APOLLO* W2 Core Project Burden of injuries in Europe *APOLLO is a multi-study package partially funded under the EC DG Sanco 2004 call for proposals

Agenda Overview of WP2 –Objectives and Process for WP2 core tasks –Relationship with umbrella project –Deliverables Logistics of the project –What it actually means Developments to date –Web site –Analyses of HDD –Statistics Portal –Time Frame

WP2 Overview: Objectives and Process Title: “The Burden of Injuries in EU: Indicators and Recommendations for Prevention and Control” Aim: To produce evidence relevant to European policy makers on the burden of injuries together with information on the efficiency of relevant injury prevention interventions.

WP2 Core Overview: Objectives and Process Specific Objectives: 1.To map the urgency for taking action for prevention of injuries due to the magnitude of the problem by calculating an array of indicators, which are in accordance with the work proposed by the Working Party on Indicators of the EC 2.To build capacity among new member states to adequately measure their burden of injuries with a view of monitoring the impact of their injury prevention efforts 3.To develop the theoretical framework for essential indicators, which are currently missing with integration of injury severity measures and exposure to risk denominators 4.To produce tools for linking injury severity with health outputs and costs by member states 5.To recommend appropriate future data collection efforts

APOLLO Structure & Funding (100%)60% WP2 is 30% of APOLLO Core is 38% of WP2 Or 11% of APOLLO They get their € directly

WP2 Core Deliverables 1.Report on the Burden of Injuries in Europe 2.… 6.A web-based query system to produce additional tables and figures with injury data per country and for Europe at large 7.Final report summarizing all the above

Logistics of WP2 Core activities WP2 core involves participation of a total of 24 countries. Managed by Universidad de Navarra (UN) Team Deals, primarily with explotation of Hospital discharge data And some work on either Emergency discharge data Health Interview Data Which is population-based, that is, we know of denominators. Whether national, regional, or local (e.g., city-wide), we will take what there is, in the above listed order (national>regional>local)

What it actually means Define datasets available --telephone interview conducted, summary presented as poster in Vienna and being prepared as manuscript –Good news, all have HDD, most 2004, most ICD-10 (4 ICD-9-CM) Develop a listing of indicators to be calculated –So far, 300 reviewed, 20 selected with further breakdowns by age and gender Create/Update/customize software algorithms to derive numerators and denominators for indicator development. –For example, maps from ICD into AIS, ICD into Barrel matrix…

Cont´d ) Develop a website that will become the “working space” for project partners Development of sofware to analyze data Analyze those data that participating countries cannot analyze by themselves Development of the web-query system Development of Report on Burden

Developments to date Summary on data sources completed – poster available, manuscript under preparation Summary on indicators completed, manuscript under preparation for APHA Web site as working tool completed

- 3 Levels of Users: - Administrators – Participants – Public

Analysis of HDD undergoing –in 14 steps 1.Gather Census Data 2.Gather (additional) information on Hospital Discharge Data 3.Gather Hospital Discharge Data and temporarily upload it to UN 4.Check for quality of injury codes 5.Apply ICDMAP algorithm 6.Apply Barell Matrix algorithm 7.Apply AIS to FCI algorithm 8.Apply external causes of injuries 9.Apply nature of injury categories algorithm 10.Upload augmented hospital discharge data to UN temporarily 11.Calculate frequency distributions 12.Upload log file of frequency distributions 13.Upload results from log file onto web-query system 14.Calculate indicators partners UN

Programming for HDD StataSPSS ICD-9-CM Quality of ICD codes check Barell matrix (ICDMAP ICD9CM-AIS98) Other nature and mechanism categories Frequency distributions Quality of ICD codes check Barell matrix (ICDMAP ICD9CM-AIS98) Other nature and mechanism categories Frequency distributions ICD-10 Quality of ICD codes check Barell matrix ICDMAP ICD10-AIS98 Other nature and mechanism categories Frequency distributions Quality of ICD codes check Barell matrix ICDMAP ICD-10-AIS98 Other nature and mechanism categories Frequency distributions In sum: 18 programs developed + 2 The software is open to the public. You can use it for other projects. You can give it to other people. Just cite it appropriately. A suggested reference is available in each program.

STATISTICS PORTAL Using the Statistics Menu you can specify the parameters for your Query.

Project Timeline Start date Dec 1, APOLLOS…C WP2S…C WP2 “core”S…C Close country enrollmentS…C Selection of indicatorsS…C Develop web as tool for project management S… Develop dummy burden reportS Develop analyses routinesS… Data analysesS…C Web based query systemS…C Burden report reviewS…C MeetingsXXX Telephone/ contacts with subcontractors S…C Telephone/ s with subprojectsS…C Final reportS..C S= Start, C= Completed      

For questions or comments

APOLLO WP2 core participanting countries 1.Austria 2.Belgium 3.Bulgaria 4.Czech Republic 5.Denmark 6.Estonia 7.Finland 8.Germany 9.Greece 10.Hungary 11.Ireland 12.Italy 13.Latvia 14.Malta 15.Norway 16.Poland 17.Portugal 18.Slovakia 19.Slovenia 20.Spain 21.Sweden 22.The Netherlands 23.Turkey 24.United Kingdom

Acknowledgments The UN team is comprised of Uwe Ewert, Jan Krafka, Rafael Heredero, Montserrat Ruiz, Maria del Carmen Lezáun, Cristina Patsouris, and María Seguí-Gómez. We appreciate the assistance of Lois Fingerhut, Maureen Brenan, Cristina Rodriguez and Isabel Ricart in the development of some of the programms. We are thankful to Ellen MacKenzie for providing access to the ICDMAP from ICD-9- CM to AIS98