1. Arpo Aromaa, KTL Background, Terminology and Scope (Comment from Discussant) Working Paper No.12 21 November 2005 STATISTICAL COMMISSION andSTATISTICAL OFFICE OF THE UN ECONOMIC COMMISSION FOREUROPEAN COMMUNITIES EUROPE (EUROSTAT) CONFERENCE OF EUROPEAN WORLD HEALTH STATISTICIANS ORGANIZATION (WHO) Joint UNECE/WHO/Eurostat Meeting on the Measurement of Health Status (Budapest, Hungary, 14-16 November 2005) Session 1

2. Measurement of health Do we need a broader framework and analysis of definitions and purposes of health measurement? –scientific; health policy and planning; both –measurements are poor or unavailable in many of the areas needed for policy and practice Is the distinction and role of health status vs. health states clear?

3. Information for policy and practice Health status and health states –including major diseases and functioning Modifiable determinants Need for promotion and prevention Need for care and rehabilitation Need for care and aids Expected future developments (based on determinants, trends and current health)

4. HIS, why not HES Is it wise to concentrate solely on interview methods? Measurements of functioning, functional limitations and activity limitations add to dimensions, validity and comparability (between populations and time), and a number of them could be incorporated in home health interviews.

5. Health states Usefulness of separating health states from many other measures of health? Which health state dimensions? Is the distinction between capacity and performance useful in survey work? Can useful scales be constructed for each of the health state dimensions? And can (or should) different dimensions be ’added up’ for combined measures?

6. Current health alone? Are the arguments for concentrating on current health states convincing? For health policy and health care planning important issues take into account determinants of health, promotion and prevention, and current and future (care) needs and their determinants. Should recommendations on health states clearly mention and define other important areas?

7. Next steps Need for a precise road map for future work? How to ensure that key developments are coherent with those of various actors? Is this effort only one of the many leading to recommendations but little practical use?

8. Washington Group Is it likely that disability measurement by censuses will become a preferred solution? What is the intended relationship of census questions to national health survey questions? How useful has ICF been in the development of the questions? Some draft questions combine two different functions - do they work?