The last ten years have witnessed an increased investment in European and international initiatives and projects to improve health data for cross-country research. The major goals have been to help national policy-makers, on the one hand, to better assess the health status of their populations and on the other hand, to monitor how health care systems of their countries perform compared to other countries. There are, however, limits to what can be learnt from comparisons at the aggregate, health care system level of analysis. Disease level analysis has therefore been receiving increased attention (e.g. OECD, 2003). This approach is of particular interest when studying health care for chronic diseases. Indeed a large share of health care resources and public and private expenditure is presently spent on health care services for patients with a chronic illness, the majority of which are usually 50 years old or more. Due to ageing populations and medical-technological progress, European countries have experienced a shift in the burden of disease towards chronic diseases.
EuroREACH is a coordination action that aims to overcome the compartmentalisation of data collection and analysis of chronic diseases – both on a national and European level – in order to study the questions listed above in a cross-country, comparative perspective. European datasets for comparable health care data so far mainly have relied on strategies to make the best use of data originally produced at the national level.
The following approaches are followed in order to link the various datasets of chronic patients who tend to slip “in and out of the health system”:
Although the focus is on health care for chronically ill patients, many of the findings and recommendations, as well as the generic guidance that the Handbook provides, are also relevant and apply to other health services research and public health research more broadly. Indeed the latter face similar data challenges and frequently use the same main data sources, such as patient registries and other administrative systems.The findings from the EuroREACH project feed into a digital compendium of health data initiatives and information systems, the Health Data Navigator (HDN). It was developed as part of the EuroREACH project and serves as a toolbox to researchers, policy makers and other stakeholders. Ultimately it aims to improve the quality of comparative health systems analysis and performance measurement and to encourage cross-country exchange of good practice data use. The Health Data Navigator can be accessed under the following link: www.healthdatanavigator.eu
The HDN lists national and international data bases relevant for performance assessment with a particular focus on patient-level and disease-oriented data. An important added value of the HDN is to inform visitors of the *appropriateness and quality of data* they may want to use. In particular, data sources reported in the HDN are described in greater detail where information exists in regard to accessibility, coverage, quality, linkage and strenghts and weaknesses.
The Health Data Navigator offers guidance on pertinent issues in international health research including:
