Methods
Firstly, the indicators selected to establish the health profiles of the regions of Europe will be defined. The choice will be influenced by the different examples of health profile already existing and the results of European projects on health indicators (Echi and Isare) giving information on the validity and availability of those data at the regional level. The chosen indicators will represent a core set of information to enable regional/national and international comparison of health and health inequalities across Europe. This will build on the work of the ISARE project which has already identified which indicators and datasets are available at the regional level.
Once the indicators have been selected, the data necessary for establishing the health profiles will be assembled, either from Eurostat or at the individual country level by means of the partners for the countries where the regional level relevant for comparison of health indicators is different of the NUTS 1 or 2 levels (the ISARE project has identified that an appropriate level for regional analysis for 4 countries is NUTS 3; Sweden, Slovenia, Czech Republic and Denmark; for two countries -Portugal and Finland- the health regions did not correspond to NUTS levels) and also for the data not available via Eurostat. Once collected the data will be validated, and integrated into the Isare internet site.
At the same time, a model for health profiles will be established, and after this, health profiles will be created for all the regions. They will be sent to the correspondents in each country for validation, and addition of qualitative information.
The data compiled in establishing the health profiles will be used to highlight inequalities between the regions. Once the data collected for all the regions of all the members state (plus candidate countries if possible) statistical analysis will be undertaken. Based on previous experiences on building typology of regions, three types of data will be included in the analysis: socio economic and demographic indicators, indicators describing the health status of the population and indicators describing health services. The first part of the analysis will use descriptive techniques (component analysis) in order to select the data the most relevant to build the typology (informative power and level of correlation with the other variable included in the analysis). With those selected data we will perform a hierarchical classification analysis in order to form a small number of groups of regions presenting similar characteristics. This typology of the regions of Europe, grouping regions with similar socio-sanitary profiles, will then be described, based on the main factors used to build the classification. This typology will be interpreted by the different participating countries so that they can learn about the health and social conditions unique to their country.
Tentatively, a database at infra-regional level will also be established thanks to the partners in each country. The choice of sub regional level will be made in collaboration with the partners in order to ensure availability and comparability of the data at that geographically finer scale. The feasibility of data collection at infra-regional level has already been tested, and 10 countries/regions appear to be able to provide these data. Once these data have been collected, we will perform the same type of analysis as for the typology at regional level and we will establish health and social profiles at infra-regional level.
To ensure the best dissemination of the results of the project, a list of institutions and professionals working in HIS (Health Information Systems) at regional level in the EU will be established. The associated and collaborative partners will be asked to identify these institutions and professionals in their own country / region. A directory of these institutions and professionals will be built and used for the dissemination of the regional health profiles and of the typology at regional and infra-regional level. From this list, a small group of professionals selected on their experience and interest in the dissemination of public health results in a goal of decision making will be set up. A literature review of the methods of dissemination of the results of public health studies will be prepared, focused on the links between public health information and the processes of decision making. A seminar will be organised with a few number of experts (around 10). From the analysis of the literature review and by consensus, they will produce guidelines on the dissemination and use of the tools of the project.
The project organizers acknowledge the need for sustainability of the production of the European Health Profiles after the successful completion of this project. This will require the co-operation and commitment of organizations outside the control of the project organizers. However we will make every effort using lobbying, presentations and publications of the project as a mechanism for identifying a sustainable funding stream to ensure that there is both a regular production of European Health Profiles and an update of the typology of the regions within and ever changing Europe.