CHALLENGES IN CALCULATING AND ASSESSING HEALTH INDICATORS

Abstract

Undoubtedly, public health is inseparable from individual health, which is most often measured by public health outcome indicators; morbidity, disease prevalence, and mortality rates correlate with preventive measures.

Specialist from the Health Information Center of the Institute of Hygiene, using data from the Compulsory Health Insurance Fund Information System „Sveidra“, provide analyses on the number of patients (according to various dimensions), the composition of hospitalized patients, the number of surgical operations and procedures performed in hospitals, the number of visits to doctors or dentists, the number of registered patients in primary healthcare institutions, hospital bed utilization data, and other health-related indicators. They also develop methodologies for calculating these indicators.

„Sveidra“ is an administrative database designed to monitor healthcare services funded by this insurance system.  However, calculating health indicators using administrative data presents significant challenges for specialists due to the following reasons:

• A highly precise and detailed mothodology is required for indicator calculation, which demands expertise and experience. The interpretation and comparability of the obtained indicator with other European Union countries depend on the calculation methodology.
• The database is intended for the reimbursement of provided services, making data entry control essential, as incorrect information can lead to increase treatment costs.
• Incomplete data – while patient medical records and related information are included in healthcare institutions‘ internal information system („Sveidra“), Lithuania has a well-developed network of private healthcare providers. These institutions may offer a broader range of helthcare services or may not have contracts with the National Health Insurance Fund, meaning that not all information regarding Lithuanian residents‘ healthcare visits or health data is recorded in „Sveidra“. This should be considered when analyzing morbidity or disease prevalence for specific conditions.

Despite these challenges, the health data available in „Sveidra“ by place of residence enables the analysis of health disparities across Lithuanian municipalities and counties. Additionally, individual-level outpatient and inpatient morbidity statistics, segmented by age, gender, diagnosis, and place of residence, allow for the calculation, assessment, monitoring, and detailed analysis of healthcare facility performance indicators. The detailed information enables the evaluation of connections between different healthcare sectors and the continuity of treatment. By selecting provided services based on their nature, patient age, gender, and place of residence, valuable insights can be obtained for monitoring and evaluating the effectiveness of preventive programs.