlier in 2011. Please describe briefly (500-700 words) current opportunities for optimizing the system (e.g. new IT developments, re-organisation of health information, demands for more effective

The Ministry of Health (department of prevention) has financed (years 2012-13) a project for the consolidation of the SINIACA surveillance system and its integration with the IDB. The regions that have joined the SINIACA, for the purposes of this project are: Valle d'Aosta, Piemonte, PA Trento, Liguria,

The relevant opportunity was the beginning of

a register of the attendances of patients in the

Emergency Departments in Italy with a

common minimum data set at national level,

together with a correspondent register of

interventions of the 118 health rescue service


15

prevention) Emilia-Romagna, Toscana, Marche, Umbria, Abruzzo, Molise and Sardegna. Eleven regions out of the existing twenty. Among these, Piemonte, P.A. Trento and Umbria were not participating in the surveillance network before. In some of the participating regions (eg. Piemonte and Umbria) is already active or at start up (eg. in Sardegna) an ED all injuries surveillance based on a non-analytical coding system, with no indication of the mechanism of the accidental or intentional event occurs. These regional ED registries adopt the national standard for ED general registry. These data linked with the registries of the health emergency rescue services can be converted into JAMIE-MDS format. These registries, while producing only summary information (general indication of the number of accidents: domestic, traffic, sports, etc.., no other information), have the advantage to cover all or most of the hospitals of the regions concerned. Among the activities of the project there will be a national recognition of the presence and effective operation of such surveillance system conform to the national standard of ED registry, even in regions not belonging to SINIACA (eg. Lazio and Lombardia), in order to acquire the relevant data for MDS. This for the

(EMUR registers). These databases of the

activities of emergency services have included

the surveillance of injuries so that has been

possible to fulfil, at least for the patients

transported to hospital through the 118

service, the IDB MDS requirements.

In year 2011 the EMUR registers were active in around half of the 20 Italian regions. We chose those where the health emergency registers were already well established or of better quality as to completeness of registration. The availability of registers operating in all the hospitals (all the specializations) of entire regions has consented to have the reference populations of the emergency services network and to calculate in an affordable way the incidence rates of injuries for large territories in which are included different types of living conditions, for instance for what concerns the degree of urbanization. At the same time the existence of the SINIACA network of sampling hospitals for ED surveillance of home accidents has made possible, with the sustain of the Minister of Health, consolidating and extend the surveillance of injuries in analytical format in a way compatible with IDB FDS. This was the opportunity for having a FDS surveillance of home injuries in a quite large

16

construction of a national framework on accidents and, where possible, regional, by crossing MDS data with the FDS data of the SINIACA hospitals. In order to integrate the Italian system of surveillance of accidents in the corresponding European system provided by JAMIE, fulfilling the commitments made by the Italian government, it will be activated a network sample composed of 10 hospital emergency departments, enrolled in the SINIACA, distributed throughout the country in urban, middle-urban and rural areas, which data on home accidents will be converted into JAMIE-FDS format. A smaller sample of hospitals will record also injuries from road traffic accidents and violent events (assault, self-harm).

number of hospitals compared to other countries. It was a convenience sample of hospitals, but distributed throughout the national territory and formed essentially of general hospitals (but 1 paediatric hospital was also included) in different type of geographic areas. This sample represents more than 1% of the Italian population. It was possible to extend the FDS surveillance to the road traffic accidents in a good number of hospitals and was also launched a sample for surveying of violent events (aggression or self-injury). The availability of existing networks has permitted to have the surveillance in a sufficiently large sample of hospitals, thank also to the double level of depth in of data collection (minimum and full) . That was a key factor of success considering the limitation of available financial resources. This optimization in conclusion has permitted the pursuing of the "all-injuries" surveillance in a large MDS sample and the FDS surveillance in a good number of general hospitals. Now we are in advanced phase of test of the software procedures we developed for the automatic coding of the external causes of injuries directly from automatic reading of the description of the accident by open text. If these procedures (the one for recognition of

17

selected products has shown up a high capacity of classification) will prove to be successful, at least partially, in general classifications of the external causes of injury, then the entire process of registration of cases will be dramatically simplified and speeded up. In fact the recurrent cases could be automatically codified by the software directly from reading of anamnesis (or etiology) in open text format, such as it is currently recorded in every hospital. Only the cases that the software did not succeed in recognize would need manual coding by mean of human operators.


The feasibility of the project stems from the fact that the surveillance network is based first on the activity of ED, which now have many years experience in the activities of SINIACA. Moreover, the National Institute of Health and a sample of hospitals within SINIACA already participated in the EU-IDB surveillance system. Based on methods developed and experience gained in these activities, the network will be extended to the regions above that, until now, have not participated in the surveys of the ED SINIACA. Among these, a pilot centre in Umbria (Spoleto Hospital) participated successfully in the past to the European EU-IDB and recently to the INTEGRIS European project.

The main challenge in the MDS surveillance, after the assessment of data quality and completeness, was the effective possibility of converting the EMUR codes into the IDB MDS ones. Consequently to the analysis of the coding manuals and the observation of the real use of codes in the cases recorded we decided to limit the conversion only to the cases of ED attendances coming from the 118 services. This because only records of the 118 services have enough information to classify the cases of fall in particular. On average these are the most severely injured patients at ED. Nevertheless the register of ED attendances and the register of 118 service (rescue

18

SINIACA data analysis on home accidents has always shown a significant concordance in different territories among the results of different injury coding systems (SINIACA vs. IDB) in the distribution of patients by age-sex specific groups and the mechanism of injury. This allows, according to the methods developed within the European surveillance projects, to estimate the injury incidence parameters at national and regional level, especially for those regions that having a synthetic ED injury reporting system. The 10 hospitals participating in the European JAMIE-FDS network have been identified within the network of the SINIACA Eds. It will be applied an automatic system of conversion of the Italian coding systems (SINIACA codes for home accidents, DATIS codes for road traffic accidents) into the European IDB coding system (JAMIE-FDS) that we developed during the course of the European pilot project INTEGRIS (Integration of European Injury Statistics). Basically this procedure will guarantee the recording and conversion of cases of home accidents into the European format (JAMIE-FDS). It will, then, be tested the extension of the surveillance to other types of accident, like road traffic accidents and intentional events. It will be tested also the adoption of the Full Data Set (FDS) for the

interventions) are two distinct databases and on the contrary to what it is indicated in the coding manuals, not always is possible in practice the linkage of the two records referring to the same case, because of lackings in the original registration. In most of the cases we had to recur to a probabilistic data matching. The second challenge was to extend the survey from the two initial regions (Piedmont and Tuscany), in which the MDS surveillance was already well established, toward other regions in southern Italy for which the adoption of the national standard in the ED register was just at the beginning. The effort proved to be successful in Abruzzo in which the MDS surveillance started in March 2012. Maybe it has been helpful the fact that the hospitals of this region have had a previous experience (in year 2007) of FDS surveillance within SINIACA. In Sardinia the surveillance began since 2011 with even a larger number of hospitals, but while the external causes of injury were completed pretty well, there has been a large number of missings in the coding of diagnoses. Nevertheless, all the 22 hospitals of Sardinia aside from the MDS surveillance have performed pretty well the FDS surveillance of the external causes of the home injuries and of road traffic ones.

19

registration of products involved in the accident. It will be used for this purpose a semi-structured response method in the field of free-text description of the accident, provided by SINIACA. If this method proves to be too costly, it will be experienced a system in development of automatic recognition for certain specific categories of products of interest, from free-text report of the incident. This automated procedure has been successfully tested by the National Institute of Health (over 85% of cases correctly classified), for caustics, on a large series of previous ED SINIACA records. A larger network of hospitals will adopt the Minimum Data Set (MDS) by mean of the development of an automatic conversion system of the data from the codes of the national standard of ED registry to the ones of the JAMIE-MDS.

We decided not to use the MDS data of Sardinia, but the FDS data for those hospitals which have completed the coding of diagnoses. In conclusion the MDS surveillance has been limited to three regions out of four potentially available. In the FDS surveillance the two main problems in Italy are the possibility of modifying the centralized ED software of the hospital (for legal, economical and organizational reasons) and the impacting on the working procedures of the frontline personnel in ED, nurses in particular. With regard to this last aspect you have to consider that in Italy continuity of care is not guaranteed in practice (eg. medical call services, operative on a 24 hours basis) and the territorial filter to accessing the hospital is not very efficient, because the visits of general practitioners at home are not guaranteed in practice, nor the outpatient care of the NHS is very developed. As a result many people, especially in urban area, recur directly to the hospital, even if they are not in real emergency, because it is for free (or it costs very little) and is always available. We have offered the hospital the possibility of not modifying the IT system and not impact at all on frontline personnel. Respectively by using a dedicated stand-alone software we developed for data entry to be used from

20

dedicated codifiers who manually read the anamnesis (or etiology) in open text format, reported at ED. We faced unwillingness toward this solution and our side did not encourage its feasibility, because it would have made less sustainable the surveillance, because the dedicated codifiers should then be paid on a regular basis for this specific job. So that generally we had to wait the modifications of the hospital IT system and we had also to impact on the working procedures of nurses. On one hand this fact makes the surveillance more sustainable, on the other hand it has limited the number of hospitals in which has been possible to record the violent cases (aggression or self-injury) or the product-related injuries. In particular the registration of the involved products has a large impact on the working procedures of the frontline personnel. In fact to speed up the process of registration of the patient each variable should have a limited number of items. On the contrary in coding the products are provided hundreds of possible codes. In order to solve this problem we adopted a two stage procedure. A short list of product codes has been selected from the IDB FDS manual, those which are more frequent. In practice we produced three short lists of product codes, each one with no more than 70

21

codes: one for home accidents, one for violence and one for all other accidents. The personnel of ED had to use only these short lists. In these way around 70% of cases in which a specific product was involved were coded. Later on at central level during the data quality control some dedicated codifiers who worked for the ISS have completed the remaining cases in which a specific product was not assigned. This two-stage procedure has minimized the impact on the working procedures of the ED and has permitted the registration of products, but for this reason also it was possible only in a limited number of hospitals, because has increased the work to be done at central level. This is the why we are developing automatic procedures of text recognition. Anyway the main challenge was the shortage of financial resources. In conclusion we have succeeded in setting up a wide surveillance of injuries (around 100 hospitals for MDS and 30 hospitals for FDS, 10 of which recorded also products) in Italy, compliant with IDB requirements, with a total financial support from the Ministry of Health of 235,000 euro in three years.


IDB data (0r provide a web-link) 2008-2010: Pitidis A, Gallo L, Longo E, Giustini M, Fondi G, Taggi F & Italian IDB working group. The Injury

2011-2014: Pitidis A, Fondi G and SINIACA and IDB working groups. The risk of fall in older ages: the results of

22

DataBase (IDB) in Europe, surveillance of home and leisure accidents: Italy (2005). Roma: Istituto Superiore di Sanità; 2008. Rapporti ISTISAN 08/45. Pitidis A, Gallo L, Valentini F, Bovo T, Murgano A, Dagazzini I, Rossi G, Longo E, Fondi G, Taggi F & SINIACA and IDB working grouos. SINIACA: the Italian national surveillance of home accidents on three Italian Regions: Veneto, Abruzzo, Sardinia (2005). Roma: Istituto Superiore di Sanità; 2010. (Rapporti ISTISAN 10/38). Longo E, Pitidis A. SINIACA: a system reply to the national surveillance of home injuries. Not Ist Super Sanità 2010;23(11):3-7.

SINIACA system. In Longo E, Cedri C, Giustini M. (Ed.). Ageing today: a challenge for tomorrow. Results of the European Project CHANGE (Care of Health Advertising New Goals for Elderly people). Istituto Superiore di Sanità. December 3, 2010. Proceedings. Roma: Istituto Superiore di Sanità; 2011. (Rapporti ISTISAN 11/43). Pitidis A, Longo E, Giustini F, Fondi G & gruppo lavoro SINIACA. Housewives' accidents at work: a neglected phenomenon. Not Ist Super Sanità 2012;25(7-8):13-16.

Cedri, Longo E, Masellis A, Briguglio E, Pitidis A & PRIUS and SINIACA working groups . Prevention of pediatric burns- The PRIUS project. Not Ist Super Sanità 2013;26(10):3-6. Pitidis A, Fondi G, Giustini F, Longo E, Balducci G & SINIACA-IDB working group. The SINIACA-IDB System for accidents surveillance. Not Ist Super Sanità 2014;27(2):11-16.

4.2. Is there a comprehensive reporting on

accidents/injuries available, comprising home, leisure, road, and workplace injuries at various levels of severity (deaths, hospitalizations, ambulatory treatments) – or is there any intention to produce such report? (Please provide link to the website or attach the report)

Not actually but in the near future with the publication of the report for the results of the SINIACA-IDB project.

The results of the SINIACA-IDB project in Italy are disseminated through these links: http://www.iss.it/casa http://www.iss.it/stra


Actually none.

5. Key stakeholders (main data users)

23

5.1. Which is the competent authority(most probably in the Ministry of Health) for injury statistics, in particular on and home and leisure accidents? (please provide unit, addresses, name of responsible person)

Not a single Authority for injuries. Ministry of Health (Trauma and Poisoning); v. le G. Ribotta 5 - 00144 Rome www.salute.gov.it ISTAT National Institute of Statistics (Road Traffic acc., Home Accidents; Labour accidents); Via C. Balbo 16 - 00184 Rome www.istat.it INAIL Italian National Institute for the Insurance of Injuries at Workplace (Labour acc.); P.Le Giulio Pastore 6 - 00144 Rome www.inail.it National Institute of Health (Home acc.) V.le Regina Elena 299 – 00161 Rome www.iss.it


Ministry of Health Department of Prevention v. le G. Ribotta 5 - 00144 Rome http://www.salute.gov.it/ministero/sezDipartimentiDirezioni. jsp?label=dedN&id=858&dir=dirPrevN INAIL National Institute for the Insurance of Injuries at Workplace Directorate Central Prevention

http://www.salute.gov.it/

http://www.istat.it/

http://www.inail.it/

http://www.iss.it/

http://www.salute.gov.it/ministero/sezDipartimentiDirezioni.%20jsp?label=dedN&id=858&dir=dirPrevN




24

P.Le Giulio Pastore 6 - 00144 Rome http://www.inail.it/Portale/appmanager/portale/desktop? _nfpb=true&_pageLabel=PAGE_INAIL&nextPage= Uffici_centrali/index.jsp



ISTAT Italian National Institute of Statistics via C. Balbo 16 - 00184 Rome http://www.istat.it/it/archivio/14562 Health for All http://www.istat.it/it/salute-e-sanit%C3%A0 Service: Health and Care http://www.istat.it/it/archivio/malattie


National Institute of Health SINIACA V.le Regina Elena 299 – 00161 Rome Dr. AlessioPitidis www.iss.it/casa

5.6. Is there any (other) relevant body(agency) for the prevention of home and leisure accidents (e.g. for campaigning)? (If yes,

Ministry of Health Department of Prevention v. le G. Ribotta 5 - 00144 Rome

http://www.inail.it/Portale/appmanager/portale/desktop?%20_nfpb=true&_pageLabel=PAGE_INAIL&nextPage=%20Uffici_centrali/index.jsp





http://www.istat.it/it/archivio/14562

http://www.istat.it/it/salute-e-sanit%C3%A0

http://www.istat.it/it/archivio/malattie


25

please provide unit, addresses, name of responsible person) If there are more than one, please provide information on the most important ones

http://www.salute.gov.it/ministero/sezDipartimentiDirezioni. jsp?label=dedN&id=858&dir=dirPrevN The prevention departments of the territorial units of the National Health Service (there are about 250 local units of the NHS in Italy) http://www.salute.gov.it/ministero/sezMinistero.jsp?label=ssn&id=13 INAIL National Institute for the Insurance of Injuries at Workplace Committee for the insurance of housewives against home injuries P.Le Giulio Pastore 6 - 00144 Rome http://www.inail.it/Portale/appmanager/portale/desktop? _nfpb=true&_pageLabel=PAGE_CASALINGHE


National Institute of Health SINIACA V.le Regina Elena 299 – 00161 Rome Dott. AlessioPitidis www.iss.it/casa INAIL National Institute for the Insurance of Injuries at Workplace Sector of Research , Certification and Validation Via Alessandria, 220/E - 00198 Rome





http://www.salute.gov.it/ministero/sezMinistero.jsp?label=ssn&id=13

http://www.salute.gov.it/ministero/sezMinistero.jsp?label=ssn&id=13

http://www.inail.it/Portale/appmanager/portale/desktop?_nfpb=true&_pageLabel=PAGE_CASALINGHE





26

6. Signature 6.1. Place, date Rome April 15th 2012 Rome July 31st 2014

6.2. Signature

6.3. Name, function Edited by: Giuseppe Balducci;

revised by: Alessio Pitidis

Alessio Pitidis Director of the Environment and Trauma Unit Italian National Institute of Health.

www.ispesl.it 5.8. Is there a more or less formalized


The Ministry of Health has funded the National Institute of Health for the consolidation of the SINIACA injury surveillance system in 2012-2013 and its integration with the European IDB. The National Institute of Health and INAIL collaborate with regard to the control and prevention of injuries in the housewives for which an insurance is provided by INAIL.


National Prevention Plan Ministry of Health Within the NPP there are specific sections dedicated respectively to labour injuries, road traffic injuries and home injuries. http://www.salute.gov.it/prevenzione/homePrevenzione.jsp

http://www.ispesl.it/

http://www.salute.gov.it/prevenzione/homePrevenzione.jsp

http://www.salute.gov.it/prevenzione/homePrevenzione.jsp

1


Country: LATVIA


1. Respondent 1.1. Name, title Lauma Springe, Ms. Diana Vanaga, Ms 1.2. Function Public Health Analyst 1.3. Affiliation, address The Centre of Health Economics, Duntes 12/22,

Riga, LV-1005 The Centre for Disease Prevention and Control (CDPC), Duntes 22, Riga, LV-1005

1.4. Tel-nr., e-mail-address +371 67387664, [email protected] +371 67387660, [email protected] 1.5. Website www.vec.gov.lv www.spkc.gov.lv 2. Focus of your institution in injury

monitoring


One of the functions of the Centre of Health Economics is to obtain and analyze public health data and health care statistics. This function in September 2009 was overtaken from The Health Statistics and Medical Technologies State Agency. Collection of injury

All these functions were overtaken by CDPC from the Centre of Health Economics in April 1, 2012.



2


data started in year 2005, with the implementation of European Commission pilot project for injury data collection. Data were collected in the Register of the Patients with Particular Diseases who have had Trauma and Injuries (further – Injury Register). The Injury Register is part of the Register of the patients with particular diseases, which contains personified data about patients with nine particular diseases. The Centre of Health Economics is responsible for implementation and maintenance of Web based patients register (called system PREDA). The objective of the Patient Register is to develop unified data information system about patients with particular diseases, ensure the implementation of State statistical program and international institutions with statistical information. Information from the Injury Register is used for publications and research (e.g., Yearbook of health care statistics, statistical reports in Centre homepage, performances in scientific conferences) and for health care policy planning and evaluation. The legal base for the Injury Register internationally is EU Recommendation on the prevention of injuries and the promotion of safety. Locally the Injury Register works on the framework of Cabinet of Ministers regulation

3


Nr.746 accepted in 15 of September, 2008. 3. Systematic ED based injury surveillance 3.1. Has specific injury surveillance been

pursued in EDs in three project years – e.g. with focus on home and leisure accidents, external causes of injuries, or product related injuries? (e.g. IDB, EHLASS, EPAC, LIS, AWISS)

2008-2010: Yes, Injury Database. 2011-2014: IDB continued


Collection of injury data started in year 2005, with the implementation of European Commission pilot project for injury data collection. Data were collected in the Register of the Patients with Particular Diseases who have had Trauma and Injuries (further – Injury Register). To strengthen legal base for the injury data collection, regulation of the Cabinet of Ministers came in force in year 2006. The regulation declared that data were collected in hospitals’ emergency units and injury departments. Data covered in-patient and out-patient injuries. In order to improve the injury data system, electronic data collection from the hospitals via internet was enabled in Autumn 2007. Comparing with previous data collection method (paper format), online system provided a number of benefits: data collection was much faster; processing data took less time and resources. In Autumn 2008 changes in legislation were made. The new legislation

Due to these changes in legislation in 2008, a proportion of out-patient and in-patient injuries registered in the Registry also has changed (for year 2013 it was 94,3%). The procedure for data operators about their possibilities to connect to the online system for Trauma/Injury card filling in the Registry, is the same, but due to the reorganization of institutions, the agreement must be signed and individual training must be done in the CDPC. At the moment all hospitals which provide data to the Registry, enter the information electronically to the web based online system PREDA.

4


determined that hospitals must provide information to the Register only about in-patient injuries. These changes were made in order to lighten the health care specialist work in data collection. However, there are still some hospitals that fill Trauma/Injury Cards also about out-patient injuries. The information from the Register is used for policy framework document planning and evaluation, statistical data aggregation in institutional and individual level, also in research. Data providers for the Injury Register are in-patient hospitals in Latvia. Hospital staff (doctors or nurses) collects the information from the injury patients in paper format. Then the information is entered in Web based system called system PREDA (as mentioned before). Usually there are data operators in hospitals who work with the system PREDA. In order to be able to connect to the online system and fill in Trauma/Injury cards, data operators from the hospitals have to sign an agreement and pass individual training course in the Centre of Health Economics. Also they have to sign confidentiality declaration, because the injury Register contains personified information about patients. At the moment there are two from 23 hospitals that

5


fill Trauma/Injury Cards in paper format due to lack of resources. Then the filled Trauma/Injury cards are sent to the Centre of Health Economics, where they are entered in the Injury Register. Another two hospitals at the moment cannot provide even information collection in paper format (also due to lack of resources). In the Centre of Health Economics the quality of the data in the Injury Register is checked. For quality control our own quality check plan is used, where data coding consistency with the injury case narrative, user operations auditing and other relevant quality measures are checked. The system users are informed about their most frequent mistakes. Also seminars for data operators are held when there is a necessity. Every year the information about injuries from the Injury Register is published locally in the Centre of Health Economics home page. After request information is sent to the European central Injury database (EU IDB). Before sending the Injury Register database is checked for mistakes using IDB quality control software program, version 1.2.1.

3.3. What is the formal status of this monitoring system? (e.g. based on law, implementation regulation, guideline, initiative by an

The Injury Register is based on law (regulation of Cabinet of Ministers). Due to lack of resources (financial, human and other) some of

The situation in year 2013 was the same – there were three of 23 general hospitals that did not collect data about injuries.

6


authority, private initiative) the hospitals don’t provide information to the Register. In year 2010 there were three of 23 general hospitals that didn’t collect data about injuries. When comparing the data by ICD-10 codes from Injury Register with Hospital Discharge Register underreporting to Injury Register of particular diagnosis can be seen. Hospitals that provide data to the Injury Register not always fill Trauma/Injury cards about completely all injury patients.


Data collection, handling and reporting is funded from state’s budget. As the collection of the injury data in the hospitals is based on law (regulation of Cabinet of Ministers), hospitals don’t receive additional funding for the injury data collection, handling and reporting.


The Centre of Health Economics, Registers Supervision Unit, Duntes 12/22, Riga, Latvia, LV-1005, Lauma Springe

The Centre for Disease Prevention and Control, Registers Supervision Unit, Duntes 22, Riga, Latvia, LV-1005, Diana Vanaga


Yes.


For external causes coding system in emergency departments IDB coding manual version 1.1 is used. Diagnoses used: S00.0-T78.9 (ICD-10).

The system PREDA is being prepared for the latest IDB data dictionary version 1.3 usage for data coding.


Nurses or doctors interview patients, Register online system users (data operators) fill in the information electronically. Data operators

The agreement must be signed and individual training must be done in the CDPC.

7


usually are one or more persons from the hospital staff. In order to be able to connect to the online system and fill in Trauma/Injury cards, they have to sign an agreement and pass individual training course in the Centre of Health Economics.


The regulation of Cabinet of Ministers states that every hospital has to provide information to the register about all in-patient injuries. As already mentioned, some of the hospitals due to lack of resources (financial, human and other) don’t provide information to the Register. In year 2010 there were three of 23 general hospitals that didn’t collect data about injuries.

In 2013 there were also three of 23 general hospitals that did not collect data about injuries.


No special sampling methods are used. Information in Register should be collected about every injury in-patient. When comparing IDB data with HDS data about hospitalized patients with injuries, differences can be seen (see question 3.2.).


Data entry has been done using special data entry software called system PREDA (Patients Register Data). When interviewing the patient, paper format Trauma/injury cards (blank from the regulation of Cabinet of Ministers) is used.

3.12. What kind of quality control measures are in place to ensure accuracy, reliability, coherence and comparability (what

Data are collected using blanks from the regulation of Cabinet of Ministers. The online system contains the same fields as in the blank.

In 2012 the new Injury data collection card in Latvia was approved. The seminar for hospitals and data operators about these

8


procedures, tools are applied)? To ensure data quality in Register logical record controls are used in the system. E.g., if the system user codes brain concussion as type of injury, the only part of the body that system allows to enter is brain. If some of the fields remain unfilled the system does not allow saving the data. We have our own quality control plan, where data coding consistency with the injury case narrative, user operations auditing and other relevant quality measures are checked. The system users are informed about their most frequent mistakes. We ensure training courses for health care personnel for working with the system. The system users are trained how to work with the system and after training the test must be passed to confirm that the person has enough experience to work with the system and only after passing the test user name, password and PIN code for access to system and data can be received.

changes in data input was organized. The changes in Injury card include an extra information about poisonings.

3.13. How many hospitals (ED) have been involved in the last year (2010 and 2013)? (Please provide a list of involved hospitals if possible, addresses and names of contact persons: link or attachment)

19 hospitals 20 hospitals

3.14. Approx., how many cases have been collected in the last year (2010 and 2013)?

20 751 case. 11 753 cases

9



Usually data about previous year are published in The Centre of Health Economics home page in May or June.

Usually data about previous year are published in the CDPC home page in May or June and Public Health Yearbook – in September or October.


Every year national incidence rates are calculated using Calculation of IDB Incidence Rates where data from the Injury Register and Hospital Discharge Register are combined. Patients’ registry based method is used.

National incidence rates for home, leisure and school injuries are calculated only within the JAMIE project.


There is no separate report only for findings of the ED based system. The information about findings about Injury Database is included as separate part in chapter Public Health in Yearbook of health care statistics in Latvia. Also information aggregated in tables is available in the Centre of Health Economics home page.

Comments: please see Public Health Yearbook here: http://vec.gov.lv/en/statistic Statistical information about data from Injury Database in Latvia can be found here (only in Latvian): http://vec.gov.lv/lv/33-statistika

The information about findings in Injury Database is included as a separate part in the chapter Public Health in Yearbook of health care statistics in Latvia and information aggregated in tables is available on the CDPC home page. Comments: please see Public Health Yearbook here: http://www.spkc.gov.lv/statistics/ Statistical information about the data from Injury Database in Latvia can be found only in Latvian here: http://www.spkc.gov.lv/veselibas-aprupes-statistika/

3.18. Please check what has been done with the opportunities you identified earlier in 2011. Please describe briefly (500-700 words) current opportunities for

Current opportunities for optimizing the system include new IT developments. At the moment one of the Centre of Health Economics functions is to implement the e- Health policy

The linkage between Injury Registry and information from Population Registry is done. As a challenge for optimizing the system is to envisage electronical linkage between Hospital

http://vec.gov.lv/en/statistic

http://vec.gov.lv/lv/33-statistika

http://www.spkc.gov.lv/statistics/

http://www.spkc.gov.lv/veselibas-aprupes-statistika/


10


optimizing the system (e.g. new IT developments, re-organisation of health information, demands for more effective prevention)

of the State, organize and co-ordinate the exchange of information among State health information systems. In the future the linkage between different registers and data bases is envisaged. E.g., information from population registers in Latvia, Hospital discharge register and others. This would greatly optimize the information collection, system user’s work and avoid the double entry of the same information records in different registers or data bases. In the nearest future new public health strategy will be accepted in Latvia. One of the chapters in the strategy is devoted to injury prevention. For setting the targets of this political document and also for an evaluation of the same document afterwards the information about injuries is needed. Injury Database coding is very suitable for obtaining the information about different injury circumstances as the place of injury, involved products, type of injury and other variables.

Information System from some hospitals (thus receiving more information about injuries). The new Public Health Strategy for 2011-2017 has been approved and the targets in the chapter devoted to the prevention of injuries, is based on the information from the Injury Registry. The strategy is under revision again in order to comply the included description of the situation, problem formulation, objectives, policy outcomes, courses of action included in the activities to the National Development Plan of Latvia for 2014 –2020 and the new financial programming period.


Lately the injury database in Latvia has faced many challenges: budget cuts and reorganization of health care sector agencies and authorities. With bigger support and funding Injury Register could be better both in terms of information quality and quantity. Lately, in year 2009 in line with health system reorganization in Latvia, the reorganization of

The health care budget in Latvia is still limited and, thus a lack of resources is a reason why not all injury cases are registered in the Registry. From the Ministry of Health in 2013 the Health Promotion unit was overtaken and now all issues about preventive actions are in the competence of CDPC.

11


The Health Statistics and Medical Technologies State Agency was done. The function of the Injury Register handling was overtaken by the recently created Centre of Health Economics in September 2009. Due to changes of working specialists and their responsibilities, quality of the Injury Register performance was affected for a while. Also funding for the Patients Register was affected negatively. The same way as it is in the hospitals the lack of resources sometimes is the cause for hampering better Injury Register maintenance. Another challenge worth to mention is Injury Register data quantity in terms of sampling of the hospitals. As some of the hospitals don’t provide information (at the moment two of 23 in-patient hospitals in Latvia) this may cause bias in the studies of injuries in Latvia. As these two hospitals are regional hospitals, where patients from particular region are treated, these regions are not represented in the Injury Register. Great challenge for the future is to improve the number of hospitals that collect information about patients with injuries, so the Injury Register data would cover all regions in Latvia. Also in the future Injury Register data quality should be improved. When comparing the data by ICD-10 codes from Injury Register with

The Registry linkage between Hospital Information System from some hospitals is a great challenge for the future. This linkage could let us get the information about ambulatory treated patients (at least Minimum Data Set). As recommended from toxicologists, the Trauma/Injury card has been enhanced with special records for poisoning cases. As a result, the number of registered cases of poisoning has increased significantly (from 0,3% in 2010 to 11,7% in 2013 of all registered injuries).

12


Hospital Discharge Register underreporting to Injury Register of particular diagnosis can be seen. E.g., many of the hospitals don’t provide information about poisoning cases, although poisoning cases also refer to external causes and should be collected in the Injury Register. In order to enrich this field of the Injury Register, discussions with toxicologists in Latvia are held. Toxicologists have shown interest in collecting the information (so they can see and analyze the situation in Latvia). Perhaps the Trauma/Injury card will be complimented with special records for poisoning cases (as recommended from toxicologists), but these cases would be compatible with the Injury Database coding. The benefit for the Injury Register would be the better information about poisonings. Benefit for the toxicology specialists would be data about poisoning cases in Latvia.



4.2. Is there a comprehensive reporting on accidents/injuries available, comprising home, leisure, road, and workplace injuries at various levels of severity (deaths, hospitalizations, ambulatory treatments) – or is there any intention to produce such

We don’t have separate annual comprehensive report on accidents and injuries, but we have some one-off reports on injuries. Injuries are reported within public health monitoring. The purpose of this monitoring is to assess the general trends in population’s health and to

Please see Public Health Yearbook here: http://www.spkc.gov.lv/statistics/ Statistical information about data from Injury Database in Latvia can be found only in Latvian here: http://www.spkc.gov.lv/veselibas-aprupes-

http://www.spkc.gov.lv/statistics/


13


report? (Please provide link to the website or attach the report)

identify problems related to public health. The results of the monitoring are published periodically in the form of reports and analyses. Also as mentioned before the information on findings about Injury Database is included as separate part in chapter Public Health in Yearbook of health care statistics in Latvia and information aggregated in tables is available in the Centre of Health Economics home page. Comments: Publication on injuries and external causes of death in children and young people, 2007 can be found here: http://vec.gov.lv/uploads/files/ 4d3949343abdf.pdf Publication on Health disorders due to violence and accidents can be found here (only in Latvian): http://vec.gov.lv/uploads/files/ 4d00e1c431248.pdf Please see Public Health Yearbook here: http://vec.gov.lv/en/statistic Statistical information about data from Injury Database in Latvia can be found here (only in Latvian): http://vec.gov.lv/lv/33-statistika

statistika/ Analytic material about population health from 2000–2012 in Latvia can be found here (only in Latvian): http://www.spkc.gov.lv/sabiedribas-veselibas-datu-analize/ Thematic report about elderly population health status and influencing factors in Latvia can be found here (only in Latvian): http://www.spkc.gov.lv/sabiedribas-veselibas-datu-analize/

4.3. Who is responsible for the comprehensive injury reporting? (Please provide

For public health monitoring: The Centre of Health Economics, Public Health Data

The responsible institution for public health monitoring, Public Health Yearbook and

http://vec.gov.lv/uploads/files/

http://vec.gov.lv/en/statistic

http://vec.gov.lv/lv/33-statistika


http://www.spkc.gov.lv/sabiedribas-veselibas-datu-analize/




14


institution, unit, address, name of responsible person)

Analysis Unit, Duntes 12/22, Riga, Latvia, LV-1005, Gunta Rozentale For Public Health Yearbook and aggregated injury statistics publications: The Centre of Health Economics, Public Health Department, Duntes street 12/22, Riga, Latvia, LV-1005, Jana Lepiksone

aggregated injury statistics is the Centre for Disease Prevention and Control, Duntes 22, Riga, Latvia, LV-1005.



The Centre of Health Economics, Public Health Department, Duntes street 12/22, Riga, Latvia, LV-1005, Jana Lepiksone

The Centre for Disease Prevention and Control, Duntes 22, Riga, Latvia, LV-1005, Jana Lepiksone


There is no single institution or ministry that is competent for injury prevention. Some of the ministries are responsible for injury prevention - Ministry of interior (State Policy, The State Fire and Rescue Service), Ministry of Welfare (The State Inspectorate For Protection Of Children's Rights), Ministry of Education, Ministry of Transport (Road Safety Directorate) and Ministry of Health in the Framework of Public Health Strategy. Focal person on injury prevention of Ministry of Health is Jana Feldmane Head of the Division of Environmental Health of Department of Public Health.

5.3. Which authority (most probably in the Ministry of Consumer Affairs) is competent

Consumer Rights Protection Centre, K.Valdemara street 157, Riga, Latvia, LV-1013.

Consumer Rights Protection Centre, Brivibas street 55, Riga, Latvia, LV-1010, Goods and

http://www.bti.gov.lv/eng/vbta_inspekcija/


15


for the safety of consumer products? (please provide unit, addresses, name of responsible person)

Goods and services supervision department director Linda Rinkule. Comment: Consumer Rights Protection Centre home page: http://www.ptac.gov.lv/page/256

services supervision department director Linda Rinkule Comment: Consumer Rights Protection Centre home page: http://www.ptac.gov.lv/page/256


Central Statistical Bureau, Lacplesa Street 1, Riga, LV – 1301, Social Statistics Department Director Maranda Behmane Comment: Central Statistical Bureau home page: http://www.csb.gov.lv/en


No


Health promotion specialists (injury prevention as a part of health promotion work): Ministry of Health, Public Health department, Brivibas street 72, Riga, Latvia, LV-1011, Senior health promotion specialist Solvita Klavina Ministry of Health home page: http://www.vm.gov.lv/index.php Emergency Medical Service: 118 Kr. Valdemara Street, Riga, LV-1013 Ilze Buksa, Head of Communication division (Campaigning about safety questions) Emergency Medical Service home page:

Health promotion specialists: The Centre for Disease Prevention and Control, Duntes 22, Riga, Latvia, LV-1005, Deputy Head of Unit Solvita Klavina CDPC home page: www.spkc.gov.lv Emergency Medical Service: 8 Laktas street, Rīga, LV-1013, Ilze Buksa, Head of Communication division (Campaigning about safety questions) Emergency Medical Service home page: http://www.nmpd.gov.lv/en/

http://www.ptac.gov.lv/page/256

http://www.ptac.gov.lv/page/256

http://www.csb.gov.lv/en

http://www.vm.gov.lv/index.php

http://www.spkc.gov.lv/

http://www.nmpd.gov.lv/en/

16


http://www.nmpd.gov.lv/ The State Inspectorate For Protection Of Children's Rights Ventspils Street 53 Riga, LV – 1002, Laila Rieksta Riekstina, Director of Inspectorate (Campaigning about children safety) The State Inspectorate For Protection Of Children’s Rights home page: http://www.bti.gov.lv/eng Campaigning for prevention of road traffic accidents: Road Traffic Safety Department, 25 Miera Street, Riga, LV-1001 Valda Kjaspere, Public Relation specialist Road Traffic Safety Department home page: http://www.csdd.lv/?lngID=EN State Policy, Ciekurkalna 1.line 1, k-4, Riga LV – 1026, (Campaigning for safety) Chief of the PR Unit of State Police Andis Rinkevics State Policy home page:

http://www.vp.gov.lv/?setl=2 The State Fire and Rescue Service (Campaigning for safety) 5 Maskavas Street, Riga, LV-1050, Chair of Press and Public Relations Division Inga Vetere

The State Inspectorate For Protection Of Children's Rights Ventspils Street 53 Riga, LV – 1002, Laila Rieksta Riekstina, Director of Inspectorate (Campaigning about children safety) The State Inspectorate For Protection Of Children’s Rights home page: http://www.bti.gov.lv/eng Campaigning for prevention of road traffic accidents: Road Traffic Safety Department, 25 Miera Street, Riga, LV-1001 Valda Kjaspere, Public Relation specialist Road Traffic Safety Department home page: http://www.csdd.lv/?lngID=EN State Policy, Ciekurkalna 1.line 1, k-4, Riga LV – 1026, (Campaigning for safety) Chief of the PR Unit of State Police Andis Rinkevics State Policy home page:

http://www.vp.gov.lv/?setl=2 The State Fire and Rescue Service (Campaigning for safety) 5 Maskavas Street, Riga, LV-1050, Chair of Press and Public Relations Division Inga Vetere

The State Fire and Rescue Service home page: http://www.vugd.gov.lv/eng/

http://www.nmpd.gov.lv/



http://www.bti.gov.lv/eng

http://www.csdd.lv/?lngID=EN

http://www.vp.gov.lv/?setl=2



http://www.bti.gov.lv/eng

http://www.csdd.lv/?lngID=EN

http://www.vp.gov.lv/?setl=2

http://www.vugd.gov.lv/eng/

17


The State Fire and Rescue Service home page:

http://www2.112.lv/en/


Riga Stradins University, Public Health and Epidemiology Department, asoc.prof. Anita Villerusa Riga Stradins University home page: http://www.rsu.lv/eng/


Yes. There are seminars and working parties organized by Ministry of Health and World Health Organization Country office in Latvia. Usually representatives from NGO’s are present in these seminars.


There is no national action plan for injury prevention, but injury prevention was included in Public Health strategy as a separate chapter. New Public Health strategy currently is under development and will be accepted in the nearest future. In the new strategy injury prevention also will be included as a separate chapter.

The new Public Health Strategy for 2011-2017 has been approved and injury prevention is included there as a separate chapter. But the strategy is under revision again in order to comply it to the National Development Plan of Latvia for 2014–2020 and the new financial programming period.


6.2. Signature

6.3. Name, function Jana Lepiksone Jana Lepiksone

http://www2.112.lv/en/

http://www.rsu.lv/eng/

1


Country: LITHUANIA


1. Respondent 1.1. Name, title Rita Gaidelyte, Ms 1.2. Function Head of Health Statistics Department 1.3. Affiliation, address Health Information Centre of Institute of

Hygiene, Didzioji str. 22, LT-01128, Vilnius, Lithuania

1.4. Tel-nr., e-mail-address Tel. +370 5 2773303 Fax +370 5 2624663 [email protected]

1.5. Website http://sic.hi.lt


2.1. Please describe briefly (300 – 500 words) Health Information Centre of Institute of


http://sic.hi.lt/

2



Hygiene (HIC IH) is responsible for health statistics (especially causes of deaths, health care and health resources statistics). HIC IH collects data using annual survey of health establishments (health care resources and some data on activities), calculated data from administrative data source: Compulsory Health Insurance Fund information system (CHIF IS) of the State Patient Fund which covers data on hospital discharges, out-patient (incl. primary heath care) visits, registered morbidity for out-patient and inpatient data). CHIF IS covers about 98% of hospital discharges and about 90% of outpatient visits. External causes in hospital discharge database are coded by ICD-10 on 4 digits level. External causes registered in out-patient care (incl. primary care) - 8 groups of external causes (1-transport accident, 2-work place, 3-other public places, 4-home, 5-sports, 6-in educational institutions, 7-self-harm, 8-assault, 9-others). Emergency departments are not coded external causes as patient usually is referred to hospital (in-patient) or to out-patient clinics or primary health care, and then external cause is registered. The system of monitoring of injuries is under development in Lithuania (started in 2011). How it will be done it is not clear by now.

3




2008-2010: No 2011-2014:








3.9. How is the sampling of hospitals been

4


done (How was the representativeness of the sample of hospitals ensured)?





2010: 2013:


2010: 2013:



3.17. Is there a national (annual) report about figures and findings of the ED based system? (Please provide link or file of last

5


report) 3.18. Please check what has been done with

the opportunities you identified earlier in 2011. Please describe briefly (500-700 words) current opportunities for optimizing the system (e.g. new IT developments, re-organisation of health information, demands for more effective prevention)





No. System of injuries monitoring (under developing now) suppose to include the system of reporting.


6





Health Information Centre of Institute of Hygiene.


Ministry of Health


State Non Food Products Inspectorate under the Ministry of Economy, www.inspekcija.lt


Health Information Centre of Institute of Hygiene. Causes of deaths: Kotryna Paulauskiene, Head of Causes of Death Register. Hospital discharges statistics: Rita Gaidelyte, Head of Health Statistics Department.


See 9.4

http://www.inspekcija.lt/

7



Centre of Health Promotion and Diseases Prevention, Kalvariju str. 153, LT-08221, Vilnius, Lithuania, www.smlpc.lt, responsible person: Aida Laukaitiene, Head of Non-infectious disease prevention department




“National injuries prevention programme 2000- 010”

6. Signature 6.1. Place, date Vilinus, 21.06.2011

6.2. Signature

6.3. Name, function Rita Gaidelyte, Ms

http://www.smlpc.lt/

1


Country: LUXEMBOURG


1. Respondent 1.1. Name, title Serge KRIPPLER 1.2. Function Medical doctor 1.3. Affiliation, address Direction de la Santé 1.4. Tel-nr., e-mail-address 00352/24785603 [email protected] 1.5. Website www.santé.lu www.ms.etat.lu 2. Focus of your institution in injury

monitoring


As the health burden, due to mortality and

morbidity caused by accidents is high in

Luxembourg, the elaboration of a national

strategy for their reduction figures among

the major public health priorities of our

As the health burden, due to mortality and

morbidity caused by accidents is high in

Luxembourg, the elaboration of a national

strategy for their reduction figures among

the major public health challenges of our


http://www.santé.lu/

http://www.ms.etat.lu/

2


country. The elaboration of a reliable and

performing monitoring system is a very

important part of such a strategy for

planning and evaluation purposes. Those

purposes go from injury prevention strategies

based on goals for injury burden reduction in

road traffic, in accordance with the actual

UN/WHO goal for the decade of road safety

action 2011-20, to home and leisure accident

prevention and measures of improvement of

protection at work. The emergency room data

will be very precious for the identification of

fields requiring action, the description of target

groups or target types of injuries and accident

causes, for the monitoring of prevention

programs as well as for the evaluation of

medical planning needs. Injuries are amongst

the 5 leading major causes of death, grouped

by ICD-10 chapters, in adults >19 years and the

leading cause of death in children ≤19 years. Being a small country with +- 500 000

inhabitants, the total numbers of those deaths

are to small for annual in depth analysis of

leading accident mechanisms and the

identification of priority targets and the short

country. The elaboration of a reliable and

performing monitoring system is a very

important part of such a strategy for

planning and evaluation purposes. Those

purposes go from injury prevention strategies

based on goals for injury burden reduction in

road traffic, in accordance with the actual

UN/WHO goal for the decade of road safety

action 2011-20, to home and leisure accident

prevention and measures of improvement of

protection at work. The emergency room data

will be very precious for the identification of

fields requiring action, the description of target

groups or target types of injuries and accident

causes, for the monitoring of prevention

programs as well as for the evaluation of

medical planning needs. Injuries are amongst

the 5 leading major causes of death, grouped

by ICD-10 chapters, in adults >19 years and the

leading cause of death in children ≤19 years. Being a small country with +- 500 000

inhabitants, the total numbers of those deaths

are to small for annual in depth analysis of

leading accident mechanisms and the

identification of priority targets and the short

3


term evaluation of the reaching of the set goals,

especially in children. Furthermore the causes

of death certificates have limited information

on accident causes and circumstances making

evidence based planning difficult. A dynamic

injury surveillance system, representative of

the whole population and considering lethal

and non-lethal injuries with in depth

information of the causes of accidents as well

as the short-term and long-term outcome is

therefore considered by the stakeholders as

being an in-discussable need for effective

injury prevention planning. Furthermore the

long-term outcome evaluation has its benefits

in quaternary prevention planning in the fields

of work reintegration as well as long-time care

and support needs.

term evaluation of the reaching of the set goals,

especially in children. Furthermore the causes

of death certificates have limited information

on accident causes and circumstances making

evidence based planning difficult. A dynamic

injury surveillance system, representative of

the whole population and considering lethal

and non-lethal injuries with in depth

information of the causes of accidents as well

as the short-term and long-term outcome is

therefore considered by the stakeholders as

being an in-discussable need for effective

injury prevention planning. Furthermore the

long-term outcome evaluation has its benefits

in quaternary prevention planning in the fields

of work reintegration as well as long-time care

and support needs.

Representativeness is a major issue in such

a small country with only five emergency

department hospitals, an alternating 24

hour on duty system for three of those

hospitals as well as specialized medical

services only present in one hospital as a

national service. It has thus been decided,

4


after a pilot phase in 2011, to implement an

all hospitals all cases exhaustive injury

surveillance system with four MDS

hospitals and one FDS. A first non-

complete dataset could be delivered to IDB

in 2012 and recently exhaustive data for

2013 has been delivered together with an

estimation of HLA Incidence rate. A first

national report is being finalized mid-2014.

Such an extensive surveillance system

obviously bears a great burden of funding.

Thus finding partners and users for the

IDB data on the national level is one of the

main objectives for the years to come in

order to preserve this surveillance system. 3. Systematic ED based injury surveillance 3.1. Has specific injury surveillance been


2008-2010: No systematic injury surveillance system except for the IDB pilot project 2009 described in baseline questionnaire.

2011-2014: Uptake of an exhaustive all five hospitals all cases surveillance system with one FDS hospital, the others being at MDS level. HLA incidence calculation and provision of an exhaustive dataset to IDB for 2013. National report in progress.


All emergency department treated injury cases were included in the register in 2013. Out of the five hospitals in Luxembourg, one was

5


collecting data at FDS level and four at MDS level. Situated in the capital the FDS hospital is the national reference centre for neurosurgery, hand surgery and for paediatric. Anonymous unlinkable information is extracted form hospital electronic records. The necessary FDS information is based on the admission motif completed by nurses and descriptive texts completed by doctors, during anamnesis and clinical examination. Text data are later coded at FDS level. Icd-10 chapter 19 and 20 codes are used to select the cases and to complete data on injury circumstances, nature of injury and body part. The four MDS hospitals, (one in the north, one in the south and two in the central region have adapted their ED patient files in order to collect the necessary MDS data. The selection of cases is done at the triage. Data entry is done in a second stage in two MDS hospitals with paper and pencil patient files. Data extraction was performed in the two other MDS hospitals with electronic patient files. The system benefits from the guidance and support of a steering committee with members

6


from the Ministry of Health, the CRP-Santé and the Hospitals. (3 times per year). A monitoring procedure has been set up to improve the data quality. Data form all hospitals are merged and a national MDS data base is created. A national report is produced based on data of an entire year.


Initiative by the Ministry/Directorate of Health


Ministry/Directorate of Health


Centre de Recherche Public de la Santé, Centre d'Études en Santé Publique, 1A-B, rue Thomas Edison, L-1445 Strassen Luxembourg, Dritan Bejko


Yes


IDB-All injuries


Nurses and doctors interview patients

7



All 5 hospitals included


All cases within hospitals included


For two MDS hospitals with no electronic patient files in a first stage the paper/pencil system is used. Data entry is performed in a second stage. For the three other hospitals extraction of data from the electronic patient files is done.


Coherence checks. Descriptive text data included in the data base to check the coded variables and correct queries. Monitoring and retrospective evaluation by reviewing flies of all patients visiting the ED on randomly selected weekends and weekdays. Indicators are then calculated to determine the ability of the system to

a) identify each injury case and b) to correctly classify the data from each

case. 3.13. How many hospitals (ED) have been

involved in the last year? (Please provide a list of involved hospitals if possible, addresses and names of contact persons: link or attachment)

2010: - 2013: 5 Hospitals

8



2010: - 2013: N=61401


4-5 months (after the end of the year)


Yes. All ED treated injury cases included. For calculation of incidence rate the numerator was the registered number of home, leisure and school injury cases of residents for a specific age-group and sex included (x 1000). The denominator was the number of residents of same age-group and sex in 2013.


Yes, production in progress

3.18. Please describe briefly (500-700 words) current opportunities for optimizing the system (e.g. new IT developments, re-organisation of health information, demands for more effective prevention)

One major objective that is currently in progress is the informatisation of the 2 ED where data was collected by pen and paper as the recoding was too cost intensive. This initiative came from the 2 hospitals themselves and the NDA is supporting this development and adapting it to IDB needs. Training of hospital paramedical and medical staff has to be maintained and developed in order to enhance the data coding quality and to obtain a sustainable surveillance system. Especially the participation of medical staff could be improved locally. New partners for data use and dissemination

9


have to be identified and collaborations established in order to explore the full potential of this surveillance system and to make it sustainable. In this perspective, the first all year all cases results report being produced is a powerful tool to promote the surveillance system and its potential. Another interesting development that has to be followed closely is the initiative from the national consumer protection authority to introduce an injury surveillance system as a legally mandatory tool in its new governing law. Alongside similar efforts at EU level, this could be a major opportunity to establish the IDB-JAMIE surveillance as a continuous legally binding system.

3.19. Please describe briefly (500-700 words) challenges to the system (e.g. reorganization of lead agency, severe budget cuts, decisions on reducing the scope)

One of the major challenges of such an extensive and exhaustive system is its funding. The whole funding for the scientific development of the system, quality controls, training and data analysis is currently assured by the Ministry/Directorate of Health. Data collection is being done by hospital staff without any specific funding thus making their work burden even larger. The workload on both hospital and lead agency level is specifically high in those hospitals with a pen and paper system and cannot be continued. As the installation of an

10


electronic patient file and reporting system is well progressing, this will most likely only be temporary. In order to assure data collection and coding quality and to reduce the workload of the lead agency and thus the funding burden, qualified coding staff should be introduced on a permanent level in the FDS hospital as part of the medical documentation cell.




There is no such report since the last HLA-report from 2001 done under the EHLASS project. It is planned to produce such regular reports once the ED injury reporting system is fully implemented

Yes, report finalisation for 2013 in progress


Centre de Recherche Public de la Santé, Centre d'Études en Santé Publique, 1A-B, rue Thomas Edison, L-1445 Strassen Luxembourg, Dritan Bejko


probably in the Ministry of Health) for injury statistics, in particular on and home

Ministry of Health-Directorate of Health-Secrétariat Général Villa Louvigny

11


and leisure accidents? (please provide unit, addresses, name of responsible person)

Allée Marconi L-2120 Luxembourg Serge Krippler


Ministry of Health-Directorate of Health-Secrétariat Général Villa Louvigny Allée Marconi L-2120 Luxembourg Dr. Hansen-König, Director of Health


ILNAS 34-40, avenue de la Porte-Neuve L - 2227 Luxembourg (Lëtzebuerg)

ILNAS 1, avenue du Swing L-4367 Belvaux


Ministry of Health-Directorate of Health-Secrétariat Général Villa Louvigny Allée Marconi L-2120 Luxembourg M. Guy Weber STATEC- Division SOC statistiques sociales 13, rue Erasme L-1468 Luxembourg M. Paul Zahlen


12





Yes there is a formalized collaboration between the directorate of health and the national bureau of statistics

Yes there is a formalized collaboration between the directorate of health and the national bureau of statistics. There is also regular contact between the consumer protection authority and the Directorate of Health.


6. Signature 6.1. Place, date Luxembourg, 16.05.2011 Luxembourg,

6.2. Signature

6.3. Name, function Serge KRIPPLER Serge KRIPPLER

1


Country: MALTA


1. Respondent 1.1. Name, title Ms Audrey Galea 1.2. Function National Data Administrator 1.3. Affiliation, address Dept. of Health Information and Research

(DHIR) 95, G'Mangia Hill G'Mangia, PTA 1313 Malta

1.4. Tel-nr., e-mail-address 00356 25599 000 , [email protected] 1.5. Website http://www.gov.mt/frame.asp?l=1&url=http://

www.sahha.gov.mt/pages.aspx?page=41



The Department of Health Information and Research (DHIR) forms part of the Health

The Department of Health Information and Research (DHIR) forms part of the Ministry for

2



Division and falls under the Directorate of Strategy and Sustainability. It is responsible for the collection, analysis and delivery of health related information in Malta. It provides high quality epidemiological information and indicators on the health of the population and health services. Health information is made available to policy and decision makers, for the public in general, interested institutions and others that may require it.

The overall objectives of the DHIR are: To gather, analyse and disseminate

health information; To conduct epidemiological surveys

and maintain disease registers; To maintain and develop the range of

services and products that the department produces, ranging from reports to requests for customised information, accurately and in a timely manner;

To co-ordinate and prepare reports identifying issues, problems, unmet needs and service gaps, and recommend initiatives, review of policies, and amendments to procedures and programmes as

Energy and Health and falls under the Office of the Chief Medical Officer. It is responsible for the collection, analysis and delivery of health related information in Malta. It provides high quality epidemiological information and indicators on the health of the population and health services. Health information is made available to policy and decision makers, for the public in general, interested institutions and others that may require it.

The overall objectives of the DHIR are: To gather, analyse and disseminate

health information; To conduct epidemiological surveys

and maintain disease registers; To maintain and develop the range of

services and products that the department produces, ranging from reports to requests for customised information, accurately and in a timely manner;

To co-ordinate and prepare reports identifying issues, problems, unmet needs and service gaps, and recommend initiatives, review of policies, and amendments to procedures and programmes as required;

3


required; To develop the infrastructure needed

for the provision of non-expenditure data for the System of Health Accounts;

To promote and carry out research; To communicate relevant results and

reports from the above initiatives to stakeholders and the public.

DHIR is responsible for the management of national health datasets on mortality, cancer, congenital anomalies, organ transplant, obstetrics, hospitals information system and accidents and injuries as well as for a number of other databases on health service activity.

DHIR having such responsibilities enables better dissemenination of injury data thus making it possible for more specific injury prevention campaings and strengthing liason with Malta Standards Authority regarding product safety.

To develop the infrastructure needed for the provision of non-expenditure data for the System of Health Accounts;

To promote and carry out research; To communicate relevant results and

reports from the above initiatives to stakeholders and the public.

DHIR is responsible for the management of national health datasets on mortality, cancer, congenital anomalies, organ transplant, obstetrics, hospitals information system and accidents and injuries as well as for a number of other databases on health service activity.

DHIR having such responsibilities enables better dissemenination of injury data thus making it possible for more specific injury prevention campaings and strengthing liason with Malta Standards Authority regarding product safety.


pursued in EDs in past three years – e.g. with focus on home and leisure accidents, external causes of injuries, or product related injuries? (e.g. IDB, EHLASS, EPAC,

2008-2010: Yes. From one public hospital and including all injuries. Data for IDB is collected from Gozo General Hospital is paper based.

2011-2014: From 2013 data is being collected from the two public hospitals on the Maltese islands . Gozo General Hospital is paper based whilst

4


LIS, AWISS) Matere Dei Hospital in Malta data is transferred electronically.

3.2. If yes: Please describe briefly the system

(500 – 700 words) Data from the A & E Department in Gozo

General Hospital (GGH) is collected on a

specific form specifically designed by DHIR

which included the minimum data set of

information requested by DG SANCO.

The form is subdivided into the following

sections:

patient demographics (patient’s personal details)

date and time of injury and of patient’s presentation at A & E

place of accident cause of accident motor vehicle accident information

(type of vehicle/s involved, counterparts and whether patient was driver/passenger/pedestrian)

activity (patient’s activity during injury)

part of body injured type of injury objects involved (direct and indirect) accident description intent (accidental or intentional) treatment and follow-up.

Data from the A & E Department in Gozo

General Hospital (GGH) is collected on a

specific A & E form. Patient Demographics are

filled in by the officer at the reception area

whilst medical details are compiled by the

nursing officer. These forms are then

forwarded to DHIR on a monthly basis.

Very often data derived from these forms do

not disclose important items such as place of

accident, activity when injured and external

causes (objects involved) rendering such data

very much incomplete.

Data for Malta from Mater Dei Hospital is

forwarded in excel format and uploaded in a

specifically designed data mining software to

identify the injuries.

Injury records for Gozo General Hospital and

Mater Dei Hospital are coded against the IDB-

All Injuries Coding Manual Data Dictionary

and data captured into the main database at

5


The user of the form is only asked to tick the

information required, apart from a few sections

which require very short texts. This was

designed in such a way so as to facilitate the

filling up of the form, to render the information

more specific and clear and also not to increase

the workload of the nurse/doctor in

attendance.

A patient presenting with an injury would

have a form filled by the responsible staff,

usually, a nurse. Completed forms are then

forwarded to DHIR on a monthly basis where

they are coded against the IDB-All Injuries

Coding Manual Data Dictionary. All data is

then entered into the main database at DHIR.

Data is kept in accordance with the Data

Protection Act, 2001. This allows an effective

cross-link with hospital discharge registers and

national mortality register in order to avoid

duplications, to verify length of stay and

death-related injuries and detect injuries

bypassing emergency departments. Data is

validated on a yearly basis.

DHIR.

All records are cross linked with the Hospital

Discharge Register and the National Mortality

Register.

Data is kept in accordance with the Data

Protection Act, 2001. This allows an effective

cross-link with hospital discharge registers and

national mortality register in order to avoid

duplications, to verify length of stay and

death-related injuries and detect injuries

bypassing emergency departments. Data is

validated on a yearly basis.

6


At present data from GGH is no longer compiled by in-hospital staff but a an employee from DHIR collects data personally from the A & E register. This has resulted in a wider capture of data compared to that put on the actual form itself. However data derived from the register did not disclose important items such as place of accident, activity when injured and external causes (objects involved) rendering such data very much incomplete.


Initiative taken by the DHIR in support of the European Injury Surveillance system.


The Public Service.


Dept. of Health Information and Research (DHIR) 95, G'Mangia Hill G'Mangia, PTA 1313 Malta


Yes

3.7. Which coding system (for external causes) is used in the ED based monitoring? (e.g. only 2-digits V01-Y98 of ICD-10, IDB-All

IDB-All injuries

7


injuries, ICECI, NOMESCO) 3.8. Who actually collects the data in hospitals?

(e.g. patients fill in forms, nurses or doctors interview patients)

Nurses


No sampling.



Gozo General Hospital – paper based Mater Dei Hospital – electronic capture, using a data mining system.


Software queries (excel and manual)


2010: 1 hospital – Gozo General Hospital 2013: 2 hospitals – Gozo General Hospital and Mater Dei Hospital


2010: 3, 248 from Gozo General Hospital only. 2013: 28, 067 from Gozo General Hospital and Mater Dei Hospital.


7 months. Depends on crosslinks with National Death Register and Hospital Activity Analysis

3.16. Were (national) incidence rates for NA

8




NA.


Implementation of new software

The piloting of new data mining software is currently way. The ultimate aim of this software is to facilitate the processing of data from ED at Mater Dei Hospital. All data (approx 10,000 records per month) from ED is transferred in excel format on a monthly basis to DHIR. for facilitating data from MDH. It would have been practically impossible for staff at MDH to compile IDB forms as the amount would be too much to deal with. Undertaking the task by DHIR staff to eliminate cases not pertinent to IDB would have been unfeasible due to the low level of human resources. User focus – This relates to motivational factors whilst drawing in all stakeholders in order that they start owning the system. This would mainly involve acknowledging the users role as a participant and partaker in the collection of data. The importance and relevance of users’

Implementation of new software

The new data mining software is currently working and has proved to be an ideal tool to increase efficiency. Work is still underway to compile the data dictionary and the software still needs some minor amendments.

9


input are highlighted in order to emphasise ownership of the system. Such training sessions provide opportunities to instil confidence and acquire competence to execute the data compilation correctly. Networking with main stakeholders

The opportunity to work in conjunction with other entities is to be explored once data from major hospitals is collated. Such networking would have a beneficiary impact at national level as prevention and consumer safety would be streamlined and relevant information would be shared appropriately and to the level required to maximise efficiency.


Lack of IDB staff at DHIR to process all the data. DHIR only employs two of its personnel on a part-time basis to deal with the processing of data coming from GGH and as from this year from MDH. It is thought that this current status would persist at least in the foreseeable future. Reluctance by data collectors from EDs to provide

data in complete form. Respective personnel at ED who are responsible for compiling relevant data tend to omit certain fields which form part of the minimum data set for IDB. They feel that this

Lack of IDB staff at DHIR to process all the data

DHIR has added one full timer to the two previous part-time employees. Respective personnel at ED who are responsible for compiling relevant data tend to omit certain fields which form part of the minimum data set for IDB. They feel that this

10


is time consuming due to work overload. Though the situation has been slightly alleviated at GGH due to additional help from the DHIR itself, permanent personnel at the ED do not yet appreciate the need for such surveillance. Data collected is not put to immediate use. Stakeholders like Malta Standards Authority and Health Promotion cannot use IDB data due to it incompleteness from data sources as they deem that data collected at GGH still lacks completeness for their relative use. One hopes that, with the inclusion of the other main hospital, MDH, the client base shall improve its trust and, consequently, its use. Inexistent lobbying for a legal base

A form of legal basis which would provide mandatory basis for such data to be collected in its completeness and entirety is needed. This would be possible in Malta if IDB is included as one of the registers backed by the Public Health Act thus making injuries to be legally notifiable in the same way as other data for infectious diseases, occupational health and safety, cancers and deaths. Stakeholders like Malta Standards Authority, Transport Malta and National Statistics Office, apart from DHIR

is time consuming due to work overload. Personnel at the ED do not yet appreciate the need for such surveillance. Stakeholders like Malta Standards Authority Health Promotion and Commission for Domestic Violence cannot use IDB data due to it incompleteness from data sources as they deem that data collected at GGH still lacks completeness for their relative use. One hopes that, with the inclusion of the other main hospital, MDH, the client base shall improve its trust and, consequently, its use. A form of legal basis which would provide mandatory basis for such data to be collected in its completeness and entirety is needed. This would be possible in Malta if IDB is included as one of the registers backed by the Public Health Act thus making injuries to be legally notifiable in the same way as other data for infectious diseases, occupational health and safety, cancers and deaths. Stakeholders like Malta Standards Authority, Transport Malta, Commission for Domestic Violence and

11


can be roped in to make a stronger case. National Statistics Office, apart from DHIR can be roped in to make a stronger case.



https://ehealth.gov.mt/HealthPortal/chief_medical_officer/healthinfor_research/registries/injuries.aspx


Comprehensive reporting is done for Deaths, Occupational Health and Safety for workplace, Police for road and traffic accidents and National Statistics Office.




Dept. of Health Information and Research (DHIR) 95, G'Mangia Hill G'Mangia, PTA 1313 Malta





12




Malta Competition and Consumer Affairs

Authority

Evans Building,

2nd Floor, Merchants Street,

Valletta VLT1179

Malta


Dr. Neville Calleja, Director Dept. of Health Information and Research (DHIR) 95, G'Mangia Hill G'Mangia, PTA 1313 Malta


No


No


Department of Health Promotion & Disease Prevention The Emporium, 5B, C. DE BROCKTORFF Street

Department of Health Promotion & Disease Prevention The Emporium, 5B, C. DE BROCKTORFF Street

13


Msida Malta Department of Environmental Health Ministry for Energy and Health 15 Merchants Street Valletta VLT 2000 Malta

Msida Malta Department of Environmental Health Ministry for Energy and Health 15 Merchants Street Valletta VLT 2000 Malta Commission for Domestic Violence Ministry of Justice, Dialogue and the Family Palazzo Ferreria Republic Street Valletta


Yes, with the National Mortality Register and the Hospital Discharge Register.

Yes, with the National Mortality Register and the Hospital Discharge Register and Commission for Domestic Violence.


No

6. Signature 6.1. Place, date 16.05.2011 09/07/2014

6.2. Signature

14

6.3. Name, function Audrey Galea Audrey Galea

1


Country: NETHERLANDS


1. Respondent 1.1. Name, title Anneke Bloemhoff, Msc Huib Valkenberg, Msc 1.2. Function Researcher 1.3. Affiliation, address Consumer Safety Institute

Rijswijkstraat 2, 1059 GK Amsterdam, NL PO Box 75169, 1070 AD Amsterdam, NL

1.4. Tel-nr., e-mail-address +31 71 5114518; [email protected] +31 71 5114598; [email protected] 1.5. Website www.veiligheid.nl 2. Focus of your institution in injury

monitoring


The goal of the Consumer Safety Institute is to improve safety within society by reducing the number of injuries resulting from accidents. The Consumer Safety Institute focuses on

2


plan to do it serious accidents, because – in addition to causing a great deal of suffering – they result in high medical costs. The Consumer Safety Institute’s Dutch Injury Surveillance System continually monitors developments relating to accidents and injuries in the Netherlands. The Dutch Injury Surveillance System plays an important and unique role in collecting epidemiological accident data (scale, seriousness, costs and factual information about accidents). This makes it the most important source of information for injury prevention policy in the Netherlands. The Dutch Injury Surveillance System is used to register information on patients attending the Emergency Department (ED) of a hospital. The Consumer Safety Institute uses this information to identify high-risk groups and risk factors and to set priorities in problem areas, ultimately resulting in preventive measures. The Dutch Injury Surveillance System is also important in terms of estimating and monitoring the possible effects of measures. The main purpose of the accident data is to support policy designed by the Ministry of Health, Welfare and Sport to increase safety in the home and leisure activities. Other Ministries and organisations

3


also make use of the data, including the Ministry of Transport, Public Works and Water Management, the Ministry of Social Affairs and Employment, local government bodies, research institutes, universities, businesses, the European Commission and of course the Consumer Safety Institute itself. The Dutch Injury Surveillance System provides the participating hospitals with management information regarding their EDs. Alongside information about the background to accidents, ED staff also record personal and admission details and information regarding the diagnosis, the treatment and the discharge of patients. The uniform registration of information by the participating hospitals enables comparisons to be made between hospitals. The Consumer Safety Institute makes this so-called benchmark information available to the participating hospitals. The benchmark information shows, for example, whether the duration of treatments or the waiting times differ from those in other hospitals.


pursued in EDs in past three years – e.g. with focus on home and leisure accidents,

2008-2010: Yes 2011-2013: Yes

4


external causes of injuries, or product related injuries? (e.g. IDB, EHLASS, EPAC, LIS, AWISS)


Dutch Injury Surveillance System. Twelve hospitals participating in the Dutch Injury Surveillance System form a random sample of general and university hospitals in the Netherlands. This random sample can be used to make reliable estimates regarding the total number of cases treated in EDs as a result of accidents throughout the Netherlands. A standard set of variables and code lists has therefore been devised. This is divided into two groups: basic data and injury event information. Basic data

Basic data includes personal information and information relating to arrival, diagnosis, treatment and discharge. This includes registration of information such as the time of arrival at the ED and the time of discharge. Basic data of this kind is recorded for all patients.

Injury event information

In addition to the basic data, injury event information is also recorded for patients

Fourteen hospitals participating in the Dutch Injury Surveillance System form a random sample of general and university hospitals in the Netherlands.

5


with an injury or symptoms of poisoning. This information provides data relating to the cause of the accident and the circumstances under which it occurred. Injury event information is divided into modules. There are modules for home and leisure, sports, traffic and occupational accidents, as well as for injuries resulting from violence and self-mutilation. Every module includes questions specifically related to the particular module. Every hospital has its own method for collecting the information that is registered in the Dutch Injury Surveillance System. In consultation with the Consumer Safety Institute, the registration is integrated into the daily activities of the ED to the greatest possible extent. In general, most hospitals work as follows: When a patient reports to the ED, the receptionist fills in an ED form for the hospital’s administrative records. Usually this is entered into the Hospital Information System (HIS). If the patient has an injury or displays symptoms of poisoning, injury event information will also be noted. In the course of treating the patient, hospital staff members also record information regarding the treatment and add additional details to

6


the event information. Discharge information is also registered. Hospitals can record the required information in various ways. If the hospital has a Hospital Information System (HIS) into which the Dutch Injury Surveillance System is integrated, the relevant data can be entered directly into the HIS. Information already entered into the HIS does not need to be entered again. Hospitals that do not use the so-called ISSHIS system (the Dutch Injury Surveillance System combined with the Hospital Information System) can make use of stand-alone ISS software. This software was developed by the Consumer Safety Institute and is based on Lotus Notes. It is also possible to export data from the HIS, which can in turn be imported into the Dutch Injury Surveillance System and added to. The hospitals send the entered data to the Consumer Safety Institute electronically. The name, address and any other information that may identify a patient is not included, thereby ensuring that the Dutch Injury Surveillance System complies with the regulations of the Personal Data Protection Act . At Consumer Safety Institute, the data

7


is recorded in a central database, which is used for statistical analyses. The data entered into the Dutch Injury Surveillance System is checked in various ways to safeguard the quality of the information.


No formal status. Initiative of Consumer Safety Institute, endorsed by the Ministry of Health. Hospitals participate on voluntary basis. CSI has contracts with each participating hospital.


Main funding by the Ministry of Health. Funding for data with respect to traffic accidents by the Ministry of Transport


Consumer Safety Institute Rijswijkstraat 2, 1059 GK Amsterdam, NL PO Box 75169, 1070 AD Amsterdam, NL Mr. Hidde Toet, Msc


Yes. Responsible organisation.


DISS coding system, (almost completely) compatible with IDB All Injuries


Every hospital has its own method for collecting the information that is registered in the Dutch Injury Surveillance System. In

8


consultation with the Consumer Safety Institute, the registration is integrated into the daily activities of the ED to the greatest possible extent. In general, most hospitals work as follows: When a patient reports to the ED, the receptionist fills in an ED form for the hospital’s administrative records. Usually this is entered into the Hospital Information System (HIS). If the patient has an injury or displays symptoms of poisoning, injury event information will also be noted. In the course of treating the patient, hospital staff members also record information regarding the treatment and add additional details to the event information. Discharge information is also registered.


Hospitals participate voluntarily. We try to include in the sample large and small hospitals, rural and urban, academic and general hospitals and as much as possible different geographical areas in the country. Based on research we conclude that the sample is relatively representative for common accidents. We do not report about accidents with too small numbers.

3.10. How is the sampling of cases within hospitals been done (How was the representativeness of the samples in

No sampling. All injury cases, 24x7.

9


hospitals ensured)? 3.11. How is data entry been done?


Hospitals can record the required information in various ways. If the hospital has a Hospital Information System (HIS) into which the Dutch Injury Surveillance System is integrated, the relevant data can be entered directly into the HIS. Information already entered into the HIS does not need to be entered again. Hospitals that do not use the so-called ISSHIS system (the Dutch Injury Surveillance System combined with the Hospital Information System) can make use of stand-alone ISS software. This software was developed by the Consumer Safety Institute and is based on Lotus Notes. It is also possible to export data from the HIS, which can in turn be imported into the Dutch Injury Surveillance System and added to. The hospitals send the entered data to the Consumer Safety Institute electronically.


See chapter 2.3 in the LIS Factsheet for all quality measures.

3.13. How many hospitals (ED) have been involved in the last year? (Please provide a list of involved hospitals if possible, addresses and names of contact persons:

2010:

- Streekziekenhuis Koningin Beatrix;

2013:

- Streekziekenhuis Koningin Beatrix;

10


link or attachment) Winterswijk

- VU medisch centrum; Amsterdam

- Diaconessenhuis; Meppel

- Canisius-Wilhelmina Ziekenhuis;

Nijmegen

- UMC Nijmegen St. Radboud; Nijmegen

- Sint Jans Gasthuis; Weert

- Ziekenhuis Lievensberg; Bergen op Zoom

- Ziekenhuis Gelderse Vallei; Ede

- Academisch Medisch Centrum;

Amsterdam

- Maasziekenhuis Pantein; Boxmeer

- IJsselmeerziekenhuizen, Zuiderzee

hospital; Lelystad

- Sint Lucasziekenhuis; Winschoten

- Delftzicht ziekenhuis; Delfzijl

Winterswijk

- VU medisch centrum; Amsterdam

- Diaconessenhuis; Meppel

- UMC Nijmegen St. Radboud; Nijmegen

- Sint Jans Gasthuis; Weert

- Ziekenhuis Lievensberg; Bergen op Zoom

- Ziekenhuis Gelderse Vallei; Ede

- Academisch Medisch Centrum;

Amsterdam

- Maasziekenhuis Pantein; Boxmeer

- IJsselmeerziekenhuizen, Zuiderzee

hospital; Lelystad

- Ommelander ziekenhuis Groep locatie

Lucas ; Winschoten

- Ommelander ziekenhuis Groep locatie

Delfzicht; Delfzijl

- Admiraal De Ruyterziekenhuis; Goes

- Admiraal De Ruyterziekenhuis;

Vlissingen

11


3.14. Approx., how many cases have been collected in the last year (2010)?

2010: 100.000 cases 2013: 90.000 cases


On average the final data are ready for analysis (including extrapolation factor for national figures) in September after the year of data collection.


See for method chapter 3.1 of the LIS factsheet. Latest national incidence figure for home, leisure and school injuries: 470.000 injuries that needed ED attendance (2005-2009)


http://www.veiligheid.nl http://www.veiligheid.nl/cijfers/prive-ongevallen http://www.veiligheid.nl/onderzoek/cijfers-over-sportblessures http://www.veiligheid.nl/cijfers/arbeidsongevallen

http://www.veiligheid.nl http://www.veiligheid.nl/cijfers/prive-ongevallen http://www.veiligheid.nl/onderzoek/cijfers-over-sportblessures http://www.veiligheid.nl/cijfers/arbeidsongevallen


The automation of processes within hospitals, including EDs, is proceeding rapidly. The number of ED-specific modules of hospital information systems that are available on the market is steadily increasing. Suppliers of Hospital Information Systems are also catering to the growing need for the registration of data for

http://www.veiligheid.nl/cijfers/prive-ongevallen

http://www.veiligheid.nl/cijfers/prive-ongevallen

12


reasons that include diagnosis and treatment combinations and the records required by health insurers. Hospitals place great value on recording all data only once in order to keep administrative costs as low as possible. It is vital that the Dutch Injury Surveillance System caters to these developments to ensure its continued existence. Accordingly, the Consumer Safety Institute is working on the implementation of other methods of collecting data. The Consumer Safety Institute is working together with several HIS suppliers in order to include Dutch Injury Surveillance System registration in their ED modules. By making these investments the Consumer Safety Institute hopes to ensure that hospitals that currently participate in the Dutch Injury Surveillance System will continue to do so in the future. In cooperation with other organizations, the Consumer Safety Institute is also investigating whether hospital databases, including the Dutch Injury Surveillance System, can be linked together or combined. The National Bureau of Statistics will link DISS in 2011 at a case by case basis with census data which provides additional information on the injury patients (e.g.

13


income, education level, social gradient, occupation, health status, use of drugs etc). In 2010 CSI started a research into automatic text recognition in the narrative texts. The aim is to minimise data entry and coding of data by hand.

- 3.19. Please check what has been done with

the challenges you identified earlier in 2011. Please describe briefly (500-700 words) challenges to the system (e.g. reorganization of lead agency, severe budget cuts, decisions on reducing the scope)

From 2012 onwards CSI faces a budget cut from the Ministry of Health, the main funder of DISS. This poses a thread to the funding of DISS. Participation in the national hospital discharge information system is voluntary for hospitals. The funding of this system is also decreasing. The participation of hospitals in this sytem is decreasing, which poses a thread to the reliability of the data and to the calculation of the extrapolation factor for ED cases

Number of hospitals is increased to fourteen in 2012.



4.2. Is there a comprehensive reporting on accidents/injuries available, comprising home, leisure, road, and workplace injuries at various levels of severity (deaths, hospitalizations, ambulatory treatments) – or is there any intention to produce such report? (Please provide link to the website

http://www.veiligheid.nl/ongevalcijfers/algemeen-overzicht http://www.veiligheid.nl/overig/FA04BAAC6FB004ECC125788B006C3A75/$file/Factsheet%20vgl%20uitw%20oorzaken%202005-2009%20incl%20tabellen.pdf

http://www.veiligheid.nl

14


or attach the report)


Consumer Safety Institute Ms Christine Stam



Ministerie van Volksgezondheid, Welzijn en Sport Directie Voeding, Gezondheidsbescherming en Preventie drs. Noorlander, T. (Therese) Postbus 20350 2500 EJ DEN HAAG 070 340 79 11 070 340 69 41 Ministerie van Volksgezondheid, Welzijn en Sport Directie Sport drs. Koornneef, M. (Maarten) Postbus 20350 2500 EJ DEN HAAG 070 340 7911 070 340 63 78

Ministerie van Volksgezondheid, Welzijn en Sport Directie Voeding, Gezondheidsbescherming en Preventie Maurice Nijstad Postbus 20350 2500 EJ DEN HAAG 070 340 79 11 Ministerie van Volksgezondheid, Welzijn en Sport Directie Sport Jasmijn Willemsen Postbus 20350 2500 EJ DEN HAAG 070 340 7911


Ministerie van Volksgezondheid, Welzijn en Sport Directie Voeding, Gezondheidsbescherming en Preventie

Ministerie van Volksgezondheid, Welzijn en Sport Directie Voeding, Gezondheidsbescherming en Preventie

15



drs. Noorlander, T. (Therese) Postbus 20350 2500 EJ DEN HAAG 070 340 79 11 070 340 69 41 Ministerie van Volksgezondheid, Welzijn en Sport Directie Sport drs. Koornneef, M. (Maarten) Postbus 20350 2500 EJ DEN HAAG 070 340 7911 070 340 63 78 Ministerie van Volksgezondheid, Welzijn en Sport Directie Sport drs. Koornneef, M. (Maarten) Postbus 20350 2500 EJ DEN HAAG 070 340 7911 070 340 63 78

Maurice Nijstad Postbus 20350 2500 EJ DEN HAAG 070 340 79 11 Ministerie van Volksgezondheid, Welzijn en Sport Directie Sport Jasmijn Willemsen Postbus 20350 2500 EJ DEN HAAG 070 340 7911 Ministerie van Volksgezondheid, Welzijn en Sport Directie Sport Jasmijn Willemsen Postbus 20350 2500 EJ DEN HAAG 070 340 7911


nieuwe Voedsel en Waren Autoriteit Bureau Risicobeoordeling en Onderzoeksprogrammering dr.ir. Aken, D. van (Dirk) Postbus 19506 2500 CM DEN HAAG 070 448 4848

nieuwe Voedsel en Waren Autoriteit Bureau Risicobeoordeling en Onderzoeksprogrammering Postbus 19506 2500 CM DEN HAAG [email protected], 0900-0388


16



Centraal Bureau voor de Statistiek

T.a.v. Centrum voor Beleidsstatistiek

Postbus 24500

2490 HA Den Haag

Tel. (070) 337 47 92

[email protected]

Accountmanager: N. Sluiter (Nicol) 070-

3374792 [email protected]

Hospital Discharge Statistics: A.. Bruin (Agnes) [email protected] 070 3375299

Centraal Bureau voor de Statistiek

T.a.v. Centrum voor Beleidsstatistiek

Postbus 24500

2490 HA Den Haag

Tel. (070) 337 47 92

[email protected]


Rijksinstituut voor Volksgezondheid en Milieu (RIVM) Centrum voor Volksgezondheid Toekomst Verkenningen (cVTV) Postbus 1, 3720 BA Bilthoven Contact Person Care atlas: H. Giesbers (e-mail:

[email protected])

Contact person National Compass: (e-mail: [email protected]


Consumer Safety Institute Rijswijkstraat 2, 1059 GK Amsterdam, NL PO Box 75169, 1070 AD Amsterdam, NL

5.7. Is there any (other) relevant institute with Nederlands Instituut voor Sport en Bewegen Nederlands Instituut voor Sport

http://www.rivm.nl/over-rivm/organisatie/vz/vtv/index.jsp

mailto:[email protected]?subject=H.%20Giesbers:%20Gezondheidsproblemen%20

mailto:[email protected]?subject=Dr.%20P.E.D.%20Eysink:%20Letsels%20en%20vergiftigingen

17


research interest in home and leisure injury prevention? (If yes, please provide unit, addresses, name of responsible person)

NISB drs. Boer, R. (Remco) Postbus 643 6710 BP EDE 0318 49 09 00 06 21 64 95 78 www.nisb.nl GGD Nederland Commandeur, S. (Sylvia) Postbus 85300 3508 AH UTRECHT (030) 2523004 www.ggd.nl W.J.H. Mulier Instituut Centrum voor sociaal-wetenschappelijk sportonderzoek Herculesplein 269 3584 AA Utrecht 030721 www.mulierinstituut.nl Centrum Criminaliteitspreventie Veiligheid (CCV) Vor, G. de (Goof) Postbus 14069 3508 SC UTRECHT 030 751 6777

en Bewegen NISB Postbus 643 6710 BP EDE 0318 49 09 00 www.nisb.nl GGD Nederland Postbus 85300 3508 AH UTRECHT (030) 2523004 www.ggd.nl W.J.H. Mulier Instituut Centrum voor sociaal-wetenschappelijk sportonderzoek Herculesplein 269 3584 AA Utrecht 0307210220 www.mulierinstituut.nl Centrum Criminaliteitspreventie Veiligheid (CCV) Postbus 14069 3508 SC UTRECHT 030 751 6777 www.hetccv.nl TNO Kwaliteit van Leven, Gortergebouw

18


www.hetccv.nl TNO Kwaliteit van Leven, Gortergebouw Healthy for Life dr. Meeteren, N.L.U. van (Nico) Postbus 2215 2301 CE LEIDEN 088 866 90 00 088 866 62 60 www.tno.nl

Healthy for Life Postbus 2215 2301 CE LEIDEN 088 866 90 00 www.tno.nl


NO


NO

6. Signature 6.1. Place, date Amsterdam. May 30, 2011 Amsterdam. July 17, 2014

6.2. Signature

6.3. Name Anneke Bloemhoff Huib Valkenberg

1


Country: NORWAY


1. Respondent 1.1. Name, title Johan Lund, dr. philos. 1.2. Function Senior advisor 1.3. Affiliation, address Norwegian Safety Forum. PO Box 2473 Solli, NO-0202

Oslo, Norway

1.4. Tel-nr., e-mail-address +47 9575 9850, [email protected]

1.5. Website www.skafor.org 2. Focus of your institution in injury

monitoring

The Norwegian Safety Forum (NSF) is designed to provide

information on all aspects of injuries and safety, and to

promote co-operation between business, public sector and

non-governmental organizations. NSF is an NGO working


2

on an agreement (also financial) between the Norwegian

Insurance Association and the Ministry of Health. NSF is

mainly working on the area for home and leisure accident,

since existing NGO’s in Norway are working on traffic and fire safety, and one NGO partly working on

occupational injuries. But NSF is also working on getting

an overview over the whole injury field with regard to

statistics, since no institution in Norway is working on this

since 2003.

The Forum does not themselves register accident and

injury data or do research on such data, but aims at

promoting other relevant institutions to collect such data.

The Forum also focuses on the need of knowledge and the

importance of sound data bases on accidents and injuries

and updated statistics, as well as research on methodology

so that future plans of action can be based on knowledge

of the present situation and knowledge about what

activities incitements that gives the best results.

During the years 1990-2002 national statistics on all types

of accidents and injuries was published from the National

Institute of Public Health in Norway. The base for the

statistics was a national injury register. It was a sample

register, covering about 7 % of the Norwegian population

and based on registration of in- and out patients in four

3

hospitals in Norway, in the towns of Harstad, Trondheim,

Stavanger and Drammen. This register was established at

the National Institute of Public Health in 1990, after a

development period of five years. It was, however, closed

down in 2003, mainly due to financial constraints.

NSF has done quite a lot of advocacy in order to

reestablish sound injury registers in the health sector after

the close down of the National Patient Register (NPR).

Those advocacy activities contributed to that a new

National Injury Register as a part of the National Injury

Register are now been established in 2009. All Norwegian

hospitals shall register a minimum data set on all injury in-

and out-patients during the routine without extra funding.

(A report on the new Norwegian Injury register and

comparison between the MDS in NISS and EU-IDB is

enclosed – NISS will in this survey be called NIR) The

implementation of this register takes more time than

expected due to delays in the development of the software

necessary to register and send these data to NPR. For the

time being, only a handful of the Norwegian hospitals are

sending the data to NPR. It is expected that all hospitals

will register the MDS during 2012, making it possible to

publish national injury statistics for in- and outpatients in

2012.

A misprint in the left column: The register that was closed down was the National Injury Register. The National Patient register was and is still working. And also here: The new National Injury Register established in 2009 is a part of the National Patient Register. In all hospitals in Norway it is mandatory to register a MDS on all injuries treated, both as in- and out-patients. During the years 2011-2014 the Ministry of Helth and the Directorate of Health has been working on getting the NIR to be more complete on collecting this Minimum Data Set (a bit more comprehensive then the IDB MDS) . A working group is established, visits to hospital units are done, autumn 2014 will the rest of all the 24 units be visited. Responsible persons at each hospital will during autumn 2014 be appointed

4

NSF has their webpages (www.skafor.org) where also accident and injury data are shown. For the time being only data on injury and accident mortality is shown (http://www.skafor.org/no/hoved/skadedata/oversikter/), however only in Norwegian. It is an aim these pages also will include also data on injury morbidity when the new National Injury Register are able to produce valid statistics on all types of injury and accidents treated as in-and out-patients in the Norwegian hospitals

to assure continous follow-up of the regsitration completeness and quality of the data in all hospitals. To get such a MDS-system working in the routine of all hospitals, it is necessary with contious follow-up, information and motivation work, qulity controls and feed-back to the hospitals together with data deliveries to central and local authorities on injury prevention. In the national report (ref 4.1. below) made for data registered during 2013, 303078 unique injuries were recorded treated in all Norwegian hospitals (in- and outpatients) according to ICD10, ch. 19. Of these, 110 871 (36 %) had been recorded also with the injury MDS. (See also section 4.1 below)

3. Systematic ED based injury surveillance

This section (3) is describing the activities in Noway related to collection of FDS.

This section (3) is describing the activities in Noway related to collection of FDS.

3.1. Has specific injury surveillance been pursued in EDs in past three years – e.g. with focus on home and leisure accidents, external causes of injuries, or product related injuries? (e.g. IDB, EHLASS, EPAC, LIS, AWISS)

2008-2010: In three hospitals in the north of Norway, injury and accident data are registered for both in- and out-patients these years, for all injuries. Involved products are registered.

2011-2014: These three hospitals have recorded the Full Data Set (FDS) in these years, except that one of them terminated the registration from January 2014.


This system is the same as the National Injury Register at

the National Institute of Public Health in the years 1990-

http://www.skafor.org/

http://www.skafor.org/no/hoved/skadedata/oversikter/

5

2002, where Harstad hospital was one of four participating

hospitals. The registration has continued at Harstad

hospital mainly based on local funding. The person in

charge of this system is professor Børge Ytterstad, who

also now is affiliated to the University of Tromsø and the

University hospital in North of Norway, where Harstad

hospital is participating. At this hospital there has been

recording of accident and injury data since 1985, i.e. more

than 25 years with the same methodology. The detailed

NOMECO classification is used, including about 1000

codes for products.

He managed to include the same injury registration

system in two other hospitals in the towns of Hammerfest

(from 2003) and Narvik (from 2006). When patients arrive

at the hospitals, a paper form is filled by the patient himself.

If he/she is not able to fill in the form, help from

nurses/administrative personnel is given. At this form, the

patients answer questions about when, where and how,

together with a short description of the incident. This form

is following the patient when treated by the doctor, who

fills in severity (AIS), intent and diagnosis.

Special trained personnel codes the information according

to NOMESCO and transfer the data to the computer.

6

Each year about 7000 injuries are registered in the system:

Harstad 3600, Narvik 2500 and Hammerfest 1000.

3.3. What is the formal status of this

monitoring system? (e.g. based on law, implementation regulation, guideline, initiative by an authority, private initiative)

Private initiative, but in agreement with the hospitals.


There are some funding coming from the University Hospital of North of Norway


These are both in- and out patients. Responsible person is Børge Ytterstad, University of Tromsø, NO-9037 Tromsø


No, not directly. However, we have discussed with prof. Ytterstad about how we might get this access. This is not yet solved.

We got a file with 1000 injuries. However, the format of the file was different to our format and for the time being, not possible to translate.


NOMESCO-classification


Mainly patients fill in the form, evt. with help of nurses/administrative persons. Doctors are filling in medical data.


No sampling was done.

7


All injured patients arriving the hospitals are been registered.


Paper forms transferred to computers by special software.


No information about quality control is been given.


2010: Three hospitals, the contact person is professor Børge Ytterstad, see 6.5

2013: 3 hospitals


2010: About 7000 2013: About 7000



No


No national report on this as is a regional project.

3.18. Please describe briefly (500-700 The system is now paper-based. It might be developed to It is proposed that there should be 4-5

8

words) current opportunities for optimizing the system (e.g. new IT developments, re-organisation of health information, demands for more effective prevention)

be an integral part of the hospital record. Due to the rather high amount of registered data, it will be necessary in Norwegian hospitals to have extra registration resources (compared with the MBS in NIR that shall be registered in the routine without extra registration resources).A future model might be to have 4-6 hospitals in Norway (so representative as possible) registering this amount of injury and accident data (corresponding to the full NOMESCO classification. However, to fully understand the incidences in order to design preventive means, there is a need for in-depth investigations, e.g. to make telephone interviews to a ab. 50-100 persons having had an accident or injury that it put on the agenda for prevention. Such in-depth investigations (questionnaires with 2-4 pages) have been tested, and are possible to carry out in the health system, however require fundings for being made.

hospitals in Norway financed by the governement to collect a FDS and to carry out periodic in- depth investigations. However, due to financial and personell constraints, the focus from the authorities is to get the MDS-system working satisfactorilly (see section 4 below), before starting on a FDS- system.

3.19. Please describe briefly (500-700 words) challenges to the system (e.g. reorganization of lead agency, severe budget cuts, decisions on reducing the scope)

This registration system is vulnerable due to not fully integrated in the health system. There should be a development that it will be a part of the new National Injury Register. Later in this survey, it is referred to a national strategic plan 2009-14 (see 9.9). In this plan an important aim is to get data on injuries and accidents for monitoring and prevention. During this time period, there should be made national proposal to establish such a combined injury registration system, and get enough economic and personnel resources to give valid statistics and data that will enable sound prevention activities to be proposed.

There has not been made any formal official proposal to establish such a system in Norway. However, informal proposals are made, a system like that has been working before in Norway and is still working as described in this section. We have a lot of experiences on how to get such a system running. What is lacking is financial resources and political and administrative will.

4. National injury reporting This section (4) is describing the activities in Norway This section (4) is describing the

9

related to collection of a MDS. activities in Norway related to collection of a MDS.


2008-2010: 2011-2014: Report for 2011 data: http://www.helsedirektoratet.no/publikasjoner/personskadedata-2011-norsk-pasientregister/Sider/default.aspx Report for 2012 data: http://www.helsedirektoratet.no/publikasjoner/personskadedata-2012/Sider/default.aspx Report for 2013 data (see also section 2 above) is found at: http://www.helsedirektoratet.no/publikasjoner/personskadedata-2013/Sider/default.aspx The data reported these years are:

Year Ch. 19 MDS % Hospitals

2011 302566 77894 26 8 2012 299969 93005 31 13 2013 303078 110871 37 16

Ch 19: Amount of unique injuries treated as in-and outpatients in all 24 hospital units. MDS: Amount of these injuries

10

registered with a MDS. % MDS of Ch. 19 Hospitals: Number of hospitals where a MDS is registered and reported


For the moment no such report. However, the Ministry of Health has now given the National Institute of Public Health resources for a two year project to create a comprehensive overview of the injuries and accidents in Norway, based on the existing registers for traffic and occupational injuries, registers in the health system and death register. This report should be published autumn 2013.

This report is published in May 2014: http://www.regjeringen.no/pages/38714450/skadebildet_norge_270514.pdf This report describes how injury patients (N ab. 300000) in the National Patient Register (ref 4.1) have been connected with injury patients in the register of treatments by GPs and municipalities AEDs by the unique birth number of the patients. Hence, a total number of medical treated injury patients in Norway is assessed to be 540000 annually, of these 240000 finally treated by GPs and municipalities AEDs.


National Institute of Public Health, PO Box 4404 Nydalen, NO-0403 Oslo, Norway, department of statistics, director Else Karin Grøholt

This unit is not responsible to make this reporting as a routine. They have however, competence to do it, and are working on this on specially funded projects, as this described in 4.2 above.

5. Key stakeholders (main data users) 5.1. Which is the competent authority

(most probably in the Ministry of Health) for injury statistics, in particular on and home and leisure accidents? (please provide unit,

The Directorate of Health, Department of Community Public Health, PO BOX 7000 St. Olavsplass, NO-0130 Oslo, Norway, director Ole Trygve Stigen.

The responsible person is now changed to director Jakob Linhave, Department of Environment and Health.

http://www.regjeringen.no/pages/38714450/skadebildet_norge_270514.pdf

http://www.regjeringen.no/pages/38714450/skadebildet_norge_270514.pdf

11

addresses, name of responsible person)


Same as 9.1


Directorate for Civil Protection and Emergency Planning (under Ministry of Justice), Rambergveien 9, N=-3115 Tønsberg, Norway, Departement for products and consumer services, director Torill Tandberg


Mortality statistics: Section for health statistics in the National bureau of statistics, PO Box 8131 Dep, NO-0033 Oslo, Norway, section leader Elisabetta Vassenden.

Mortality statistics is now transferred to National Institute of Public Health, address see 5.5, responsible person: Marta Ebbing. Hospital discharge register and Norwegian Injury Register: The Directorate of Health, Department of National Patient Register, PO BOX 7000 St. Olavsplass, NO-0130 Oslo, Norway, responsible person: Morten Støver.


National Institute of Public Health, PO Box 4404 Nydalen, NO-0403 Oslo, Norway,director Else Karin Grøholt

12


Norwegian Safety Forum is a body for prevention of home and leisure accidents, with contacts to other organisations working on prevention of accident at various parts of the home and leisure area. Adress: see 1.3, director Eva Vaagland


Sport injuries research group at the Norwegian University of Sport and physical Education, PO Box 4014 Ullevål stadion, NO-0806 Oslo, Norway, professor Roald Bahr,


There is established a working group with the all the important directorates working on prevention of traffic, occupational, home and leisure accidents (all together nine directorates) with responsibility to implement the national strategic plan mentioned in 9.9.


Yes, a national strategic plan for the period 2009-2014, enclosed. There is established a steering group consisting of the eleven ministries that have signed the plan for steering the work that is done by the working group mentioned in 9.8

6. Signature 6.1. Place, date Oslo, 16.05.2011 Oslo 31.7.14 6.2. Signature

6.3. Name Johan Lund Johan Lund

1


Country: POLAND/ WIELKOPOLSKA REGION

Question Status 2013 (Start May 2013) Status 2014 (please report only changes)

1. Respondent 1.1. Name, title Dr Mariusz Sykała 1.2. Function Director of Specialistic Hospital Ambulatories,

Senior Consultatnt at Pediatric Surgery Department

1.3. Affiliation, address Memorial Holy Family Pediatric Hospital Poznan

1.4. Tel-nr., e-mail-address 004861 8506201, [email protected] 1.5. Website www.szoz.pl 2. Focus of your institution in injury

monitoring

2.1. Please describe briefly (300 – 500 words) why and for what purpose your institution handles or reports injury data, in particular data from emergency departments on

All of the information is being registered in the internal computer system of the hospital in ED. Before the JAMIE beginning our database was not that detailed and focused on medical

Careful analysis of numbers, causes and types of injuries gives us a possibility to prevent certain types of trauma in children population. This way this particular database enables the

2


home and leisure accidents – or how you plan to do it

information.

regional government to build a prevention system depending on places and situations of traumas (we gathered the information which institutions should cooperate with us in terms of prevention – these are schools, kidergardens, creches, sport activities etc.) We are open for collaboration with the media when it comes to preparing prophylaxis programmes. Additionally these data are being used in our medical publications and presentations for local and international pediatric surgery congresses.


pursued in EDs in past three years 2012-2014, with focus on home and leisure accidents, external causes of injuries, or product related injuries? (e.g. IDB, EHLASS, EPAC, LIS, AWISS)

2008-2010: NO For collecting the FDS cases we were using IDB programme from Oct 2013 to May 2014


There is no systematic injury surveillance in emergency departments, neither in the Wielkopolska region nor in Poland at national level.


- Pilot project, endorsed by the national Ministry of Health.

3



- Our hospital with EU project co-funding.


At regional level: Marshal's Office of the Wielkopolska region (Department of Healthcare and Addiction Prevention) At national level: Ministry of Health in Warsaw.


-


ICD-10 with 3 digits


doctors (both ED and wards’ doctors)


Our hospital has been approached through the Marchal’s Office of the Wielkopolska region.


All of the patients with all kind of trauma were registered for MDS.


Data were taken from internal hospital system. (with hospital ITspecialists’ help special software to get the”trauma” data was created)

3.12. What kind of quality control measures -

4




1 - Memorial Holy Family Pediatric Hospital Poznan


MDS May2013-May2014: 14.569,00


around 16hours/week/per person


-


Never heard of it.


There is an increasing public health interest in injury data in order to guide prevention services. This interest is in particular strong regarding improving child safety.

3.19. Please check what has been done with the challenges you identified earlier in

The healthcare system in Poland undergoes many reforms and faces many challenges.

5


2013. Please describe briefly (500-700 words) challenges to the system (e.g. reorganization of lead agency, severe budget cuts, decisions on reducing the scope)

Injury prevention is not high priority.


IDB data (0r provide a web-link) Presentation during the JAMIE meeting in

January 2014 inVienna – available on the EuroSafe website.


All of these information is available at the hospital level and are saved in the internal hospital system. The data is then being sent to Ministry of Health and NHS for the statistic purposes (they are being sent coded with ICD-10)


At the hospital level it is Hospital Statistic Department. The data is then being sent to the Wielkopolska Marshalls Office for the statistic purposes (they are being sent coded with ICD-10)



Ministry of Health with Health Council and NHS

5.2. Which authority or agency (Ministry of Ministry of Health with Health Council and

6



NHS, Wielkopolska Marshall’s Office


Information n/a






Ministry of Health and its Departments

5.7. Is there any (other) relevant institute with research interest in home and leisure injury prevention? (If yes, please provide unit,

Information n/a

7


addresses, name of responsible person) 5.8. Is there a more or less formalized


Information n/a


Information n/a

6. Signature 6.1. Place, date Poznań, 1.07. 014 Poznań, 1.07. 014 6.2. Signature

6.3. Name Dr Mariusz Sykała Dr Mariusz Sykała

1


Country: PORTUGAL


1. Respondent 1.1. Name, title Teresa Contreiras 1.2. Function Senior Public Health Doctor 1.3. Affiliation, address Ministry of Health

National Health Institute Doutor Ricardo

Jorge

Epidemiology Department Head of Department: Carlos Dias [email protected]

1.4. Tel-nr., e-mail-address Av. Padre Cruz 1649-016 LISBOA Teresa Contreiras Email: [email protected] Tel:+351 217526487|Fax+351 217526499

1.5. Website www.insa.pt


http://www.insa.pt/

2




The main objectives of the system ADÉLIA are: • Short-term trends and frequency of ADL in general and its various forms, as well as the characteristics of victims, and situations of those involved; • Long-term: to identify risk situations and dangerous products, which enable the occurrence of ADL, thus establishing a support base for defining prevention policies based on evidence



2008-2010: Yes . With some problems (informatics software) due to reorganization of NH S, Some public hospitals are under private management. The data collected in health center is not available in 2009 and 2010, but is not lost the participation on IDB of the Health center. With the implementation of the FDS module they should enter in the surveillance system again.

2011-2014: YES, ADÉLIA


YES. ADÉLIA system is based on registration in a sample of emergency services in the NHS for collecting and analyzing data on home and leisure accidents (ADL) which involved use of emergency health units of the National Health Service This system is developed in close

3


collaboration with Central Management System Health.


Initiative by Ministry of Health INSA


INSA


National Health Institute Doutor Ricardo

Jorge / Epidemiology Department


Yes


IDB All injuries ICD9- 4 digits


The software is the hospital ED system managed by ACSS SINUS SONHO The emergency departments of hospitals and their counterparts within the network of health centers are the source system data Adelia. The registration of ADL is done taking advantage of the administrative act of inscription on the urgency, being the subject of a participating administrative training

4



Based on the 5 health regions. The sample of health units constituting the system Adélia was formed as follows: • For a random selection method was chosen 6 hospitals and 15 Health Centers of the National Health Service • Each of these units were sent a letter of invitation to participate in the project, explaining the objectives and how it works. • After this consultation was made a final list of Hospitals and Health Centers have expressed interest in participating and who met the logistical and technical conditions of participation (or SONHO- SINUS systems installed in ACSS).

A random selection method was chosen to select hospitals from the National System. These hospitals must cover the minimum of 10% of the population of Portugal.


No sampling


Data linked with internal hospital system. Registration for all emergencies Home and Leisure Accident (ADL) arriving at the emergency department of a particular health unit, supported by a modular application (module ADÉLIA) inserted in the applications of the ACSS SINUS and SONHO. Registration is done by the employee of urgency at the time of registration of the user, following

5


instructions from a manual developed by the DEP. The set of causes listed in programs and SINUS SONHO, causes are selected that meet the definition of ADL. 1.1 Module ADELIA) consists of a dialog box, collects information on the casualty, accident and its circumstances, as well as the characteristics of the lesion. Fields or items available in this module are: • Sex and Date of birth of the victim; • Date and time of care in the emergency room; • Date and time of the accident; • Location of the accident - the two classification levels; • Activity at the time of the accident (domestic activities, education, etc. - Rated at two levels); • Mechanism of injury (how the injury was caused, eg by fire, fall, etc. - Rated at two levels); • type of lesion (for example, open wounds, burns, etc.). • Part of body injured (eg head, trunk, etc. - Rated at two levels); • Description of accident (performed very briefly, to describe what caused the injury, pointing out what went wrong, any products involved, the crash site and other information

6


that is considered relevant). 3.12. What kind of quality control measures


Data bases Validation : validity includes the degree of filling of the database and inconsistencies between fields and analysis of the description field.


2011: 5 Central Hospitals 2 North 2 Center Coimbra 1 South Algarve

2013: 4 hospitals


2011: 6000 registries

2013: 7370 cases


2 months



YES http://www.insa.pt/sites/INSA/Portugues/ComInf/Noticias/Documents/2011/Abril/ADELIA_2006_2008.pdf


New sampling based in 10%

http://www.insa.pt/sites/INSA/Portugues/ComInf/Noticias/Documents/2011/Abril/ADELIA_2006_2008.pdf



7






YES. http://www.insa.pt/sites/INSA/Portugues/ComInf/Noticias/Documents/2011/Abril/ADELIA_2006_2008.pdf

Yes . Report available next month


INSA



Ministry of Health National Health Institute Doutor Ricardo

Jorge

www.insa.pt

Av. Padre Cruz 1649-016 LISBOA




http://www.insa.pt/

8


Teresa Contreiras Email: [email protected]


Ministry of Health Direcção Geral da Saude/ General Directorat

for Health

-Direção de Serviços de Promoção e Proteção

da Saúde/Heatlh Promotion and Protetion

Gregória von Amann E-mail: [email protected]


Ministry of Economy Direcção-Geral do Consumidor Praça Duque de Saldanha 31, 3º andar, 1069-013 Lisboa Sónia Passos [email protected] tel. + 351 21 356 46 58 fax + 351 21 356 47 19 www.consumidor.pt


(Mortality) Statistics Portugal www.ine.pt Av. António José de Almeida 1000-143 Lisboa Tel.: + 351 218 426 100 Fax: + 351 218 426 380 E-mail:[email protected] Only Mortality



http://www.consumidor.pt/

http://www.ine.pt/


9



Yes INSA


NO


NO


Yes. Intersectoral collaboration


YES www.dgs.pt

6. Signature 6.1. Place, date Lisbon, 30.09.2011 11 .07.2014

6.2. Signature

6.3. Name Teresa Contreiras Teresa Contreiras

http://www.dgs.pt/

1


Country: ROMANIA


1. Respondent 1.1. Name, title Razvan Mircea Chereches, MD, PhD 1.2. Function Director 1.3. Affiliation, address Center for Health Policy and Public Health,

Babes Bolyai University, Cluj-Napoca

1.4. Tel-nr., e-mail-address 0264402215; [email protected] [email protected]; [email protected]

1.5. Website www.publichealth.ro www.publichealth.ro 2. Focus of your institution in injury

monitoring Our institution has an internal department:

Department of Occupational and Environmental Health which coordinated the implementation of IDB and JAMIE and will continue the work on injury surveillance systems.

2.1. Please describe briefly (300 – 500 words) Center for Health Policy and Public Health is a As part of the Babes-Bolyai University and



2



research center, part of Babes-Bolyai University, Cluj-Napoca. Our center implemented the pilot IDB study in 2009 and 2010 and established cooperation with 2 Emergency Departments in Romania (one for adults and one for children). Our center supervised the data collection, interpreted the data and presented the report in public conferences were stakeholders from the public authorities were invited. CHPPH is not a public authority and does not collect and manage injury data at national level.

National Data Administrator for IDB and JAMIE we implemented this two projects in the field of injury data surveillance and monitoring. We collaborate with the Emergency Departments on several projects that use data from the injury and violence prevention field.

3. Systematic ED based injury surveillance - 3.1. Has specific injury surveillance been

pursued in EDs in past three years (2008, 2009, 2010) –e.g. with focus on home and leisure accidents, external causes of injuries, or product related injuries? (e.g. IDB, EHLASS, EPAC, LIS, AWISS)

2008-2010: No 2011-2014: JAMIE/IDB pilot implementation in 2012/2013. No specific measures outside the JAMIE implementation in the partner hospitals. Mortality data is provided by National Institute of Public Health, National Center for Public Health Statistics and Information, using the ICD-10 coding (document available in Romanian: http://www.ccss.ro/public_html/sites/default/files/ /Buletin%20Informativ%20Cauze%20de%20Deces%202012.pdf)


-

3



So far, there is an interest from the National Institute of Public Health to continue injury surveillance at national level using ED data – no clear decision was made.


-


National Institute of Public Health: 1. National Center for Public Health Statistics and Information (http://www.ccss.ro/public_html/) Contact Information: Str. George Vraca nr. 9, sector 1, 010146 Bucuresti tel: 0213140890 fax: 0213112998 e-mail: [email protected]


Our institution has access to available data if a partnership is developed between our institution and ED’s and some data is available if our institution asked the ED data/information by sending in a request based on the public interest information.


ED data is collected using only 2-digits V01-Y98 of ICD-10 at national level; ED data in the hospitals involved in the JAMIE Project - IDB-All injuries.

http://www.ccss.ro/public_html/

4



Medical doctors and medical nurses were the actual data collectors. For FDS, the patient or relative was asked to give more information related to the event’ For MDS, there was no contact with the patient, the data was extracted from the general ED medical chart of the patient.


Hospitals have been selected based on: Geographic location Size/type of hospital Acceptance of the hospital to collect data was necessary Sample is not random – convenience sample of hospitals


All injury cases (as defined in the data dictionary) within the ED of the hospitals were targeted to be collected during the 12 months of data collection based on the incidence rates provided by the involved hospitals before data collection started. RTI are underreported in 1 out of 4 ED; Data was collected during the shifts of the appointed data collectors; there is a variation of % of the data collected from the total no of injuries between hospitals as well; in the hospital were FDS was collected, 80% of all injuries was collected; in the hospitals were

5


MDS was collected, the % of injury cases collected is different based on the availability of time of the data collectors involved in this project.


Data was collected on paper and introduced in the IDB software for FDS and in an online form developed by our Center for the MDS.


The Minimum Quality Control Checks for MDS (according to chapter 8 of the JAMIE-Manual) have been carried out; The Minimum Quality Control Checks for FDS (according to chapter 8 of the JAMIE-Manual) have been carried out.


2010: - 2013: four hospitals: FDS: Unitatea de Primire Urgențe – Serviciul Mobil de Urgență Reanimare și Descarcerare Târgu-Mureș (UPU-SMURD)Emergency Unit –

Mobile Emergency Service for Resuscitation and

Extrication (UPU-SMURD) Târgu-Mureș

Cotact person: Dr. Melinda Gal, [email protected] Dr. Cristian Boeriu, [email protected] MDS: Unitatea de Primire Urgențe - Serviciul Mobil de Urgență Reanimare și Descarcerare (UPU-SMURD) Oradea



6


Emergency Unit – Mobile Emergency Service for Resuscitation and Extrication (UPU-SMURD) Oradea Contact Person: Dr. Hadrian Borcea, [email protected] Unitatea de Primire Urgențe - Serviciul Mobil de Urgență Reanimare și Descarcerare (UPU-SMURD) Sfântu Gheorghe Emergency Unit – Mobile Emergency Service for Resuscitation and Extrication (UPU-SMURD) Sfântu Gheorghe Unitatea de Primire Urgențe - Serviciul Mobil de Urgență Reanimare și Descarcerare (UPU-SMURD) Miercurea Ciuc Emergency Unit – Mobile Emergency Service for Resuscitation and Extrication (UPU-SMURD) Miercurea Ciuc


2010: - 2013: 10 855 cases for 2013; FDS: 2873; MDS: 7982


Incidence data can be asked directly from each Emergency Unit for research or education purposes. The data is not centralized and the exact information needed must be mentioned in the request. They Emergency Unit can respond to the request in 30 working days.

3.16. Were (national) incidence rates for home, leisure and school injuries derived?

No


7


What method was used? 3.17. Is there a national (annual) report about

figures and findings of the ED based system? (Please provide link or file of last report)

No


Our actions to support a national injury surveillance system were towards increasing the dialogue with the National Institute of Health which is responsible with national data collection; and with the State Secretary Raed Arafat, who leads the department for interventions in case of emergencies. The National Institute of Public Health is the liaison to the Secretary of State; our contact persons for the Institute have all the information they need in order to further move in the direction of implementing a national injury surveillance system in Romania. There was no re-organisation of health information, but the department for interventions in case of emergencies moved from the Ministry of Health to the Ministry of Internal Affairs. We are in close contact with the Institute by providing the evidence they need to further advocate for the measure. The process of collaboration is on-going; they showed interest

8


in doing this, no decision made so far. 3.19. Please check what has been done with

the challenges you identified earlier in 2011. Please describe briefly (500-700 words) challenges to the system (e.g. reorganization of lead agency, severe budget cuts, decisions on reducing the scope)

-



Gal M, Rus D, Peek-Asa C, Cherecheş RM, Sirlincan EO, Boeriu C, Baba CO. Epidemiology of assault and self-harm injuries treated in a large Romanian Emergency Department. Eur J Emerg Med. 2012: 19(3):146-52. Rus D, Chereches RM, Peek-Asa C, Marton-Vasarhely EO, Oprescu F, Brinzaniuc A, Mocean F. International Journal of Injury Control and Safety Promotion (2014): Paediatric head injuries treated in children’s emergency department from Cluj-Napoca, Romania, International Journal of Injury Control and Safety Promotion, DOI: 10.1080/17457300.2013.872671.

4.2. Is there a comprehensive reporting on accidents/injuries available, comprising home, leisure, road, and workplace injuries

No We are planning to produce a summary report on the data collected with the IDB during the JAMIE Project. The summary report will be

9


at various levels of severity (deaths, hospitalizations, ambulatory treatments) – or is there any intention to produce such report? (Please provide link to the website or attach the report)

available online at www.publichealth.ro


The Center for Statistics and Informatics in Public Health. It is a center in the National Institute for Statistics. Address is str. George Vraca nr.9, Sector 1, Bucuresti. Contact person: Ecaterina Scortan, +40213140890.

For the IDB, JAMIE Project, the Center for Health Policy and Public Health is responsible on communicating the IDB-JAMIE implementation and findings at national level. So far the information was communicated on-line and through direct e-mail to a list of stakeholders, and through face-to-face meetings with the National Institute of Public Health. At national level, for comprehensive injury reporting is responsible the Ministry of Health with its administrative institute: the National Institute of Public Health. This institute also has the National Center for Health Promotion

and Evaluation

(http://www.insp.gov.ro/cnepss/) with this

specific function.

Contact persons:

Alexandra Cucu, MD – General Director,

National Center for Health Promotion and

Evaluation (http://www.insp.gov.ro/cnepss/)

[email protected];

Florentina Furtunescu, MD, MPH, PhD

http://www.publichealth.ro/

http://www.insp.gov.ro/cnepss/



10


Associate Professor,

Department of Public Health and Management

University of Medicine and Pharmacy "Carol

Davila", Faculty of Medicine;

National Institute of Public Health

[email protected] 5. Key stakeholders (main data users) 5.1. Which is the competent authority (most


The Center for Statistics and Informatics in Public Health. It is a center in the National Institute for Statistics. Address is str. George Vraca nr.9, Sector 1, Bucuresti. Contact person: Ecaterina Scortan, +40213140890.

National Institute of Public Health: 1. National Center for Public Health Statistics and Information (http://www.ccss.ro/public_html/) Contact Information: Str. George Vraca nr. 9, sector 1, 010146 Bucuresti tel: 0213140890 fax: 0213112998 e-mail: [email protected] 2. National Center for Health Promotion and

Evaluation (http://www.insp.gov.ro/cnepss/) Contact Information:

Str. Dr. Leonte, nr. 1-3, Bucuresti

E-mail: [email protected]

Contact Persons:

Alexandra Cucu, MD – General Director,


Evaluation

E-mail: [email protected];


http://www.ccss.ro/public_html/



11






Davila", Faculty of Medicine,

National Institute of Public Health,

E-mail: [email protected]. 5.2. Which authority or agency (Ministry of


No specific agency/department, Ministry of Health, Intr. CristianPopişteanu, nr. 1-3, sector 1, postal code 0100 4, Bucureşti. The only structure that might have some tangency with the field is the National Institute for Health, Dr. Adriana Pistol. Str. Dr.Leonte Anastasievici Nr.1-3, Sector 5 Bucuresti, directie.generala@ insp.gov.ro 050463, Romania. Prevention research may also be funded by National Authority for Scientific Research (finances solely based on call for proposals): Str. Mendeleev, nr. 21-25, cod 010 6 , sector 1, București, România, +40-21-319.23.28


National Authority for the Protection of Consumers, Bucureşti, BulevardulAviatorilor nr. 72, sector 1, Romania

National Authority for the Protection of Consumers, Bucureşti, BulevardulAviatorilor nr. 72, sector 1, Romania Website: http://www.anpc.gov.ro/

5.4. Which unit in the national bureau of statistics is responsible for health statistics

National Institute of Statistics; Dissemination office:


12


as mortality and hospital discharge statistics? (please provide unit, addresses, name of responsible person)

Tel. +4021 318 1871 / +4021 317 7770; Fax: +4021 318 1874; E-mail: [email protected]


There is a national public health institute, but it is not dealing with injury data (not in a visible way) National Institute for Health, Dr. Adriana Pistol. Str. Dr.LeonteAnastasievici Nr.1-3, Sector 5 Bucuresti, [email protected], Romania.

National Institute of Public Health, Str. Dr.LeonteAnastasievici Nr.1-3, Sector 5 Bucuresti, [email protected], Romania Contact Persons: Alexandra Cucu, MD – General Director,









National Institute of Public Health;

E-mail: [email protected]. 5.6. Is there any (other) relevant body (agency)

for the prevention of home and leisure accidents (e.g. for campaigning)? (If yes, please provide unit, addresses, name of responsible person) If there are more than one, please provide information on the most important ones

No


1. GRSP – Global Road Safety Partnership

Romania

National Institute of Public Health, Str. Dr.LeonteAnastasievici Nr.1-3, Sector 5




13



Contact person: MirceaIosif, road safety and traffic management expert, GRSP Romania representative Address: Sos. Colentina, nr. 68, cod 021187, sector 2, Bucuresti, Romania. Telefon: +40.314.043.892 Tel./Fax: +40.212.414.509 Mobil: +40.723.587.460 E-mail: [email protected] [email protected]

Bucuresti, [email protected], Romania Contact Persons: Alexandra Cucu, MD – General Director,









National Institute of Public Health;

E-mail: [email protected]


Collaboration with GRSP and with Cluj Police Department. Until now, a partnership agreement has been put in place. The idea discussed is to establish a system for connecting the database of police, the IDB data and the emergency department data. The PD gave us their 2010 database to see the level of complexity and potential points to be improved. Another partnership established in 2010-2011 is the one with Global Road Safety Partnership (GRSP), an NGO developing road safety projects. They agreed to support us in the future injury prevention projects and to seek funding (from the ones being allocated for

Collaboration with the National Institute of Public Health; face-to-face meetings in December 2012 with Dr. Alexandra Cucu and Dr. Florentina Furtunescu and monthly follow-up through e-mails with Dr. Florentina Furtunescu on the status of developing a Romanian Injury Surveillance System taking as example of good practice the JAMIE Project. Collaboration and close contact with continue after July 2014.




14


Romania GRSP) for a future joint project. 5.9. Is there a national action plan for (home


No No

6. Signature 6.1. Place, date Cluj-Napoca, 29.06.2011 Cluj-Napoca,

6.2. Signature

6.3. Name Răzvan M. Cherecheş Răzvan M. Cherecheş

1


Country: SWEDEN


1. Respondent 1.1. Name, title Anders Tennlind, Statistician Pernilla Fagerström, Programme officer 1.2. Function NDA IDB Sweden 1.3. Affiliation, address National Board of Health and Welfare, S-106 30

Stockholm, Sweden

1.4. Tel-nr., e-mail-address + 46 75 247 32 20 [email protected]

+46 75 247 36 06 [email protected]

1.5. Website www.socialstyrelsen.se 2. Focus of your institution in injury

monitoring


The main reason why collecting detailed data (IDB) on injury events is to supply statistics to anyone in Sweden who deals with injury prevention, but also to supply statistical information to authorities which have a special

http://www.socialstyrelsen.se/

2


plan to do it responsibility on safety in their sector of the society. Likewise, it´s also important to supply data for research in this field. Sweden participates in the IDB and collect detailed data from 4 counties which together covers approximately 9 percent of the entire Swedish population. Beside IDB Sweden there is also two registers that are less detailed but cover the entire population. These are the cause of death register and the patient register (which contains both discharges and persons treated as outpatients at hospitals). Composed all those data forms a rather good national information system on injuries. Another purpose on collecting detailed information on injuries is to participate in EURO-IDB.



2008-2010: Yes, IDB. 2011-2014: Yes, IDB


The system consists of a sample of ED’s, collecting information on injury events. Today, seven hospitals, together covering approximately nine percent of the entire Swedish population is participating. The patient is asked to fill in a questionnaire

3


describing the injury event. If the questionnaire of some reason not has been filled in, the information will be collected from the medical record. The administrative and medical information is reported by the medical staff. Special educated personnel is coding and entering the data into the database. Once a year the data is reported to the National Board of Health and Welfare, where the data are thoroughly checked on quality before being published.


The IDB Sweden is legally a part of the National Patient Register, and strictly follows the regulation and instruction on this register.


The ministry of health finance approximately 15-20 percent of the total costs of the database. The rest, 80-85 percent, is the financed by the County Councils. These are regional authorities responsible for the health care system in the different counties.


Responsible for IDB Sweden: Mr Anders Tennlind National Board of Health and Welfare Department of Statistics, Monitoring and Evaluation S-106 30 Stockholm, Sweden

Responsible for IDB Sweden: Ms Pernilla Fagerström National Board of Health and Welfare Department of Statistics and Comparison S-106 30 Stockholm, Sweden

3.6. Does your organisation have access to this Yes, we are the responsible organisation

4




NCECI (NOMESCO), IDB AI, ICD-10. When reporting to EURO-IDB data is translated into IDB AI.


The patient is asked to fill in a questionnaire describing the injury event. If the questionnaire of some reason not has been filled in, the information will be collected from the medical record. The administrative and medical information is reported by the medical staff.


The hospital sample is not a statistical sample, but more like a “convenience” sample. The hospitals has been chosen because of their own interest in collecting injury data mainly for use in local or regional injury prevention activities.


All injuries treated at the ED’s of the participating hospitals are included in the IDB Sweden.


Patient Questionnaire: Paper/pencil Medical information: Computerized hospital System IDB data entry: Special developed data entry software.

5



Data quality control is made at the time of data entry by the special educated coding personnel and after delivering data to the national database also by the statisticians at the National Board of Health and Welfare. If something remarkable is found, the coding personnel are asked to check this up and if necessary supply additional information. Control on missing data is regularly made by the coding personnel at the hospitals.


2010: - Norrland University Hospital in Umeå - Uppsala University Hospital - Karlstad Hospital - Arvika Hospital - Torsby Hospital - Skaraborg Hospital

- Skövde Unit - Lidköping Unit

All hospitals can be reached by contacting Mr Anders Tennlind at the National Board of Health and Welfare (se chapter 1 in this questionnaire)

2013: 7 hospitals


2010: 55330 2013: 56 100


5-6 weeks 10-12 weeks

3.16. Were (national) incidence rates for Yes, by matching with the population register. Yes, for 2013 data by matching with reference

6



data from the national patient register and the population register.


Yes www.socialstyrelsen.se/publikationer2011/2011-5-5 (Only in Swedish)

Not annual, the latest is based on IDB 2010 data http://www.socialstyrelsen.se/Lists/Artikelkatalog/Attachments/18491/2011-11-18.pdf (Only in Swedish)


We´re working on developing a new data recording system, which will work together with the national hospital based system on traffic accidents called STRADA (Register owner: Swedish Transport Agency). The purpose is to match IDB Sweden and STRADA in order to avoid double registration on traffic injuries.

Due to legal and administrative issues, the planned new registration program SKADA has been cancelled.


One big challenge is to persuade the government on raising more money for increasing the payment to the hospitals already participating in IDB Sweden, but also for involving additional hospitals.


IDB data (0r provide a web-link) 2008-2010: 2011-2014: -


Sweden has national registers on deaths and patients (both discharges and outpatients) treated in hospital. The registers are coded according to ICD10. The cause of death register

http://www.socialstyrelsen.se/publikationer2011/2011-5-5


http://www.socialstyrelsen.se/Lists/Artikelkatalog/Attachments/18491/2011-11-18.pdf


7



(CDR) uses 3 digits and the Patient register (PR) uses 5 digits of the chapter XX codes. However, this means that there is no possibility to select home, leisure, and workplace injuries from the CDR. The reporting of the 4th and 5th digit of the external cause code to the PR unfortunately suffer from poor quality, though the majority of the cases are reported with unspecified 4th and 5th digit. Every year the latest statistics on injuries, deaths and discharges, is presented as Official Statistics of Sweden. Discharges: www.socialstyrelsen.se/publikationer2010/2010-10-18 Deaths: www.socialstyrelsen.se/publikationer2011/2011-3-22

Discharges: http://www.socialstyrelsen.se/Lists/Artikelkatalog/Attachments/19228/2013-10-22.pdf Deaths: http://www.socialstyrelsen.se/publikationer2013/2013-8-6/Sidor/default.aspx


Responsible for the National Cause of Death Register and statistics on deaths: Ms Charlotte Björkenstam Responsible for injury statistics: Mr Anders Tennlind Both at: National Board of Health and Welfare

Responsible for the National Cause of Death Register and statistics on deaths: Mr Jens Hörnblad; Responsible for injury statistics: Ms Pernilla Fagerström Both at: National Board of Health and Welfare Department of Statistics and Comparison







http://www.socialstyrelsen.se/publikationer2013/2013-8-6/Sidor/default.aspx

http://www.socialstyrelsen.se/publikationer2013/2013-8-6/Sidor/default.aspx

8


Department of Statistics, Monitoring and Evaluation S-106 30 Stockholm, Sweden

S-106 30 Stockholm, Sweden



National Board of Health and Welfare Department of Statistics, Monitoring and Evaluation S-106 30 Stockholm, Sweden Responsible person: Mr Anders Tennlind

National Board of Health and Welfare Department of Statistics and Comparison S-106 30 Stockholm, Sweden Pernilla Fagerström E-mail: [email protected] Annelie Schönbeck E-mail: [email protected]


Ministry of Health and Social Affairs, Division for Public Health and Health Care Fredsgatan 8 SE-103 33 Stockholm Tel: + 46 8 405 10 00 Contact person: Ms Caroline Nilsson E-mail: [email protected]

Ministry of Health and Social Affairs, Division for Public Health and Health Care Fredsgatan 8 SE-103 33 Stockholm Tel: + 46 8 405 10 00 Contact person: Ms Petra Zetterberg Ferngren [email protected]


The Swedish Consumer Agency Box 48 SE-651 02 Karlstad Sweden Contact person:





9


Ms Anna Strandberg E-mail: [email protected]


The National Bureau of Statistics is not the responsible authority for statistics on these topics. Instead it is the National Board of Health and Welfare. See above for address and contact persons.


There is a national public health institute, but they are not dealing with injury data.


The Swedish Contingencies Agency (MSB) SE-651 81 Karlstad Sweden MSB coordinates the National Child Safety Council Contact person: Ms Katarina Rydberg or Mr Daniel Carlsson E-mail: [email protected] [email protected] MSB also works with injury analysis (statistics) Contact person: Mr Thomas Gell e-mail: [email protected]

MSB coordinates the National Child Safety Council Contact person: Mr Daniel Carlsson E-mail: [email protected]







10




Yes, especially on child safety and injury analysis


Yes, on child safety

6. Signature 6.1. Place, date Stockholm 09/06/2011 Stockholm 10/07/2014

6.2. Signature

6.3. Name Anders Tennlind Pernilla Fagerström

1


Country: SLOVENIA


1. Respondent 1.1. Name, title Mateja Rok Simon, MD, MSc Tina Zupanič 1.2. Function National IDB data administrator 1.3. Affiliation, address Trubarjeva 2, 1000 Ljubljana, Slovenia 1.4. Tel-nr., e-mail-address ++386-1-24-41-500,

[email protected] +386-1-24-41-458, [email protected]

1.5. Website http://www.ivz.si/ http://www.nijz.si 2. Focus of your institution in injury

monitoring


National Institute of Public Health is the

leading public health organisation in Slovenia

and has responsibility for health statistics

based on national legislation. National health

statistics databases on mortality, morbidity,


http://www.nijz.si/

2


rehabilitation and health care system were

developed and established at the institute.

Morbidity data are published every year in

Health Statistics Yearbook and some further

analysis specific to public health problems

including injuries are conducted. Results of

injury data analysis are used for presenting

burden of injury in Slovenia and raising public

awareness of injuries as a major public health

problem. Through injury data research

vulnerable population groups and causes of

injury occurrence are detected and prevention

initiatives are supported. Injury data

surveillance in different health care settings

enables policy makers to rationally plan

resources within health care system and reduce

health inequalities.



2008-2010: Yes. National injury surveillance system in EDs was established in 1997, data on external causes are collected, but not on place of injury occurrence, activity at the time of injury occurrence or products.

2011-2014: Yes.


National Outpatient Information System was

implemented in 1997 and it consists of Primary

In Slovenia emergency departments data on

injuries and poisonings are part of the Out-

3


Health Care Information System and

Outpatient Specialist Services Information

System which comprises also Emergency

Department Data. According to national

legislation all hospitals with emergency

departments have an obligation to collect data

on all injuries and poisonings treated at EDs

and send data to National Institute of Public

Health. Individual records from hospitals are

transformed into aggregated form at regional

level and sent to national database at National

Institute of Public Health on yearly basis.

Emergency Department Database contains

data on hospital identification, specialist

service department identification, age group,

sex, health insurance status, main diagnosis

(ICD-10), external cause of injury (ICD-10).

Patient Specialist Services Database, where

reports are submitted after all curative

activities have been carried out in out-patient

specialist services. Due to the fact that the Out-

Patient Specialist Services Database is normally

submitted to by the National Institute of Public

Health (NIPH) in aggregated form without

personal identifier, it was necessary to

introduce a separate data capture of individual

level records for the purpose of FDS and MDS

data preparation, based upon special

agreements with four selected sample

hospitals, which are representative for the

entire country, from 2011 onwards. Captured

data include injury specific variables like place

of occurrence, mechanism of injury, activity

when injured and underlying object/ substance

producing injury.


Surveillance system based on national legislation.


Ministry of Health, National Health Insurance Company.

3.5. Who is responsible for dealing with ED injury data? (Please provide institution,

National Institute of Public Health, Health Data Centre, Trubarjeva 2, 1000 Ljubljana,

4


unit, address, name of responsible person) Marjeta Zaletel 3.6. Does your organisation have access to this



Full 3-digits V01-Y98 of ICD-10, but no fourth digit for place/setting

In 2013 Australian modification of ICD-10 (6th ed.) was implemented in Slovenia, so from 2013 onwards bridge coding from ICD-10-AM (6th) to ICD-10 is applied to injury data before they are transformed into standard FDS and MDS data format.


Administration staff, data based on patients fill in forms and doctors interview patients.


No sampling, all hospitals with ED departments in the country are obligated to report data.

Sample hospitals, were selected in such a way that geographically cover entire country. Slovenian FDS sample include one general hospital and one university hospital (the biggest Slovenian hospital). Known bias: 1. A part of eye injuries is not included in case of one sample hospital. That is approx. 3% of all emergency ambulatory treatments in this hospital, but it is assumed that most of those injuries are actually treated also in other clinics of this hospital, as this are injuries that also covers other parts of the head/ body and not only eye. 2. Our sample covers the majority of skiing

5


injuries in Slovenia, as in one sample hospital (general hospital) the majority of skiing injuries in Slovenia are treated.

MDS sample covers more than 37% of all national discharges and more than 53% of all ambulatory emergency department treatments and FDS sample covers about 30% and 41% respectively.


No sampling, all patients treated at the hospital EDs are included..

All cases within sample hospitals are included.


Data entry is carried out at PC stations linked with internal hospital health information system.


Only controls that assure relevant codes from existing classifications.


2010: 12. 2013: Four MDS reference hospitals among which two of them are also FDS reference hospitals.


2010: 2013: 102731 MDS cases and 78834 FDS cases.

3.15. What is the average production time for

6


data release? 3.16. Were (national) incidence rates for


No, because at EDs they don’t collect injury data on place/setting of injury occurrence, nor data on activity at the time of injury occurrence.

Yes. HDR method was used.


Yes. Statistics of treatments in ED’s is a part of Specialist Services Statistics. http://www.ivz.si/Mp.aspx?ni=0&pi=7&_

7_id=407&_7_PageIndex=0&_7_groupId

=228&_7_newsCategory=&_7_action=

ShowNewsFull&pl=0-7.0.

Yes. Statistics of treatments in ED’s is a part of Specialist Services Statistics. http://www.ivz.si/Mp.aspx?ni=202&pi=18&_18_view=item&_18_newsid=2326&pl=202-18.0.


Renovation of hospital discharge surveillance

system has started and renovation of

outpatient specialist services (including

emergency departments at hospitals) is also

foreseen (National Institute of Public Health in

cooperation with National Insurance

Company). At the same time a proposal of a

new national law on health data collection

system is in preparation and National Institute

of Public Health would be able to include some

new methodology and data variables into

proposed hospital discharge and ED datasets.

At the moment, major renovation of the Out-

Patient Specialist Services Database is taking

place, so all the out-patient data, including

emergency department data on injuries and

poisonings, will be reported to NIPH as

individual level records from 2015 onwards,

and this will enable easy access to injury data

in all Slovenian hospitals and its

transformation into standard FDS and MDS

data format.

Also a proposal of a new national law on

health data collection system is in preparation

and National Institute of Public Health would

be able to include some new methodology and

data variables into proposed hospital discharge

http://www.ivz.si/Mp.aspx?ni=0&pi=7&_

http://www.ivz.si/Mp.aspx?ni=202&pi=18&_18_view=item&_18_newsid=2326&pl=202-18.0


7


and ED datasets.


Demands for rationalisation of hospital data collection at national level by merging two hospital data systems (health statistics data and DRG-related health care financing data) in joint data surveillance system.

From 2013, due to rationalisation, two hospital data systems (health statistics data and DRG-related health care financing data) were merged into one hospital data surveillance system at national level.



4.2. Is there a comprehensive reporting on


Yes. Injury statistics is presented within

broader annual report on national health

statistics.


7_id=407&_7_PageIndex=0&_7_groupId

=228&_7_newsCategory=&_7_action=

ShowNewsFull&pl=0-7.0.

Home and leisure injuries are not reported for all levels of severity because there are no data available on place/setting of injury occurrence in mortality, ED and primary health care databases.

Yes. Injury statistics is presented within

broader annual report on national health

statistics.

http://www.ivz.si/Mp.aspx?ni=202&pi=18&_18

_view=item&_18_newsid=2326&pl=202-18.0.

Home and leisure injuries are not reported for

all levels of severity because there are no data

available on place/setting of injury occurrence

in mortality, ED and primary health care

databases.


National Institute of Public Health, Health Data Centre, Trubarjeva 2, 1000 Ljubljana,




8



Marjeta Zaletel



Statistical Office of the Republic of Slovenia has appointed National Institute of Public Health as a competent authority on “health” and “health and safety” statistics including injury statistics.


Ministry of Health, Directorate for Public Health, Tivolska 50, 1000 Ljubljana, Mojca Gruntar Činč, Director general

Ministry of Health, Directorate for Public Health, Tivolska 50, 1000 Ljubljana, Mojca Gobec, Acting director general


Ministry of the Economy, Directorate for Internal Market, Kotnikova 5, 1000 Ljubljana, Drago Napotnik, Acting director general

Ministry of economic development and technology, Directorate for Internal Market, Kotnikova 5, 1000 Ljubljana, Dušan Pšeničnik, MSc., Director general


Statistical Office of the Republic of Slovenia has appointed National Institute of Public Health as a competent authority on “health” and “health and safety” statistics including mortality and morbidity statistics. National Institute of Public Health, Health Data Centre, Trubarjeva 2, 1000 Ljubljana, Marjeta Zaletel

5.5. Is there a national public health institute, which is dealing with injury data? (If yes,

Yes. National Institute of Public Health, Health

9


please provide unit, addresses, name of responsible person)

Data Centre, Trubarjeva 2, 1000 Ljubljana, Marjeta Zaletel


No.


No.


No.


No.

6. Signature 6.1. Place, date Ljubljana, 14.6.2011 Ljubljana, 9.7.2014

6.2. Signature

6.3. Name Mateja Rok Simon Tina Zupanič

1


Country: TURKEY


1. Respondent 1.1. Name, title Asli Sungur, Chem. Eng. MSc. Sevgi Güler, MD 1.2. Function Engineer MD 1.3. Affiliation, address Public Health Institute of Turkey, Ankara,

Turkey Public Health Institute of Turkey, Ankara, Turkey

1.4. Tel-nr., e-mail-address +905426138065, [email protected] 1.5. Website www.thsk.saglik.gov.tr www.thsk.saglik.gov.tr 2. Focus of your institution in injury

monitoring


In the process of its preparations for full membership of the EU, Turkey is implementing a strategy for market surveillance and inspection. A National Market Surveillance and Control Strategy Document (2010-2012) has been published by the Ministry

Instead of focusing only on product-related injuries, the Institute decided to establish a system which is in line with the EU-IDB standards and to implement the data collection at IDB-FDS level, which is quite detailed for covering the role of products in the causation

2


of Economy and updated by another National Market Surveillance and Control Strategy Document (2012-2014). The first strategy document includes the firm commitment of the national government to establish an injury database, allowing injuries and accidents related to consumer products to be recorded and to provide these data to organizations in charge of market surveillance and inspection. This was done with a view to enable risk-based planning of market surveillance and inspection activities of products. In the second strategy document a commitment to the regular monitoring of product related injuries is made and data sharing among organisations in question is emphasized. Finally, The Ministry of Economy published a regulation on market surveillance and control (Regulation Amending the Regulation on Market Surveillance and Control of Products (2013/4895) where injuries, accidents and deaths which are evaluated to be caused by products and which are transferred to medical institutions are to be recorded by a database established by the MoH and shared with organisations in charge of market surveillance and control. The MoH delegated this responsibility to the Public Health Institute of Turkey and resources have been made

of injuries.

3


available to upgrade previous pilot efforts towards a National Accident and Injury Database, abbreviated as UKAY.


pursued in EDs in past three years 2012-2014, with focus on home and leisure accidents, external causes of injuries, or product related injuries? (e.g. IDB, EHLASS, EPAC, LIS, AWISS)

2008-2010: Just a pilot by Akdeniz University (Antalya).

2011-2014: IDB-FDS level has been implemented in 15 hospitals throughout Turkey


- UKAY became ready for use in July 2011. To

test the database in practice, injury data was

collected for two months in the emergency

department of Ankara Atatürk Training and

Research Hospital in Ankara. As of August

2012, the implementation has begun to be

expanded to emergency services at 14 general

hospitals and 1 university hospital in 14

provinces (Ankara, Afyonkarahisar, Antalya,

Bursa, Balıkesir, Diyarbakır, Elazığ, Erzurum, İstanbul –with two hospitals-, İzmir, Kayseri, Samsun, Şanlıurfa, Trabzon), taking statistical region units classification into consideration.

UKAY is a web-based application. The

application interface is based on Microsoft

4


Silverlight technology, while the database is

developed in Oracle. It uses the IDB Coding

Manual Data Dictionary Version 1.1 (June

2005) [6]. Data are entered into the system via

web application, are then stored in the data

warehouse of the MoH, ready for instant

inquiry. Reports are automatically created by

business intelligence applications and are

ready for use by decision makers.

3.3. What is the formal status of this monitoring

system? (e.g. based on law, implementation regulation, guideline, initiative by an authority, private initiative)

National Market Surveillance and Control Strategy Document (2010-2012) by the Ministry of Economy

National Market Surveillance and Control Strategy Document (2012-2014) by the Ministry of Economy Regulation Amending the Regulation on Market Surveillance and Control of Products (2013/4895)


Data is collected from state hospitals and is handled by Turkish Public Health Institution. Therefore, government provides funding.


- Sevgi GÜLER, MD Ministry of Health Public Health Institution of Turkey Chronic Diseases, Elderly Health and Disability Department


- Since Public Health Institution of Turkey is the responsible organisation, it has access to the data.

5



- IDB-All injuries


- Generally medical technologes, medical secretaries and public servants who are working in EDs and who are trained specifically for injury data recording conduct face to face interviews with patients or relatives to obtain IDB-FDS level information. In each data provider hospital, the head physician who is responsible for ED organises data collection and participates meetings organised by Public Health Institution of Turkey.


- Statistical region units classification was taken into consideration for the selection of hospitals. Most of the hospitals are located centrally and well equipped where neighbourhood cities also drive benefit. Representativeness of hospitals will be checked by a comprehensive study including comparing hospital ED records and UKAY records.


- For the time being there is not a systematic for sampling within the hospitals. But it is planned to implement a systematic.

3.11. How is data entry been done? (paper/pencil or tablet-PC with special

- In the EDs cases are recorded on paper/pencil by using a standard questionnaire form and

6


data entry software, data linked with internal hospital system etc.)

coded and recorded by using a special data entry software. Data are entered into the system via web application, are then stored in the data warehouse of the MoH, ready for instant inquiry. Reports are automatically created by business intelligence applications and are ready for use by decision makers.


- The main quality control checks for inconsistent data or blanks in obligatory fields have been automatically done while recording a case. Data are subject to general quality check for completeness before yearly upload to the EU IDB.


2010: - 2013: 15 hospitals Please see the attachment for details.


2010:- 2013: 21,396


- A few weeks


- Not yet.


- Not yet.

7



Need for a sustainable market surveillance and control of consumer products (see 2.1) imposed establishment of an injury database. Previous pilot study of Akdeniz University and JAMIE project accelerated the fulfilment of the obligation of having a national injury database.

Now the management of UKAY is under the responsibility of Chronic Diseases, Elderly Health and Disability Department of Public Health Institution where data can be evaluated comprehensively and reports can be produced as a one of the missions of the department.


Additional work for hospital staff; acceptance by hospital staff. Mobility of trained hospital staff to other departments of hospital. Insufficient management support, collaboration between relevant bodies of the MoH.

A protocol emphasizing the responsibilities of relevant bodies was signed among the parties of MoH which strengthen the management support. But it is still an additional work for hospital staff in some hospitals where hospital managements do not show sufficient interest in collecting data. This has a negative influence on the motivation of data collectors.


IDB data (0r provide a web-link) 2008-2010: ? 2011-2014: The article “The EU Injury Data Base

IDB and its implementation in Turkey “

prepared for Turkish Clinics for Pediatric

Sciences, Prevention of Injuries and Promotion

of Safety Special Edition, 2014

8



For the time being, there are reports which are produced automatically by business intelligence technology by using current data of UKAY. For access to the website it is required to request user name and password from Directorate General for Health Information Systems. A comprehensive evaluation of data and reporting is planning.


Aslı SUNGUR Ministry of Health Public Health Institution of Turkey Strategy Development Department

Sevgi GÜLER, MD Ministry of Health Public Health Institution of Turkey Chronic Diseases, Elderly Health and Disability Department



Mehmet Rifat KÖSE, MD Ministry of Health Directorate General for Heath Researches, Address: Cumhuriyet Mah. Bayındır 1 Sok. No: 1 , 064 0 Sıhhıye, Ankara


Bekir KESKİNKILIÇ, MD, Deputy President Ministry of Health Deputy Presidency for Non-Communicable Diseases, Programmes and Cancer Address: Sağlık Mahallesi Adnan Saygun Cad No: 55 06100 Sıhhıye / Ankara

9


5.3. Which authority (most probably in the

Ministry of Consumer Affairs) is competent for the safety of consumer products? (please provide unit, addresses, name of responsible person)

Mehmet CÖMERT Ministry of Economy Directorate General for Product Safety and Control Address: İnönü Bulvarı No: 6 06510 Emek / ANKARA Ministry of Economy, Directorate General for Product Safety and Control is the coordinator unit for safety of consumer products. Market surveillance and control of products is under the responsibility of various ministries and authorities: Ministry of Health, Ministry of Science, Industry and Technology, Ministry of Customs and Trade, Ministry of Food, Agriculture and Livestock, Ministry of Work and Social Security, Ministry of Environment and Urbanism, Ministry of Transport, Maritime Affairs and Communications, Information Technologies and Communications Authority, Tobacco and Alcohol Market Regulatory Authority, Energy Market Regulatory Authority


Cengiz ERDOĞAN, Head of Social Sector Statistics Department Turkish Statistics Authority Address: Yücetepe Mah.Necatibey Cad. No:114 06100 Çankaya/ANKARA

http://www2.zargan.com/tr/page/search?Text=Energy%20Market%20Regulatory%20Authority%20%28EMRA%29

http://www2.zargan.com/tr/page/search?Text=Energy%20Market%20Regulatory%20Authority%20%28EMRA%29

10



Sevgi GÜLER, MD Ministry of Health Public Health Institution of Turkey Chronic Diseases, Elderly Health and Disability Department


-


There is a graduate program in Demography and Epidemiology of Injuries Department under Health Science Institute in Gazi University. Prof. Dr. Mustafa KEREM, Head of Institute Address: Emniyet Mah. Taç Sok. No: 3 Eczacılık Fakültesi Dekanlık Binası 1. Kat 06500 Y.Mahalle/ANKARA


A Coordination Board for Market Surveillance and Control meets twice a year. The members are comprised of above mentioned ministries and institutions (see 5.3) In these meetings implementation of current National Market Surveillance and Control Strategy Document is evaluated where one of the topic is commitment to the regular monitoring of product related injuries and data sharing

11


among organisations. 5.9. Is there a national action plan for (home


Not yet.

6. Signature 6.1. Place, date

6.2. Signature

6.3. Name

1


Country: UNITED KINGDOM / ENGLAND

Question Answer Additional links, attachments, and comments –

please be as detailed as possible

1. Respondent 1.1. Name, title Wendi Slater, Ms 1.2. Function Senior Public Health Intelligence Analyst 1.3. Affiliation, address South West Public Health Observatory,

Grosvenor House, 149 Whiteladies Road, Bristol BS8 2RA

1.4. Tel-nr., e-mail-address 0117 9706474 x304 [email protected]

1.5. Website www.swpho.nhs.uk

2. Focus of your institution in injury

monitoring

http://www.swpho.nhs.uk/

2


SWPHO analyses data and produces information to inform decision-making on public health issues at local, regional and national level. We have a lead role on behalf of the regional Public Health Observatories in England to improve the availability and use of injury-related information. We have also worked with other countries in the UK to develop the Injury Observatory for Britain and Ireland (IOBI) as a focus for collaborative efforts and to disseminate information and evidence through a dedicated website and newsletter. We are in the process of developing a national online tool for England to provide comparative information across a range of injury-related indicators at local level. The first test version of the tool will focus on hospital bed admissions and mortality data, as the current national emergency medicine department dataset (collated by a separate institution The Information Centre for Health and Social Care’) is incomplete, of suspect quality and limited with regard to cause and context details. However, we will then look at ways of incorporating emergency medicine related indicators, along with accompanying advice, to encourage use of the data where useful and also data collection improvements. We are also working on a pilot in collaboration with the College of Emergency Medicine to test

SWPHO Injury pages: http://www.swpho.nhs.uk/resource/view.aspx?RID=33520 These are linked to/from the IOBI website: http://www.injuryobservatory.net/index.html The Information Centre for Health and Social Care is responsible for routine data collection from hospital services in England. SWPHO and other regional Public Health Observatories have access to the resulting databases – both data extracts and online interrogation – to enable flexible analysis. Further details about this data and other injury related data sources used by the PHOs are available through SWPHO’s guide to injury information resources: http://www.swpho.nhs.uk/resource/item.aspx?RID=63592 Please note that SWPHO and other regional PHOs are currently undergoing a transition process due to significant changes to the NHS and public health organisations in England. We will be amalgamated with other public health organisations into one new national organisation Public Health England’ which will come into existence April 2013. Public Health England may take on some of the analytical work currently undertaken by the

http://www.swpho.nhs.uk/resource/view.aspx?RID=33520


http://www.injuryobservatory.net/index.html

http://www.swpho.nhs.uk/resource/item.aspx?RID=63592


3

a method for significantly enhancing data collection on cause and context of all types of injury (that will mostly satisfy the top level requirements of the EU IDB) to inform expansion of the method across England.

Information Centre for Health and Social Care, with the latter focussing on improving data collection and accessibility.

3. ED Statistics (EDS) 3.1. Is there a national statistic of treatments in

ED’s (including injuries)? (Please provide a link or attach the last report, if possible)

1. Yes – data should be collected from all ED, minor injury unit and NHS Walk in centres in England. However note that the current data is released as experimental statistics’ as data completeness and quality needs to improve. (See earlier note 3.3).

2. There is an archive of detailed external cause and context data up to 2002 collected on home and leisure accidents in a selected number of EDs in the UK.

1. Reports and analysis of Accident and Emergency Hospital Episode Statistics (HES)’ data 2007-08 to 2009-10: http://www.ic.nhs.uk/statistics-and-data-collections/hospital-care/accident-and-emergency-hospital-episode-statistics-hes Dataset details ( A&E HES Data dictionary’): http://www.hesonline.nhs.uk/Ease/servlet/ContentServer?siteID=1937&categoryID=289 Further details regarding diagnosis codes etc. (see links on left side panel): http://www.datadictionary.nhs.uk/version2/web_site_content/pages/codes/clinical_coding/clinical_coding_navigation.asp?shownav=1 2. Royal Society for the Prevention of Accidents - Home and Leisure Accident Surveillance (HASS/LASS) detailed statistics for 2000-2002 - based on A&E attendances at a sample of UK depts. Reports & data query options. Right click mouse for option to rotate image clockwise to view reports:

http://www.ic.nhs.uk/statistics-and-data-collections/hospital-care/accident-and-emergency-hospital-episode-statistics-hes



http://www.hesonline.nhs.uk/Ease/servlet/ContentServer?siteID=1937&categoryID=289


http://www.datadictionary.nhs.uk/version2/web_site_content/pages/codes/clinical_coding/clinical_coding_navigation.asp?shownav=1



4

http://www.hassandlass.org.uk/query/index.htm Email: [email protected]

3.2. Who is responsible for handling of data and publishing of results of the EDS? (Please provide institution, unit, address, name of responsible person)

1. The Information Centre for Health and Social Care,

1 Trevelyan Square, Boar Lane, Leeds, LS1 6AE UK

Unsure who has current ultimate responsibility. One key contact is: Chris Roebuck: [email protected] 2. RoSPA Head Office, RoSPA House, 28 Calthorpe Road, Edgbaston, Birmingham B15 1RP UK Unsure who has responsibility. One key contact is: Errol Taylor: [email protected]

http://www.ic.nhs.uk/ [email protected] Tel. 0845 300 6016


Yes – data extracts and online access – to enable flexible analysis

3.4. What level of coding of external causes of ICD codes are not collected. A limited set of Dataset details ( A&E HES Data dictionary’):

http://www.hassandlass.org.uk/query/index.htm

http://www.hassandlass.org.uk/query/index.htm




http://www.ic.nhs.uk/


5

injuries is implemented in national HDS? (e.g. full 3-digits V01-Y98 of ICD-10, but no fourth digit for place/setting, or E-codes of ICD-9)

codes are collected on external cause. Patient Group’ indicates whether the cause was a road traffic collision, sports injury, firework injury, other accident, assault or deliberate self harm. A limited set of diagnosis codes are used (which include body part and body side affected) and some of these indicate to a limited extent external causes such as burns/scalds, poisoning etc..

http://www.hesonline.nhs.uk/Ease/servlet/ContentServer?siteID=1937&categoryID=289 Further details regarding diagnosis codes (see links on left side panel): http://www.datadictionary.nhs.uk/version2/web_site_content/pages/codes/clinical_coding/clinical_coding_navigation.asp?shownav=1 * Note that for some diagnoses (e.g. burns/scalds’ or poisoning’) there is an option

to record sub-codes providing further information (e.g. poisoning due to: prescriptive drugs; proprietary drugs; controlled drugs; or other, including alcohol. However data completenes of sub-coding is currently poor.

4. Pilot of ED based injury surveillance

4.1. Has a pilot on collecting ED injury data pursued in past three years - with focus on external causes of injuries, product related injuries, home & leisure accidents? In which year has the pilot been done? If there have been more studies, please refer to the most important one

Yes. We are currently working on a pilot and data collection started in May 2011 in one pilot site.

4.2. If yes: Please describe briefly the pilot

study (500 – 700 words) We are currently working on a pilot in collaboration with the College of Emergency Medicine (CEM) to test a method for significantly enhancing data collection on






6

cause and context of all types of injury. The aim is for the pilot to inform expansion of the method across England for routine data collection on all ED injury-related attendances. The injury-related items have been incorporated into the proposed CEM Emergency Medicine Minimum Data Set

(MDS)’. The items are based on an extended version of AWISS (All Wales Injury Surveillance System) and will mostly satisfy the top level requirements of the EU IDB. At present pilot data collection is only underway in paediatrics. We would like to engage a new pilot site to test collection in adults. The pilot has been considerably delayed and affected by: i) problems with conflicting priorities and developments at prospective ED pilot sites and ii) the need to align the pilot with the development of the CEM Emergency Medicine MDS. We can only collect data on paediatrics at the current pilot site because unfortunately the hospital decided to change the routine data collection on adults to a different IT system. (Note that we are also about to test interviewer based collection at the children’s ED to test the quality of the new routine collection and the extent and ease of enhancing collection further to inform possible future collection at sample ED sites. This enhanced collection will include

7

either level2 or level 3 data on object/substance – to be confirmed).

4.3. Who provided the funding for the pilot data collection, handling and reporting?

Department for Health

4.4. Who was responsible for the pilot on ED injury data? (Please provide institution, unit, address, name of responsible person)

Pilot overseen by South West Public Health Observatory, Grosvenor House, 149 Whiteladies Road, Bristol BS8 2RA. SWPHO Director: Julia Verne: [email protected] Project lead: Wendi Slater [email protected]

4.5. Which coding system was used for the recording of external causes? (e.g. full IDB-All Injuries, IDB-V2000, ICECI, others)

The proposed routine collection incorporates an extended version of AWISS (All Wales Injury Surveillance System) which will mostly meet the top level (level 1) requirements of the EU IDB.

4.6. Did individual cases contain information about medical diagnoses (e.g. S00-T98 of ICD-10)?

Yes. The CEM Emergency Medicine Minimum Dataset allows for ICD10 or SNOMED coding. The current pilot site uses SNOMED.

4.7. Who actually collected the data in hospitals? (e.g. patients fill in forms, nurses

The current pilot site is testing nurse data collection. Future collection may be based on a



8

or doctors interview patients) mix of nurse and doctor data collection. 4.8. How was the data entry done?


Routine data collection will be via an enhanced version of the existing ED networked PC based data collection system. (The interviewer collection will use a PC and separate simple data collection form).

4.9. How many hospitals (ED) were involved in the pilot? (Please provide a list of involved hospitals, addresses and names of contact persons: link or attachment)

3 pilot sites were initially involved but currently just one hospital has been able to commit to getting the data collection underway:

St. Mary’s Hospital, Praed Street, London W 1NY Telephone: 020 3312 6666

Consultant lead: Ian Maconochie: [email protected] As noted earlier- we are seeking a further pilot site (or sites) to test data collection on adults/all attendees.

St. Mary’s Hospital, London: http://www.imperial.nhs.uk/stmarys/ourservices/accidentandemergency/index.htm

4.10. Approx., how many cases have been collected during the pilot?

Initial aim: analysis of routine data collection on approx. 365 paediatric cases in a 2 month period. However, we may slightly extend the period of analysis as the interviewer side of the pilot has been delayed. (Interviewer collection on 200 cases over 6 week period with data collection hopefully starting July)

4.11. Is there a report about this pilot See attached report: EM injury data collection The pilot arose from the recommendations


http://www.imperial.nhs.uk/stmarys/ourservices/accidentandemergency/index.htm

http://www.imperial.nhs.uk/stmarys/ourservices/accidentandemergency/index.htm

9

implementation? (Please provide a link or attach the report)

pilot – interim report end Mar 10’

of the Feasibility of Establishing a UK Wide Injury Database’ report: http://www.rospa.com/homesafety/resources/statistics/injury-database-feasibility.aspx

4.12. Why was it not possible yet to transfer the pilot into a sustained system? Please describe briefly (500-700 words) the challenges (e.g. lack of interest of stakeholders, resistance from hospitals, conflicting interests)

The pilot is still underway. As noted earlier, the pilot has been considerably delayed and affected by: i) problems with conflicting priorities and developments at prospective ED pilot sites and particularly ii) the need to align the pilot with the development of the CEM Emergency Medicine MDS. SWPHO is also facing challenges due to the change of government in May 2010 which resulted in a freeze on recruitment of permanent staff and uncertainty and work required regarding transition arrangements as we move to the creation of Public Health England.’ Financial resources are also under strict control and are likely to be tight in the coming years.

4.13. Please describe briefly (max. 750 words) current opportunities for re-starting the system (e.g. new IT developments, re-organisation of health information, demands for more effective prevention)

The MDS now has the backing of the College of Emergency Medicine president and vice president and the aim now is to encourage hospitals to collect the injury related items within the MDS. (The MDS is being piloted at a further 5 sites but they are not collecting the specific injury-related items, although they are collecting full diagnosis codes and the clinician commentary free text field). The current pilot will hopefully provide encouragement and the

The new public health strategy Healthy lives, healthy people’: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_121941

http://www.rospa.com/homesafety/resources/statistics/injury-database-feasibility.aspx

http://www.rospa.com/homesafety/resources/statistics/injury-database-feasibility.aspx

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_121941



10

IT system being used is apparently used in approx 50% of hospitals in England so it would be relatively straightforward for the IT supplier to implement the changes at other sites. Also importantly, as mentioned in 2.1, there is also a significant re-organisation of public health in England and the new public health strategy is emphasising the need for a more health promotion/illness prevention focus.

5. National injury reporting 5.1. Is there a comprehensive reporting on


No. At present data is reported via various general reporting tools. We are currently developing an Injury Profiles’ tool for England which will provide local level comparisons across a range of injury related indicators. The test version will go live Jan 2010 (to be confirmed) and this will pull together indicators from existing tools. We will then update and develop this further. See earlier section .1 for further details and SWPHO’s guide to injury information resources.

SWPHO’s guide to injury information resources: http://www.swpho.nhs.uk/resource/item.aspx?RID=63592


South West Public Health Observatory, Grosvenor House, 149 Whiteladies Road, Bristol BS8 2RA. Ultimate responsibility: SWPHO Director: Julia Verne: [email protected] Others contacts: Paul Brown, Wendi Slater




11

& Liz Rolfe – same email structure as above.



Department of Health Wellington House 133-155 Waterloo Road, London, SE1 8UG. Dr Sunjai Gupta Deputy Director: Head of Public Health Strategy, Social Marketing and Sexual Health Branch, Health Improvement and Protection Directorate Area 626 [email protected] Other contact: Sue Maisey [email protected]

http://www.dh.gov.uk/en/Publichealth/index.htm


As 9.1

6.3. Which authority (most probably in the Ministry of Consumer Affairs) is competent for the safety of consumer products? (please provide unit, addresses, name of

Department for Business Innovation and Skills, 1 Victoria Street, London SW1H 0ET

http://www.bis.gov.uk/





http://www.bis.gov.uk/

12

responsible person) 6.4. Which unit in the national bureau of

statistics is responsible for health statistics as mortality and hospital discharge statistics? (please provide unit, addresses, name of responsible person)

Office for National Statistics Government Buildings Cardiff Road Newport South Wales NP10 8XG

http://www.statistics.gov.uk/hub/health-social-care/index.html http://www.statistics.gov.uk/default.asp


South West Public Health Observatory has access to national detailed hospital data (from the Information Centre for Health and Social Care), detailed mortality data (from the Office for National Statistics and other data/information resources. It is developing the national Injury Profiles tool and exploring improvements to injury data on behalf of all the regional Public Health Observatories in England. South West Public Health Observatory, Grosvenor House, 149 Whiteladies Road, Bristol BS8 2RA. Ultimate responsibility: SWPHO Director: Julia Verne: [email protected] Other contacts: Paul Brown, Wendi Slater & Liz Rolfe – same email structure as above.


6.6. Is there any (other) relevant body (agency) For campaigning:

http://www.statistics.gov.uk/hub/health-social-care/index.html

http://www.statistics.gov.uk/hub/health-social-care/index.html

http://www.statistics.gov.uk/default.asp




13

for the prevention of home and leisure accidents (e.g. for campaigning)? (If yes, please provide unit, addresses, name of responsible person) If there are more than one, please provide information on the most important ones

Collaboration for Accident Prevention and Injury Control (CAPIC) – College of Medicine, Grove building, Swansea University, SA2 8PP Contact: Samantha Turner [email protected] The Royal Society for the Prevention of Accidents (ROSPA) - RoSPA House, 28 Calthorpe Road, Edgbaston, Birmingham B15 1RP, UK Tom Mullarkey MBE, Chief Executive Other contact: Errol Taylor, Deputy Chief Executive [email protected] Child Accident Prevention Trust (CAPT) - Canterbury Court (1.09), 1 - 3 Brixton Road, London, SW9 6DE, United Kingdom Katrina Phillips , Chief Executive Other contact: Mike Hayes, Head of Research and Development [email protected] Age UK

http://www.capic.org.uk/ http://www.rospa.com/about/default.aspx http://www.capt.org.uk/


Various universities undertake research on specific aspects e.g. child injury prevention or falls prevention in older people. For example: Centre for Child and Adolescent Health - a joint initiative between the University of

Centre for Child and Adolescent Health: http://www.bristol.ac.uk/ccah/research/childhoodinjury/ University of Nottingham – Injury epidemiology and prevention research:




http://www.capic.org.uk/

http://www.rospa.com/about/default.aspx

http://www.capt.org.uk/

http://www.bristol.ac.uk/ccah/research/childhoodinjury/

http://www.bristol.ac.uk/ccah/research/childhoodinjury/

14

Bristol and University of the West of England. Child injury programme lead: Prof. Elizabeth Towner Oakfield House, Oakfield Grove, Clifton, Bristol BS8 2BN, UK [email protected] University of Nottingham, Division of Primary Care, Community Health Sciences. Injury epidemiology and prevention research. (Current website problem so unfortunately can’t provide further details) University of Manchester– Social Care and Population Health: Active Aging research group. This includes research on falls prevention Chris Todd [email protected] The School of Nursing, Midwifery and Social Work, The University of Manchester, Room 6.314b, Jean McFarlane Building, University Place, Oxford Road, Manchester M13 9PL, UK

http://www.nottingham.ac.uk/injuryresearch/projects/index.aspx University of Manchester – falls prevention research: www.nursing.manchester.ac.uk/research/researchgroups/socialcareandpopulationhealth/activeageing/ http://www.nursing.manchester.ac.uk/staff/ChrisTodd


No. There are various collaborations such as The Injury Observatory for Britain and

Ireland’ and The Miskin Group

The Injury Observatory for Britain and Ireland http://www.injuryobservatory.net/ The Miskin Group: http://www.miskin-group.org.uk/



http://www.nottingham.ac.uk/injuryresearch/projects/index.aspx

http://www.nottingham.ac.uk/injuryresearch/projects/index.aspx

http://www.nursing.manchester.ac.uk/research/researchgroups/socialcareandpopulationhealth/activeageing/



http://www.nursing.manchester.ac.uk/staff/ChrisTodd

http://www.nursing.manchester.ac.uk/staff/ChrisTodd


http://www.miskin-group.org.uk/

15


No single plan. Injury prevention tends to be incorporated within national action plans for population groups such as children or older people.

For example, regarding children: Staying Safe: Action Plan (Feb 2008): https://www.education.gov.uk/publications/eOrderingDownload/DCSF-00151-2008.pdf


7.2. Signature

7.3. Name Wendi Slater Wendi Slater

https://www.education.gov.uk/publications/eOrderingDownload/DCSF-00151-2008.pdf

https://www.education.gov.uk/publications/eOrderingDownload/DCSF-00151-2008.pdf