PROBLEMY

ZDROWIA W

SKALI

MIĘDZYNAROD

OWEJ

Wykład 3

KRYTERIA I WSKAŹNIKI
= PŁEĆ



Dokumentacja szpitalna – męska, żeńska,
nieokreślona

1.

Genetyczna

2.

Chromosomalna – y –męska,

1.

XY, XXY, XO (zespól Turnera)

3.

Chromatynowa (ciałko Barra, pałeczki dobosza) +
- żeńska XX, XXY (Klinefelter)

4.

Somatyczna – budowa ciała

5.

Gonadalna – jądra, jajniki (androgeny i estrogeny) –
zespół feminizujących jąder

6.

Gonadalna – narządy płciowe zewnętrzne

7.

Metrykalna – wpis do dokumentacji

8.

Orientacja psychoseksualna



transseksualizm

SKALE



Ilościowa



Jakościowa



Półilościowa



Pomiar wdrażania polityki zdrowotnej
UE na poziomie narodowym,
regionalnym i lokalnym przy użyciu
wskaźników już istniejących oraz
wskaźników opracowanych specjalnie dla
tej -pracy



Study to measure the implementation of
EU health policies at national, regional
and local levels, assessing the utility of
existing indicators for this task and
developing new indicators as necessary“

Public Health Evaluation and Impact

Assessment Consortium” (PHEIAC)

METODOLOGIA

IDENTYFIKACJA PROBLEMU
UZGODNIONA ANALIZA

Definicja problemu

· Agreeing Analysis (ANA):
zaadaptowanie/przeniesienie / promowanie
polityki opartych na wspólnej definicji lub
opracowanych przy użyciu identycznych metod
analitycznych oraz / lub wytycznych i inspiracji
wynikających ze wspólnych zasad.

Adopt/transpose/promote policy based on a common
problem definition, or common analytical methodologies
and/or guidelines, or inspired to common principles.

IDENTYFIKACJA PROBLEMU
USTALENIE CELÓW

Problem identification
· Setting Objectives (OBJ): Aim to a certain specific
policy objective irrespective of the concrete modalities
with which it has to be achieved.
· Drafting Programmes (PROG): Define strategies,
programmes and action plans at all the relevant levels of
Government (national, regional, local) in a given policy
area. A subset of this programming activity concerns the
specific identification of research needs with an aim for
their eventual coordination at the EU level (PROG.RES).
· Introducing Legislation (LEG): Introduce/modify
enforceable legislation/self-regulation. Self-regulation
can be represented by voluntary commitments to change
behaviour from single economic agents (LEG.VOL).

IDENTYFIKACJA
PROBLEMU

Policy Definition – Consensus Building



· Committing to Principle (PRI): Commit all
policymakers to a given horizontal health policy
principle.



· Involving Partners (PART): Promote
participatory policymaking by involving
stakeholders’ groups and patient organisations.



· Investing in Research (RES): Fund research to
spur interest in the subject in the scientific
community.



· Raising Awareness (AWA): Raise awareness
through informational/educational campaigns1.

IDENTYFIKACJA
PROBLEMU

Policy Implementation – Institutional Aspects



· Funding Policies (FUND): Make adequate resources
available to implement policies/programmes. A subset of
this may include specific suggestions to use the EU
Structural Funds and the Health Programme as a source
of financing.



· Establishing Organisations (ORG): Establish a body
clearly responsible for policy coordination and/or a focal
point entrusted with data collection and policy reporting
at the EU level. Establish a lead agency/centre of
expertise to disseminate policy.



· Building Networks (NET). Build networks of
institutions and ensure the necessary communication
among them.



· Introducing Procedures (PRO): Introduce given
procedures.

IDENTYFIKACJA
PROBLEMU

Policy Implementation – Operational Aspects



· Policing /Enforcement (POL): Policing
compliance with regulation/self-regulation by
means of administrative or judicial controls.



· Delivering Actions (DEL): Deliver concrete
activities in compliance with a given set of
implementation modalities or for certain
population targets (this can be at the national,
regional and local level).



· Ensuring Technical Capacity (CAP): Ensure
the availability of the necessary technical
means or equipment.



· Training (TRAI): Train personnel.

IDENTYFIKACJA
PROBLEMU

Feedback on Policy and Learning Mechanisms



· Harmonising Data (HAR): Establish a harmonised
set of indicators concrete to the policy area and
the national framework to describe the policy
problem to allow data comparisons at the
European level. Adopt a common set of definitions
and modify national data recording accordingly.



· Evaluating Results (EVAL): Monitor and evaluate
the effectiveness/cost-effectiveness of policies.



· Exchanging Information (EXC): Exchange best
practices and policy results at European level.



· Reporting on Implementation (REP): Report to
the Commission on implementation and results
achieved.

OBSZARY I WSKAŹNIKI
POLITYKI ZDROWOTNEJ UE

PODSUMOWANIE STUDIÓW
PRZYPADKÓW - CASE STUDIES

WSKAŹNIKI
PODSTAWOWE



Primary Indicators



The case studies carried out within the
framework of this exercise have confirmed
the relevance of indicators on



(i) the adoption or transposition of policy
definitions or methodologies (ANA),



(ii) data harmonisation (HAR),



(iii) the existence of dedicated programmes
or strategies in a given policy area (PROG),



(iv) the allocation of organisational
responsibility (ORG), and (v) the availability
of evaluation reports (EVAL).

WSKAŹNIKI PODSTAWOWE
PRZYKŁADY



All in all, these indicators, which we have been named 'primary' indicators,
represent on their own a good proxy of the level of commitment to any given
policy. Examples include, among others:



· number of MS or other relevant entities formally adopting a given
methodology/problem definition - wholly or in part (ANA);



· number of MS that have established a strategy / programme / action plan
covering the whole population (PROG);



· number of MS that have identified a body responsible for policy
coordination / a focal point (ORG);



· number of MS for which a centre of expertise entrusted with disseminating
best practice in a given policy area can be officially identified (ORG);



· number of MS providing homogeneous data to the relevant EU Health
Indicator database (HAR);



· number of MS that have put in place special registries when requested /
number of registries established



(HAR);



· number of MS or other relevant entities that have carried out evaluations /
cost effectiveness assessments of their policies (EVAL); and



· number of MS or other relevant entities that have put in place a system of
indicators to monitor policy implementation (EVAL).

WSKAŹNIKI WTÓRNE



Secondary Indicators



Other categories of indicator can be retained as secondary
indicators for complementary information purposes. They are not
generally considered as valid and feasible as primary indicators and
are subject to a number of limitations, but can nevertheless address
special purposes and information needs. These include, among
others:



· bibliographic indicators such as number of MS with evidence of a
significant debate in the scientific literature about a methodology /
policy problem (ANA);



· indicators on EU funding such as total structural fund financing
committed to implement a given health policy (STR.FUND);



· indicators on the number of MS reporting commitment to a given
policy principle to international organisations or the EU (PRI);



· indicators on the number of MS that have submitted their policy
experiences to the relevant European Coordination Mechanism /
Working Group or dedicated database / portal (EXC);



· indicators on the number of MS that have complied with their
reporting requirements when relevant (REP).

POZOSTAŁE WSKAŹNIKI

Indicators to Be Considered on an Ad Hoc Basis



Indicators on introducing legislation or self-regulation (LEG) and
on policing and enforcing it (POL), as well as those on building
networks (NET) and ensuring related technical capacity (CAP)
and on introducing given procedures (PRO) have been retained
for special cases only to be considered on an ad hoc basis.

Indicators not Currently Retained but Worth Reconsidering in the
Future



Awareness raising and communication (AWA), policy
participation (PART), research (RES), and policy funding (FUND)
indicators have not been retained partly because of disagreement
among stakeholders on their relevance in the specific country
context, partly because of severe feasibility problems. At any
rate, they remain worth considering in the future, should the
current limitations be overcome and an agreement found on their
relevance in light of well-defined benchmarks in terms of
compliance with relevant EU guidelines