Magee Hugh F
Department of Health and Children, Hawkins House, Hawkins Street, Dublin 2, Ireland.
Eur J Public Health. 2003 Sep;13(3 Suppl):73-9. doi: 10.1093/eurpub/13.suppl_1.73.
The ability to measure and compare hospital activity between EU member states is important for policy, planning, financing and assessment of population health. Earlier initiatives in this area have been largely directed at standardising high-level indicator definitions without proper account of differences in health systems and health information systems. The Hospital Data Project (HDP) develops a methodology for improved comparability of hospital inpatient and day case activity data across Europe and produces a pilot common data set. All EU members, Iceland and the World Health Organisation are participants.
The approach comprises a detailed inventory of patient-level hospital data, identification of common areas, specification of data transformations and production of pilot data sets and metadata in a common format. An expert group developed a new diagnosis shortlist based on ICD-10. The project takes account of current work in the area of health care and morbidity indictors and applies the functional specification of health systems developed by the OECD.
Seventeen countries have submitted data and metadata in the common format for a single year. Data on inpatients and day cases are classified by age, gender, diagnosis and type of admission. Numbers of hospital discharges, mean and median lengths of stay and population rates are reported. Test data on selected hospital procedures has also been collected. The full data set contains approximately 500,000 records, and software has been designed to facilitate validation and use.
Results to date are promising. It is a first step in a complex area, and further work is required to extend and refine this approach.
衡量和比较欧盟成员国之间的医院活动情况，对于政策制定、规划、融资以及人口健康评估而言至关重要。该领域早期的举措主要致力于标准化高层次指标的定义，却未充分考虑卫生系统和卫生信息系统的差异。医院数据项目（HDP）开发了一种方法，以提高欧洲范围内医院住院患者和日间病例活动数据的可比性，并生成了一个试点通用数据集。所有欧盟成员国、冰岛以及世界卫生组织均为参与方。
该方法包括对患者层面的医院数据进行详细清查，确定共同领域，明确数据转换规范，并以通用格式生成试点数据集和元数据。一个专家组基于国际疾病分类第十版（ICD - 10）制定了一份新的诊断清单。该项目考虑了医疗保健和发病率指标领域的当前工作，并应用了经合组织制定的卫生系统功能规范。
17个国家已以通用格式提交了某一年的数据和元数据。住院患者和日间病例的数据按年龄、性别、诊断和入院类型进行分类。报告了医院出院人数、平均和中位数住院时长以及人口比率。还收集了选定医院程序的测试数据。完整的数据集包含约500,000条记录，并且已设计软件以方便验证和使用。
迄今为止的结果很有前景。这是复杂领域的第一步，需要进一步开展工作以扩展和完善此方法。
