Statistical Journal of the United Nations Economic Commission for Europe - Volume 16, issue 1

Authors: Wolfson, Michael C.

Article Type: Research Article

Abstract: A major challenge in health statistics is achieving a reorientation. At present, the preponderance of “health” data concerns health care system, and then mainly its inputs and throughputs. There is a paucity of statistical information on the levels, trends and distribution of health status for the population, and various sub-groups. We know far more about the costs of health care, and the numbers of patients treated, than we do about the health impacts of the treatments, and the health of the population in general. This paper reviews the leading approaches to the measurement of population health, and discusses the main …conceptual and ethical challenges. It then illustrates some of the practical considerations in developing such measures with reference to Canadian experience. Show more

DOI: 10.3233/SJU-1999-16101

Citation: Statistical Journal of the United Nations Economic Commission for Europe, vol. 16, no. 1, pp. 1-17, 1999

Authors: Essink-Bot, Marie-Louise

Article Type: Research Article

Abstract: Disability-adjusted life-years (DALYs) constitute a member of the family of composite health outcome measures, that further includes measures such as the Healthy Life Expectancy, Disability-Adjusted Life Expectancy and Quality Adjusted Life-years. DALYs are essentially a combination of Years of Life Lost due to mortality (YLL) and Years of Life lost due to Disability (YLD) by a population. YLD are weighted for the severity of specified disabilities using disease-specific disability weights between 0 (no disability) and 1 (extreme disability). DALYs were developed in the Global Burden of Disease (GBD) study that provided quantitative, internally consistent estimates of the burden of …the disease, including non-fatal health outcomes, attributable to 107 causes, per sex, for different age groups, and per region of the world, in 1990. The GBD study has demonstrated the potential value of combining data about length of life and severity of disease in a single comprehensive measure. Descriptions of the population's health with the help of such a measure may serve as a source of information for public health policy and for prioritizing and planning health care and health services research. Recently, a coherent set of disability weights for 52 diseases that constitute the major part of ill-health in the Netherlands was derived in the Dutch Disability Weights study, and applied in Dutch burden of disease estimates in the Dutch Public Health Status and Forecast 1997 study. The present paper provides an introduction on the DALY approach by discussing some of the methods and the results of the Global Burden of Disease study, and introducing the Dutch Disability Weights study and the burden of disease estimates in the Dutch Public Health Status and Forecast 1997 study. Show more

DOI: 10.3233/SJU-1999-16102

Citation: Statistical Journal of the United Nations Economic Commission for Europe, vol. 16, no. 1, pp. 19-29, 1999

Authors: Meltzer, Howard

Article Type: Research Article

Abstract: The World Heath Organisation is in the process of revising the International Classification of Impairments, Disabilities and Handicaps (ICIDH). This paper describes the background to the ICIDH and the new features of the revised classification in relation to its aims and applications. The ICIDH has been extensively used in prevalence studies of disability and to measure the effectiveness of rehabilitation and examples of some of these studies are cited. The paper concludes with the plans for the future development of the ICIDH and the particular problems in translating the underlying concepts into assessment instruments that can provide valid and reliable …data for research and statistical purposes including comparative studies. Show more

DOI: 10.3233/SJU-1999-16103

Citation: Statistical Journal of the United Nations Economic Commission for Europe, vol. 16, no. 1, pp. 31-36, 1999

Authors: Madden, Richard | Reece, Laura | White, Peter

Article Type: Research Article

Abstract: Australia is a federation of six States and two Territories (‘the States’) with a central Government (‘the Commonwealth’). The States operate the major part of the Australian hospital system and most community health services. There is a large private sector (most doctors, pharmacists, some hospitals and the bulk of allied health services). The Commonwealth is a major funder of the States' and the private sector's health services. Health expenditure represents 8.5% of GDP. The Commonwealth provides 45% of health expenditure, the States 23% and the private sector 31%. In this mixed system, there is a strong commitment to consistent health …information. The Australian Institute of Health and Welfare (AIHW) is an independent government agency established to develop, collect and disseminate reliable, timely facts on the health of Australians and their health and community services. National agreements commit all the nine governments, AIHW and the Australian Bureau of Statistics (ABS) to work together to develop consistent, reliable and comprehensive data on health and community services in Australia. Despite the constant political differences among all the players in the Australian health system, the information effort has been exceptionally successful. The Australian experience can help and even inspire others. More tangibly, the tools developed in Australia can help others today. The tools are freely displayed through the AIHWs web site www.aihw.gov.au ). The National Health Information Knowledgebase contains the National Health Data Dictionary (7th edition), a comprehensive set of nationally agreed definitions of terms used in health statistics. All definitions follow internationally agreed formats. Behind the dictionary is a National Health Information Model. The paper will describe the health information coordination arrangements in Australia and describe the Knowledgebase, its current uses and its potential for further development, as well as for helping the development of improved health statistics in other countries and better consistency at international level. Show more

DOI: 10.3233/SJU-1999-16104

Citation: Statistical Journal of the United Nations Economic Commission for Europe, vol. 16, no. 1, pp. 37-47, 1999

Authors: Li, Larry | Henry, John | Davis, Tim

Article Type: Research Article

Abstract: Integration of socio-economic statistics and geographical data provides essential information to meet a variety of development challenges. This combination of information, particularly when married with Geographic Information Systems (GIS), has proven extremely useful in helping development managers make decisions affecting education, health, environmental protection, municipal services, economic development and location of essential infrastructure. This paper discusses the geographic dimension of statistical data and its role in economic and social development. The topics of discussion include: the importance of geostatistical data for social and economic development, how geographic representation of statistical data have been applied to a variety of development challenges, …options for disseminating geostatistical data to users, and mechanisms for GIS implementation and training. Specific examples of Statistics Canada's experiences in Canada and in other countries will be presented to illustrate the themes in this paper. Show more

Keywords: GIS , data visualisation, social and economic development, municipal, health, education, environmental planning

DOI: 10.3233/SJU-1999-16105

Citation: Statistical Journal of the United Nations Economic Commission for Europe, vol. 16, no. 1, pp. 49-58, 1999

Authors: Calder, Alistair

Article Type: Research Article

Abstract: The Office for National Statistics has responsibility for collecting and producing statistics for a wide range of demographic, social and economic topics across much of the UK. Recently a growing desire to integrate statistics from across these subject areas and to some extent with those from outside agencies, combined with customer demands for more flexible and responsive outputs, have lead to a fundamental review of how ONS data is referenced. An effective referencing strategy for ONS needs to enable the production of accurate, responsive, flexible outputs as well as coping with the problems posed by the UK's complex and ever …changing geography. The strategy that is currently being investigated is a move away from the traditional building block approach to a solution where individual survey observations are allocated accurate co-ordinate references. This type of referencing, combined with the use of GIS and digital boundaries, should provide ONS with the flexibility and responsiveness to change required. This paper describes the problems associated with the existing referencing system, the strategy which has been proposed to replace it and the benefits which should flow from this approach. Show more

DOI: 10.3233/SJU-1999-16106

Citation: Statistical Journal of the United Nations Economic Commission for Europe, vol. 16, no. 1, pp. 59-67, 1999

Authors: Slater, Barbara | Law, Stephen

Article Type: Research Article

Abstract: The Year 2000 problem is real and if not addressed could affect all industries, all sectors and all countries. Ensuring that our statistical programs continue to operate without disruption in the period leading to and through the Year 2000 continues to be one of Statistics Canada's highest priorities. To resolve the Year 2000 date problems, Statistics Canada is working on three main fronts: – To ensure that systems are properly adapted and tested so that Statistics Canada can continue to supply the information required by its clients before, through and after the year 2000; – To alert …data suppliers and partners to the issue and negotiate arrangements that will ensure that data exchanges will continue to function through the year 2000; – To take readings of the state of preparedness of Canadian businesses. On the first front, Statistics Canada initiated its management response in 1996 with the appointment of a full-time Year 2000 Co-ordinator together with a Steering Committee composed of senior departmental managers and a Working Group composed of project leaders. On completion of comprehensive inventory of the custom computer programs used in our statistical programs, the responsible line program managers developed a plan for the remediation or replacement of each application that was assessed as requiring attention. We have identified as departmental mission critical programs those that provide key current socio-economic indicators (such as the Consumer Price Index, Labour Force Survey, Gross Domestic Product, International Trade, the System of National Accounts plus its key feeder systems) and the systems related to internal pay and cash handling. A completion target date for the conversion and testing of mission critical applications has been set for the end of December 1998. Due to interdependencies between several mission critical applications and the sequencing of the testing, final testing for a small number of applications will likely not be completed until the first quarter of 1999. Other applications have a target date for conversion of mid 1999 and for testing of late 1999, but in many cases it has been practical to already convert and, in some cases, test these applications as well. Statistics Canada uses a diverse and rich computing environment including traditional mainframe and minicomputers and a variety of servers and workstations. Following an assessment of each of these computing environments, the commercial software products and the underlying network infrastructure, plans were developed and are now being implemented to ensure that the computing infrastructure continues operation uninterrrupted due to faulty date processing. On the second point, we continue to discuss mutual preparedness with other government departments, at all levels, on which we depend for a wide variety of data inputs. A communications plan is in place to alert our business respondents to the issue and negotiations are underway with key data providers regarding their continued provision of accurate and reliable data. On the last point, Statistics Canada published the results of Survey 1 and Survey 2 of the preparedness of Canadian businesses in the December 8, 1997 and July 6, 1998 editions of The Daily . Statistics Canada is planning to carry out a third survey for release in early 1999. Show more

DOI: 10.3233/SJU-1999-16107

Citation: Statistical Journal of the United Nations Economic Commission for Europe, vol. 16, no. 1, pp. 69-77, 1999

Authors: Stibbard, Peter

Article Type: Research Article

Abstract: Nowadays the use of labour statistics goes well beyond just monitoring the labour market; they are becoming well integrated into several aspects of government decision-making and influence financial markets. The methods used for their release and further dissemination are therefore rightly a matter of public concern. Virtually all international recommendations and guidance on labour statistics are restricted to the collection and processing operations. Only recently has attention been given at an international level to developing a code of best practice for dissemination – even though dissemination practices have a big influence on the reputation of statistics and the agency which …releases them. Besides the distribution of data on paper and by electronic means, guidelines of good dissemination practice should include topics such as user-friendliness, the provision of metadada, publicity for statistical products and relationships with users. Show more

DOI: 10.3233/SJU-1999-16108

Citation: Statistical Journal of the United Nations Economic Commission for Europe, vol. 16, no. 1, pp. 79-104, 1999