18
European Journal of Public Health, Vol. 23, Supplement 1, 2013
Background All patients with chronic illness make decisions and engage in behaviours that affect their health (self-management). Disease control and outcomes depend to a significant degree on the effectiveness of self-management. The objective of this metaanalysis is to determine the effectiveness of self-management interventions on hospital readmission rates and health-related quality of life in patients with heart failure. Methods A computerized search of Pubmed, EMBASE, Scopus, the Cochrane Central Trials Registry and the Cochrane Database of Systematic Reviews was conducted until February 2013 to find Randomized Control Trials of self-management interventions that enrolled patients 18 years of age or older with diagnosed heart failure. The primary outcome of interest was all-cause hospital readmission, the secondary outcomes were compliance with treatment and quality of life score. For the included studies, we computed the pooled odds ratios (OR), the 95% confidence interval and the P value for all-cause hospital readmission. The pooled effects on health-related quality of life was not computable because of the differences in behavioural scales used in the studies.
Results Overall, eight Randomized Control Trials with 1022 patients were included in the review. A meta-analysis based on six studies showed that self-management interventions significantly decreased hospital readmissions for all causes (OR 0.60; 95% CI 0.44-0.80). No significant effect on health-related quality of life was found in all but two of the five studies that evaluated this outcome. Conclusions Self-management programs targeted for patients with heart failure are effective in decreasing all-causes hospital readmissions and to a lesser extent in improving quality of life. Results from single studies seem to indicate that interventions with structured follow-up or nurse-led education are more effective than the others in improving health outcomes of patients with heart failure. Key messages Self-management programs targeted for patients with heart failure are effective in decreasing all-causes hospital readmissions. Interventions with structured follow-up or nurse-led education are more effective than the others.
L.1. Round table: European Health Information System: Steps from idea to reality Organised by: EUPHA Sections on Public Health Monitoring and Reporting and Urban Health Contact:
[email protected] Chairpersons: Marieke Verschuuren and Helmut Brand, The Netherlands
Health monitoring has been defined as essential public health function number one. Indeed it is the first of the 10 essential public health operations identified for the European region of WHO (WHO-EUR). Health monitoring is a prerequisite for good governance; the effective provision of public health and health care and the evaluation of (health) policies requires information on the population’s health and disease burden, as well as on the underlying determinants. More specifically, monitoring population health provides insights into the magnitude and distribution of health inequalities, and the magnitude, impact and distribution of health determinants, which can then be used to inform the planning of public health and health care services. This information and data has to be comparable and explorable by researchers, policymakers and citizens – a European Health Information System (HIS). Work on developing elements of a European Union (EU) HIS have emerged through a multitude of temporary projects including the European Community Health Indicators (ECHI) projects and HEIDI (Health in Europe: Information and Data Interface). So far, however, there has been little success in transforming these developments to sustainable activities. A positive development, on the other hand, is that the European Commission and the WHO-EUR have agreed on a roadmap to develop one single European HIS; the OECD joined in 2012 as a collaborator. However, for this to succeed, sustainable actions and long term visions are needed, and these are currently lacking. In December 2012, EUPHA’s president and the EUPHA section on Public Health Monitoring and Reporting sent a letter to EU Commissioner Borg to address these issues. In follow up of this letter, we will discuss in this workshop how we can turn the vision of a sustainable, policy supporting health information system for Europe from an idea to reality. A European HIS is needed now, more than ever, if we are to
attain the aspirations set out in the European health policy frameworks of the EU and WHO-EUR. The workshop will take the form of a round table. First introductory presentations will be given to stimulate the discussion. The first three speakers will examine dimensions of approaches to European health information strategies. These presentations will outline possibilities, opportunities, requirements, and challenges of a European HIS from academic, policymaker and service user viewpoints. This will be followed by a facilitated discussion which will aim to elicit expert opinion from panellists and workshop participants. Panellists will be Claudia Stein (WHO-EUR), Stefan Schreck (DG SANCO), Gaetan Lafortune (OECD), Martin McKee (EUPHA) and Hartmur Buchow (Eurostat). The objective of the workshop is to establish a common ground for policy actors and researchers The results of the workshop are aimed to inform the development of a single European HIS within the scope of the WHO-EUR, EC and OECD roadmap Key messages A European Health Information System and Strategy are prerequisites for good public health governance. Recent studies on existing strategies and practices can provide a basis to enable development. Turning the European Health Information System from idea to reality will require the committed partnership and collaboration of international organizations and the public health communities. Building a European Health Information Strategy: an overview of existing strategies Nick Fahy N Fahy Nick Fahy Consulting, Brighton, United Kingdom Contact:
[email protected]
The World Health Organization (WHO) Regional Office for Europe and the European Commission have embarked on the development of a joint roadmap to develop an integrated health information system for Europe. In order to ensure coherence across agencies, bring the roadmap into operation, and adequately support countries in their efforts to improve health reporting, a health information strategy and framework
