Indicators for evaluating European population health: a Delphi selection process

Freitas, Ângela; Santana, Paula; Oliveira, Mónica Duarte; Almendra, Ricardo; Costa, Janaína Mascarenhas Hornos da; Costa, Carlos A. Bana e

doi:10.1186/s12889-018-5463-0

Cited by 53 publications

(81 citation statements)

References 60 publications

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“…The set of indicators used within the PHI was informed via a participatory process in which experts and other stakeholders accessed updated scientific evidence and judged the relevance of indicators identified by the Consortium members within the WPs to appraise population health at the EU regional level [15]. A multidisciplinary group of 81 experts was involved in the participatory processes, from the structuring of the PHI multicriteria model (areas of concern, dimensions and indicators) to the evaluating phases (weights, value functions).…”

Section: The Construction Of Euro-healthy Phimentioning

confidence: 99%

“…A multidisciplinary group of 81 experts was involved in the participatory processes, from the structuring of the PHI multicriteria model (areas of concern, dimensions and indicators) to the evaluating phases (weights, value functions). These 51 Consortium members and 30 other stakeholders reflected not only a wide range of expertise but also Europe's diversity [15], as the group comprised representatives of national, regional and local authorities, advisors and technicians, international bodies, political parties, healthcare professionals, and urban planners ( Table 1). The participatory processes are detailed below in the section describing stakeholders' involvement.…”

Section: The Construction Of Euro-healthy Phimentioning

confidence: 99%

“…These health variations are socially and spatially patterned, and in many cases their drivers can be traced to broader determinants such as socio-economic [4] and working conditions [5,6], which people in Europe experience in very unequal ways [2,13]. To characterise the health of the population currently living in European Union (EU) regions, it is crucial to consider multiple health dimensions that go beyond the health outcomes and include a range of determinants outside the healthcare sector [14,15]. This can provide an evidence-based perspective of policies, with the potential to reduce inequalities and promote health equity [11].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Advancing tools to promote health equity across European Union regions: the EURO-HEALTHY project

Santana¹,

Freitas²,

Stefanik³

et al. 2020

Health Res Policy Sys

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Background: Population health measurements are recognised as appropriate tools to support public health monitoring. Yet, there is still a lack of tools that offer a basis for policy appraisal and for foreseeing impacts on health equity. In the context of persistent regional inequalities, it is critical to ascertain which regions are performing best, which factors might shape future health outcomes and where there is room for improvement. Methods: Under the EURO-HEALTHY project, tools combining the technical elements of multi-criteria value models and the social elements of participatory processes were developed to measure health in multiple dimensions and to inform policies. The flagship tool is the Population Health Index (PHI), a multidimensional measure that evaluates health from the lens of equity in health determinants and health outcomes, further divided into sub-indices. Foresight tools for policy analysis were also developed, namely: (1) scenarios of future patterns of population health in Europe in 2030, combining group elicitation with the Extreme-World method and (2) a multi-criteria evaluation framework informing policy appraisal (case study of Lisbon). Finally, a WebGIS was built to map and communicate the results to wider audiences. Results: The Population Health Index was applied to all European Union (EU) regions, indicating which regions are lagging behind and where investments are most needed to close the health gap. Three scenarios for 2030 were produced-(1) the 'Failing Europe' scenario (worst case/increasing inequalities), (2) the 'Sustainable Prosperity' scenario (best case/decreasing inequalities) and (3) the 'Being Stuck' scenario (the EU and Member States maintain the status quo). Finally, the policy appraisal exercise conducted in Lisbon illustrates which policies have higher potential to improve health and how their feasibility can change according to different scenarios. Conclusions: The article makes a theoretical and practical contribution to the field of population health. Theoretically, it contributes to the conceptualisation of health in a broader sense by advancing a model able to integrate multiple aspects of health, including health outcomes and multisectoral determinants. Empirically, the model and tools are closely tied to what is measurable when using the EU context but offering opportunities to be upscaled to other settings.

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Section: The Construction Of Euro-healthy Phimentioning

confidence: 99%

Section: The Construction Of Euro-healthy Phimentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Advancing tools to promote health equity across European Union regions: the EURO-HEALTHY project

Santana¹,

Freitas²,

Stefanik³

et al. 2020

Health Res Policy Sys

Self Cite

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“…Each area of concern is further divided into dimensions, which are independent evaluation axes for appraising population health, and are made operational by one or more indicators [4]. Indicators were selected through a wide Web-Delphi process where an international panel of 80 stakeholders and experts from multidisciplinary fields shared their views on which factors were deemed relevant to evaluate European population health [38]. The indicator data were collected for the year 2014 and retrieved from different official bodies, such as EUROSTAT, the European Environment Agency (EEA), and the World Health Organization (WHO) [39].…”

Section: The Euro-healthy Population Health Indexmentioning

confidence: 99%

The Role of Cohesion Policy Funds in Decreasing the Health Gaps Measured by the EURO-HEALTHY Population Health Index

Santana

Freitas

Costa

et al. 2020

IJERPH

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Social, economic, and environmental differences across the European Union significantly affect opportunities to move forward in achieving greater equity in health. Cohesion Policy (CP) funds can contribute positively through investments in the main determinants of health. The aim of this study is to analyze to what extent the planned investments for 2014-2020 are addressing the regional health gaps, in light of the population health index (PHI), a multidimensional measure developed by the EURO-HEALTHY project. The operational programs of all regions were analyzed, namely, the CP planned investments by field of intervention. Analysis of variance was performed to examine whether the regional scores in the PHI dimensions were statistically different across regions with different levels of development (measured by gross domestic product (GDP)). Results show that 98% of regions with worse performances on the PHI are less developed regions. Overall, all regions present planned investments in intervention fields linked to dimensions appraised within the PHI (e.g., employment, income, education, pollution). Yet, more needs to be done to focus regional investments in health determinants where regions still lag behind. The PHI has the potential to inform future CP restructuring, providing evidence to extend the current eligibility criteria to other dimensions beyond the GDP.

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“…In measuring the population health needed a constituent factor that clearly measured, there was comparability of indicators, and the use of appropriate statistical models to analyze. 16,17,18,19 The public health index in this study was adopted and compiled from the determinants of basic health in accordance with the Health Goals that we have and is a composite of 12 indicators adopted from the PIS-PK Program indicators. Therefore, this study has been able to describe temporarily how the impact of the Team NS Batch 1 and 2 assignments on the public health index in the Puskesmas work area was selected in 2017.…”

Section: Discussionmentioning

confidence: 99%

The evaluation of Nusantara Sehat program using Nusantara Sehat Public Health Index

Sari¹,

Hendarwan²,

Halim³

2019

hsji

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Latar Belakang: Faktor geografi Indonesia yang berupa daratan, lautan, pegunungan, dan pulau-pulau yang tersebar menyebabkan distribusi tenaga kesehatan dan akses pelayanan kesehatan yang tidak optimal. Berdasarkan Peraturan menteri kesehatan yang telah ditetapkan, pemerintah berupaya mendayagunakan secara khusus sumber daya manusia kesehatan dalam kurun waktu tertentu dengan jumlah dan jenis tertentu, agar meningkatkan akses dan mutu pelayanan kesehatan pada fasilitas pelayanan kesehatan khususnya di wilayah Daerah Tertinggal, Perbatasan, dan Kepulauan (DTPK) dan Daerah Bermasalah Kesehatan (DBK) melalui Program Nusantara Sehat (NS). Metode: Tahun 2015 telah ditugaskan Tim NS Batch 1 dan 2 pada 120 Puskesmas di DTPK dan DBK selama 2 tahun. Kemudian pada tahun 2017 setelah masa tugas berakhir, diadakan evaluasi program yang bertujuan untuk mengetahui dampak program NS terhadap indeks kesehatan masyarakat dengan menggunakan desain Pre and Post-Test Intervention with Control. Evaluasi dilakukan di 15 provinsi, 27 kabupaten, dan 60 Puskesmas pada bulan Februari - Desember 2017. Hasil: Hasil evaluasi program menunjukkan bahwa pada tahun 2017 terjadi perubahan rata-rata indeks kesehatan masyarakat dibandingkan dengan tahun 2015, baik pada Puskesmas intervensi maupun kontrol (p=0,000). Kemudian hasil uji independen t-test terhadap delta perubahan indeks menunjukkan bahwa peningkatan indeks kesehatan masyarakat pada Puskesmas intervensi lebih besar dibandingkan dengan Puskesmas kontrol (p=0,046). Kesimpulan: penugasan Tim NS pada Puskesmas telah membawa perbaikan indeks kesehatan masyarakat yang lebih baik. Diperlukan pengamatan lebih jauh terkait sustainabilitas Program NS dan analisis biaya manfaat (cost benefit analysis) terhadap Program NS. Kata Kunci: Evaluasi program, Nusantara Sehat, Indeks Kesehatan Masyarakat, Indonesia. Abstract Backgrounds: Indonesia’s geographical factors in the form of land, oceans, mountains, and scattered islands have caused the distribution of health workforce and access to health services are not optimal. Based on the Minister of Health regulation, the government seeks to utilize health human resources specifically for a certain period, with certain number and types, in order to improve access and quality of health service to health service facilities, especially in remote area through the Nusantara Sehat Program (Health Indonesia Program-NS). Methods: In 2015, NS Team Batch 1 and 2 were assigned to 120 primary health care center (Puskesmas) in remote areas for 2 years. Then in 2017 after the term ends, NS program evaluation were conducted in 15 provinces, 27 districts, and 60 Puskesmas from Feb to Dec 2017. Results: This evaluation aims to analyze the impact of NS program on public health index using Pre and Post Test Intervention with Control Design. The results of program evaluation showed that in 2017 there was a change in the average public health index compared to 2015, both in intervention and control Puskesmas (p = 0,000). The independent t-test result on the delta of index change indicated that public health index improvement at intervention Puskesmas is greater than the control (p = 0,046). Conclusion: The assignment of NS Team at the Puskesmas has brought improvement of public health index. Further observations are needed regarding the sustainability and the cost benefit analysis of NS Program. Keywords: Program evaluation, Nusantara Sehat, Public Health Index, Indonesia.

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Indicators for evaluating European population health: a Delphi selection process

Cited by 53 publications

References 60 publications

Advancing tools to promote health equity across European Union regions: the EURO-HEALTHY project

Advancing tools to promote health equity across European Union regions: the EURO-HEALTHY project

The Role of Cohesion Policy Funds in Decreasing the Health Gaps Measured by the EURO-HEALTHY Population Health Index

The evaluation of Nusantara Sehat program using Nusantara Sehat Public Health Index

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