Transcript Slovenian Experience on Measuring Health Status Darja Lavtar National Institute of Public Health, Slovenia Work Session of the Budapest Initiative on Measuring Health Status, Geneve,

Slovenian Experience on
Measuring Health Status
Darja Lavtar
National Institute of Public Health, Slovenia
Work Session of the Budapest Initiative on Measuring
Health Status, Geneve, 20-22 January 2010
Outline
Surveys measuring health status in
Slovenia:
• Pilot EHSM in 2005 (supported by Phare
2003)
• Pilot EHIS in 2007 (supported by TF 2004)
• First national EHIS in 2007 (supported by
Eurostat grant for 2006 and Eurostat
grant for 2007)
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Administrative data sources vs.
survey data in Slovenia
• Importance of national administrative
data sources used for health statistics
(causes of death, perinatal data, hospital
data, out-patient data, accidents at
work, etc.)
• Only a few surveys with health topic:
– Public opinion survey 1997,1999, 2001 (life
style)
– CINDI 2001, 2004, 2008 (life style and chronic
diseases)
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– SILC from 2005 on (MEHM, unmet needs)
Pilot EHSM in 2005: questionnaire
• Questionnaire: European Health Status
Module, English version 16-01-2005:
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–
–
–
–
–
–
Mini European Health Module
Chronic Diseases
Physical and sensory functional limitations
Personal Care Activities
Household Care Activities
Other daily activities
Psychological distress and well-being
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Pilot EHSM in 2005: methodology
• Area covered: the capital city of Ljubljana and
neighbouring settlements
• Age range: 18 to 84 years of age
• Sample size: 200
• Respondents selecting procedure: two-stage
sample design
• Data collection procedure: face-to-face
interviewing (paper questionnaire)
• Response rate: 80%
• Average time required for completing the
questionnaire: 19 minutes
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Pilot EHSM in 2005: experiences
• Youth found many of the questions redundant.
• Some people have an aid, but do not need it. Is
this the same as “has no aid”?
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Pilot EHIS in 2007: questionnaire
• Questionnaire: European Health Interview
Survey, 1st round (adopted in November
2006):
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–
–
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European
European
European
European
Health Status Module
Health Care Module
Health Determinants Module
Background Variables Module
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Pilot EHIS in 2007: methodology (1)
• Target population: Persons aged 15 years and
more, non-institutionalized
• Sampling frame: The list of persons living in the
capital city of Ljubljana and neighbouring
settlements from the Central Population Register
• Sample design: Two-stage sample design (25
PSUs, 8 units in each PSU)
• Sample size: 200 persons
• Mode of administration: Face-to-face interview
(PAPI); Sections with sensitive questions to be
completed by respondent alone and sent back to
the National Institute of Public Health in a pre8
paid and addressed envelope
Pilot EHIS in 2007: methodology (2)
• Interviewers: 8 persons (mostly students)
• Proxy respondents: Allowed in case of severe
health problems and permanent absence of the
selected person
• Response rate: 69%; for self-completion
questionnaires: 70% of respondents
• Average time required for completing the
questionnaire: 37 minutes
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Pilot EHIS in 2007: experiences
• The major problem encountered in the
translation process was that no conceptual
translation cards were provided.
• Showcards were very useful for the younger
respondents and less useful (sometimes even
confusing) for the older respondents.
• Final decision was made that the EHIS will be an
independent survey.
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National EHIS in 2007:
questionnaire
• Questionnaire: European Health Interview
Survey, 1st round:
–
–
–
–
European
European
European
European
Health Status Module
Health Care Module
Health Determinants Module
Background Variables Module
• When implementing EHIS questionnaire in
Slovenia, we strictly hold on European Health
Interview Survey questionnaire for the 1st
Round.
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National EHIS in 2007:
methodology
• Target population: Persons aged 15 years and
more, non-institutionalized
• Sampling frame: Central Population Register
• Sample design: Two-stage sample design (425
PSUs, 8 units in each PSU)
• Sample size: 3400 persons
• Mode of administration: Face-to-face interview
(PAPI) for most of the questions and two selfcompletion questionnaires
• Response rate: 68%
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National EHIS in 2007: health
status - question specific remark
• In the case of EHIS 1st round question HS.7
answer “Not applicable” should be possible at
least in case of Accident at work and Accident at
school, for people that do not work and do not
attend school, as these two questions are
unnecessary for them.
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National EHIS in 2007: results
• Wearing a hearing aid: a hearing aid was used
by 5,2% of respondents aged 15 years or more,
the share for men being 5,5% and for women
4,8%.
• Conversation with several people: In a
conversation among several people the uttered
words could be heard:
– without difficulty by 85,7% of respondents (84,8% men
and 86,6% women),
– with some difficulty by 10,5% of respondents (11,8%
men and 9,3% women),
– with considerable difficulty by 3,1% of respondents
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(2,7% men and 3,3% women).
National EHIS in 2007: experiences
• The interviewers’ recruitment presented the
biggest problem and no permanent base of the
interviewers’ could be established, as even very
serious and experienced students are not
permanent staff for interviewing.
• Based upon pilot study which was conducted in
the beginning of 2007 we decided not to allow
proxy, as it is not suitable to be used especially
in case of subjective questions.
• A larger sample should be drown in the 2nd
round of EHIS in order to allow more detailed
analyses.
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Conclusion
• Survey data analyses with health topic have not
been (yet) widely done (because of the good
administrative sources?)
• Promotion of the health survey data
• Survey materials (questionnaires, conceptual
cards, indicators, etc.) should be available – very
important for countries with less experience in
gathering the health information with survey
data
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