M O N T E N E G R O Negotiating Team for Accession of Montenegro to the European Union Working Group for Chapter 18 – Statistics Bilateral screening: Chapter 18 PRESENTATION OF MONTENEGRO Luxembourg, June 2013

HEALTH AND SAFETY Bilateral screening: Chapter 18 Presentation of Montenegro Luxembourg, June2013 Natasa Terzic Director of the Center for Health System Development Institute of Public Health STATISTICS Chapter 18: M O N T E N E G R O Negotiating Team for Accession of Montenegro to the European Union Chapter 18: Statistics

EU legal context STATISTICS Chapter 18: M O N T E N E G R O Negotiating Team for Accession of Montenegro to the European Union Chapter 18: Statistics  Regulation (EC) No 1338/2008 of the European Parliament and of the Council of 16 Decembar 2008 on Community statistics on public health and health and safety at work  Commission Regulation (EU) No 328/2011 implementing Regulation (EC) of the European Parliament and of the Council on Community Statistics on public health and health and safety at work, as regards statistics on causes of death  Commission Regulation (EU) No 349/2011 implementing Regulation (EC) of the European Parliament and of the Council on Community Statistics on public health and health and safety at work, as regards statistics on accidents at work  Commision Regulation (EU) No 141/2013 implementing Regulation (EC) of the European Parliament and of the Council on Community Statistics on public health and health and safety at work, as regards statistics based on the European Health Interview Survey (EHIS)

National legal framework  Law on health data collections (“Official Gazette of Montenegro”, No 80/08)  Law on healthcare (“Official Gazette of Montenegro” No 39/04, No 14/10)  Regulation on detailed content, form and mode of registries management for diseases of major socio medical importance, infectious diseases and other conditions related to population health (“Official Gazette of Montenegro,” No 24/12) STATISTICS Chapter 18: M O N T E N E G R O Negotiating Team for Accession of Montenegro to the European Union Chapter 18: Statistics

National legal framework  Regulation on specific health data included in registries on diseases of major sociomedical importance, infectious diseases and other conditions related to population health (“Official Gazette of Montenegro“ No 24/2012)  Regulation on methods for completing, deadlines and reporting forms for certain disease evidenced in the registry (“Official Gazette of Montenegro” No 24/2012)  Regulation on defining and sending reports for determined disease or condition evidenced in the registry (“Official Gazette of Montenegro” No 24/2012) STATISTICS Chapter 18: M O N T E N E G R O Negotiating Team for Accession of Montenegro to the European Union Chapter 18: Statistics

PUBLIC HEALTH STATISTICS Law on healh data collections STATISTICS Chapter 18: M O N T E N E G R O Negotiating Team for Accession of Montenegro to the European Union Chapter 18: Statistics Regulates:  Types, content and manner of managing data collections   Method of collecting and entering the data  Processing, use and exchange of data  Keeping medical personal records  ICD-10 as standard for diagnoses coding

Main data collections - regular annual level- STATISTICS Chapter 18: M O N T E N E G R O Negotiating Team for Accession of Montenegro to the European Union Chapter 18: Statistics Registries Registries of diseases (14) Communicable diseases Cancer Drug abuse Diabetes CVD ACS Resource registries Other data collections outpatient health care ( PHC visits, specialist visits, counselling services, morbidity..) inpatient data health care (hospital discharges, LOS, morbidity, beds, deliveries, abortions) health care workforce accidents at work professional diseases

Chapter 18: STATISTICS Chapter 18: STATISTICS M O N T E N E G R O Negotiating Team for the Accession of Montenegro to the European Union Data flows and data collections methods Chapter 18: Statistics Medical nomenclatures All Health Care Providers and Pharmacies Health statistics and public health reports, analytical reports, Statistical yearbook Health Surveys (HIS, ESPAD, GYTS, MICS) WHO, ECDC, EUROSTAT, Health Insurance Fund Invoicing data Medical nomenclatures, method. Instr. Data for health statistics and monitoring and disease surveillance (quarterly and annual reports, individual data) Institute of Public Health MONSTAT –Stat. Office Ministry of Health Health statistics data Demographic and mortality based data Financial reports

Statisics on health and safety at work IPH monitors data at the primary health care level concerning preventive examinations of employees; There is no organized manner of collecting and reporting data on accidents at work, although the definitions of AW and professional diseases have been regulated by the law; According to the relevant legal framework, and in accordance with the EU recommendations, the regulations defining registries of accidents at work and professional diseases, as well as the relevant methodology are in the final stage of preparation. Methodology for the registry of traumatisms was adopted in STATISTICS Chapter 18: M O N T E N E G R O Negotiating Team for Accession of Montenegro to the European Union Chapter 18: Statistics

HEALTH SURVEYS (within the MNE Health Improvement System Project) Health Interview Survey 2008, 2012 (by LSMS type – representative sample): Population aged 7-19 (12-19 self-administered) and 20+ (household survey) Variables: Demoraphic and socio – economic background Health status (with self perceived health) Health care use Health and social determinants (derogations in 2012) Survey methodological issues STATISTICS Chapter 18: M O N T E N E G R O Negotiating Team for Accession of Montenegro to the European Union Chapter 18: Statistics

Statistics on Causes of Death Until 2010 Statistical Office of MNE collects, process and reports the data on causes of death on national level based on death reports (including the physician certified report ) Data on causes of death have been coded by ICD-10 (prov. WHO) Institute of Public Health was a data user and responsible institution to report the WHO on statistics on causes of death disagregated by age and gender ( ) Since 2010 the Institute of Public Health collects individual death reports Additional control and quality improvement of data are in the proces in IPH to report statistical data on causes of death from 2010 onward. Regulation defining the new application form of death case and death certificate (in EU accordance ) is expected until end of STATISTICS Chapter 18: M O N T E N E G R O Negotiating Team for Accession of Montenegro to the European Union Chapter 18: Statistics

Further activities and challenges  Adoption of bylaws for the fully implementation of the relevant law on health data collections (accidents at work, professional diseases, absenteeism...);  Further development of health statistics information system;  Regulation on establishing the fact of death, cause and time of occurrence (new report form on death cases including causes of death through physician certified form);  Further harmonization of Health Interview Survey methodology (providing funds for the continuation of conducting every 5 years);  National health indicators set in accordance with the ECHI. STATISTICS Chapter 18: M O N T E N E G R O Negotiating Team for Accession of Montenegro to the European Union Chapter 18: Statistics

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