ECHI indicators→Health services

59. Cervical cancer screening

Definition

Proportion of women (aged 20-69) reporting to have undergone a cervical cancer screening test within the past three years.

Rationale

Among all malignant tumors, cervical cancer is the one that can be most effectively controlled by screening. Detection of cytological abnormalities by microscopic examination of Pap smears, and subsequent treatment of women with high-grade cytological abnormalities avoids development of cancer. Information collected in population surveys can be directly used by the public health decision makers in order to possibly adapt the organization of the prevention/screening programmes. The domain of cervical cancer screening is a priority in European Community public health policy.

Relevant policy areas

• Healthy ageing, ageing population
• Health system performance, quality of care, efficiency of care, patient safety
• Non-Communicable diseases (NCD), chronic diseases
• (Preventable) Burden of Disease (BoD)
• (Planning of) health care resources

More information

• ECHI Documentation sheet 59. Cervical cancer screening (pdf)
• This indicator is part of the ECHI shortlist

61. Timing of first antenatal visit among pregnant women

Definition

Percentage of women having their first antenatal visit in 1st, 2nd, and 3rd trimester or having no visits. Antenatal visit refers to a visit to a certified health care professional, e.g. general practitioner, obstetrician, midwife and public health nurse. Only visits to examinations and/or pregnancy-related advice are to be included. Mere prescription of a pregnancy test or booking in a maternity unit should be excluded.

Rationale

Antenatal care is the best preventive care for pregnant women to reduce morbidity and mortality in both mothers and their babies. Antenatal visits allow for the management of pregnancy, detection and treatment of complications and promotion of good health. It provides an indication of access to antenatal care. It is a better indicator for international comparisons than an indicator based on recommendations about the optimal number of antenatal visits, which vary according to policy differences among Member States.

Relevant policy areas

• Health inequalities (including accessibility of care)
• Health system performance, quality of care, efficiency of care, patient safety
• Maternal and perinatal health
• (Preventable) Burden of Disease (BoD)
• Child health (including young adults)
• (Planning of) health care resources

More information

• ECHI Documentation sheet 61. Timing of first antenatal visit among pregnant women (pdf)
• This indicator is part of the ECHI shortlist

78. Survival rates cancer

Definition

The relative survival rate for (10 different groups of) cancer; the proportion of patients who survive at least five years after diagnosis, after correction for background mortality.

Rationale

High burden diseases. Cancer survival is an indicator of the effectiveness of a country’s health care system in the area of cancer screening, screening/early detection and treatment. The health care system can improve the survival of certain cancers through early detection and appropriate treatment. Monitoring of a larger array of important cancers is important for the overall effectiveness of the system, including prevention.

Relevant policy areas

Health inequalities (including accessibility of care)
Health system performance, quality of care, efficiency of care, patient safety

More information

• ECHI Documentation sheet 78. Survival rates cancer (pdf)
• This indicator is part of the ECHI shortlist

80. Equity of access to health care services

Definition

Index of self-declared unmet need for health care services. Defined as the total self-reported unmet need for medical care (medical examination or treatment) for the following three reasons: financial barriers + waiting times + too far to travel.

Rationale

The self-reported unmet need for medical examination or treatment is an indicator for equity of access to health care services. It gives insight into the need for medical care and the obstacles that stand in the way of the actual use of health care services. As such it can provide useful information on how to overcome the obstacles for use and improve health. The underlying assumption is that the self-reported unmet need corresponds with the actual need for medical care.

Relevant policy areas

• Sustainable health systems
• Health inequalities (including accessibility of care)
• Health system performance, quality of care, efficiency of care, patient safety
• Health in All Policies (HiAP)

More information

• ECHI Documentation sheet 80. Equity of access to health care services (pdf)
• This indicator is part of the ECHI shortlist

82. Surgical wound infections

Definition

To be developed (see key issues and problems)

Rationale

Indicator for the safety of operative interventions. Wound infection can lead to re-operation and prolonged hospital stay, to increased morbidity and mortality for patients and to increased costs for the health care system. Amenable to interventions: the incidence of wound infection can be reduced by proper pre-, intra- and post-operative care, in particular strict hygiene.

Relevant policy areas

• Health system performance, quality of care, efficiency of care, patient safety
• Health threats, communicable  diseases
• Preventable health risks

More information

• ECHI Documentation sheet 82. Surgical wound infections (pdf)
• This indicator is part of the ECHI shortlist

84. Diabetes control

Definition

Proportion of adult diabetics receiving appropriate care, in terms of regular retinal exams.

Rationale

Indicator for the quality of diabetes care. Nearly all patients who have type 1 diabetes for about 20 years will have evidence of diabetic retinopathy. Timely treatment and appropriate follow-up care can delay progression and eventual blindness.

Relevant policy areas

• Healthy ageing, ageing population
• Health inequalities (including accessibility of care)
• Health system performance, Quality of care, Efficiency of care, patient safety
• Non-Communicable diseases (NCD), chronic diseases
• Preventable health risks

More information

• ECHI Documentation sheet 84. Diabetes control (pdf)
• This indicator is part of the ECHI shortlist