Metode de analiza si prognoza pentru sistemul sanitar

Program de masterat - Managementul serviciilor de sanatate - - semestrul III - An univ. 2011 2012 Prof.dr. D i l Hi P f d Daniela Hincu, Facultatea Management F lt t M t daniela.hincu@man.ase.ro; d_hincu@yahoo.com
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Tematica curs si seminar

Introducere I t d I. Problematica previziunii metode calitative si cantitative 1.1. Prezentare generala concepte, clasificari 1.2. Teme de discutie tipuri particulare de previziuni 1.3. Analiza seriilor dinamice II. Metode de previziune aplicate 2.1. Metode de ajustare, Ajustarea exponentiala. Aplicatie nr. 1

Previziunea pentru cursul de schimb valutar leu - euro ptr. octombrie 2011 (date reale pentru R l Romania www.bnro.ro) i b )

2-3-4. 2 3 4 Previziunea nr de medici la 100000 locuitori Romania; Testarea corelatiei nr. - Aplicatia nr. 5. PIB vs. speranta de viata la nastere

2.2. Extrapolarea analitica si fenomenologica 2.3. Analiza de regresie si corelatie. Regresia liniara - Aplicatiile nr.

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Tematica curs si seminar

III. III Metode de analiza si de luare a deciziilor 3.1.Procesul cunoaterii tiinifice etape. Informatii procese obtinere/procesare 3.2. 3 2 Cercetare canti & cali tativa Metoda cantitativa de analiza tativa. 3.3. Teoria deciziilor statistice. Decizii multicriteriale multiatribut.
Aplicatia nr. 6. Efectuarea unor clasamente. Decizii cu mai multe criterii comparatii, prioritizari

3.4. Actualitate in analiza deciziilor. Teoria deciziilor economie cognitiva - economia comportamentala. Elemente de managementul riscului. 3.5. 35
Aplicatia nr. 7. Evaluari cantitative ale riscului Testarea ipotezelor A li ti numerica nr. 8 Aplicatie i 8.

IV. Elemente introductive de Managementul proiectului si ACB 4.1. 4 1 Analiza cost beneficiu (ACB) A li ti nr. 9 E lifi construire modell fi i (ACB). Aplicatia 9. Exemplificare t i d financiar
pentru venituri si cheltuieli. Calculul unor indicatori VNA (NPV) si RIR (IRR) eficienta.

4.2. Analiza cost eficacitate si Analiza cost utilitate. Aplicatia nr. 10. Calcule de

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Surse de informatii si date statistice

http://data.euro.who.int/hfadb/ European health for all database (HFA-DB) World Health Organization Regional Office for Europe EUROPE IN FIGURES http://ec.europa.eu/eurostat Eurostat yearbook 2010 - chapter 2 Population:, chapter 3 Health, chapter 6 Living conditions and welfare Eurostat yearbook 2009 - chapter 5 Health, chapter 6 Living conditions and welfare WORLD HEALTH STATISTICS 2011; www.who.int/whosis/whostat/EN_WHS2011_Full.pdf WORLD HEALTH STATISTICS 2010, 2010 World Health Organization 2010, http://www.who.int/whosis/whostat/EN_WHS10_Full.pdf WORLD HEALTH STATISTICS 2009, World Health Organization 2009 http://www.cnp.ro/ro/prognoze http://www cnp ro/ro/prognoze PROIECIA PRINCIPALILOR INDICATORI MACROECONOMICI PERIOADA 2010 2014, Prognoza de primvar 2011 PENTRU

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Bibliografie
Jones, Andrew, Rice Nigel, Bago dUva Teresa, Balia Silvia Applied Health Economics, Routledge Advanced texts i E Ad d in Economics and Fi i d Finance, 2007 Raportul STRATEGIA NAIONAL DE RAIONALIZARE A SPITALELOR elaborat 2010 Ministerul Sanatatii, Banca Mondiala Raportul UN SISTEM SANITAR CENTRAT PE NEVOILE CETEANULUI, Raportul Comisiei Prezideniale pentru analiza i elaborarea politicilor din domeniul sntii publice din Romnia Noiembrie 2008 Romnia, 2008, Bucuresti Health statistics - Atlas on mortality in the European Union, EU 2009, Product code: KS-30-08-357 ISBN: 978-92-79-08763-9 WORLD HEALTH STATISTICS 2010, World Health Organization 2010, http://www.who.int/whosis/whostat/EN_WHS10_Full.pdf htt // h i t/ h i / h t t/EN WHS10 F ll df Health and safety at work in Europe (19992007) A statistical portrait http://epp.eurostat.ec.europa.eu/cache/ITY_OFFPUB/KS-31-09-290/EN/KS-31-09-290-EN.PDF Euro Health Consumer Index 2009, 2008 Second European Quality of Life Survey 2009 http://www.eurofound.europa.eu/publications/htmlfiles/ef0902.htm Human Development Report 2009 Overcoming barriers: Human mobility and development Systematic review of the effectiveness and cost-effectiveness of home versus hospital or satellite unit y f p p g f , g haemodialysis for people with end stage renal failure, NHS R&D HTA Programme Decision Analysis in healthcare, George Mason University, web site: http://guston.gmu.edu/healthscience/730/IntroductiontoDecisionAnalysis

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Detalii pentru desfasurarea examenului p

Examen scris in sesiunea - ianuarie februarie 2012 Durata - 90 min Structura subiectelor (notare prin bi l

punctaj 10-90 pct. la examenul scris +10 pct. ptr. prezenta (punctaj de 100 pct = nota 10))
Subiect deschis (din teorie de redactat cf notelor de curs/dezbaterilor) (30 pct ) teorie, cf. pct.) Teste grila cu unic raspuns corect 15 intrebari (30 pct.) Aplicatie numerica (30 pct.); Prezentarea unui referat poate substitui cele 30 pct. (max.) de la aplicatia numerica tematica este discutata la seminar cu profesorul, max. 2 persoane pe referatul prezentat oral pe parcursul a 15 20 min.

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Cuprins:
EHCI European Health Consumer Index 2009; Indexul sistemului sanitar european 2009 Surse de date: World Health Organization (WHO) The ECHI (European Community Health Indicators) European Health for All database (HFA-DB) EUROSTAT statistics by themes ECHI (European Community Health Indicators)

Tema de discutie: EHCI European Health Consumer Index 2009; Indexul sistemului sanitar european 2009 - Romania, locul 32 din 33
de tari europene in topul sistemelor sanitare
Problemele sistemului medical romanesc sunt confirmate de cel mai mai recent studiu european Euro Health Consumer Index 2009 sau Indexul European al sistemelor de sanatate 2009 [1] dedicat sistemelor medicale din 33 de tari europene care au fost luate in calcul. Olanda a fost desemnata, pentru al doilea an consecutiv, drept tara cu cel mai performant sistem medical din cele 27 de tari ale UE + alte 6 tari europene, urmata de Danemarca, Islanda, Austria si Elvetia. Tarile mari ale Europei ocupa urmatoarele pozitii: Germania (6), Franta (7), Marea Britanie (14), Italia (15) si Spania (21).Romania a fost depasita in acest clasament chiar si de Albania si Muntenegru, tari aflate in afara Uniunii Europene; fata de Indexul pe 2008, Romania a retrogradat 5 pozitii. Dupa Bulgaria, sistemul medical romanesc a fost vazut drept cel mai slab. Calculul indexului - in total sunt 38 de indicatori, grupati in 6 categorii principale, in functie de: timpul de asteptare pentru tratamente; timpul de asteptare pentru diverse programari si operatii; drepturile pacientilor si informarea acestora; sistemul informatic existent in spitale si clinici; tipurile de servicii medicale existente in tara respectiva; serviciile farmaceutice. [1] Indexul Euro Health Consumer Index 2009 se afla la cea de-a cincea editie, fiind realizat de Health Power House, o organizatie cu sediul la Bruxelles care lucreaza cu suportul Comisiei Europene inca de la prima editie, din 2005 http://www.healthpowerhouse.com/ indici internationali: Euro Health Consumer Index , Euro Diabetes Index , Euro Heart Index , Canada , Empowerment of the European Patient , Euro HIV Index , Nordic COPD Index 10/16/2011 MSS MAPSS - 2011-2012

Euro Health Consumer Index

Indexul European de Sntate[1] Raportul reprezinta o cercetare comparativ a sistemelor de profil din UE. UE Cercetarea comparativ anual a sistemelor de sntate din Europa 2009 a clasat Romnia penultima din 33 de ri europene, cu 489 puncte din 1000 posibile. Olanda ctig din nou clasamentul cu 863 de puncte, urmat de Danemarca (care i pstreaz i ea locul de anul trecut), i Islanda. Romnia nu poate s se laude nici mcar cu drepturi de baz ale pacienilor sau E-health, categorii uor ameliorabile; de rezultate nici nu poate fi vorba. Singura ar mai prost clasat dect Romnia este Bulgaria, cele dou noi state membre UE fiind ntrecute pn i de Albania, Croaia sau FYROM. Romnia are, din pcate, scoruri proaste n majoritatea domeniilor sntii , spune Dr. Arne Bjrnberg, Directorul de Cercetare al Euro Health Consumer Index. Se pare c plile informale ateptate de la pacieni sunt nc o problem serioas i o piedic n ajungerea la un sistem de sntate bazat pe echitate. Clasamentul din 2009subliniaz faptul c statele ctigtoare ncep s foloseasc informaii despre sntate i alegere pentru a implica pacienii n luarea deciziilor, construind un proces de jos n sus pentru mbuntirea performanelor. La sfritul clasamentului se afla un grup de ri blocate n vechiul sistem de sntate, ierarhizat i lipsit de transparen. Aceast diferen constituie o provocare pentru principiile de echitate i solidaritate ale Uniunii Europene.
[1] Countries included in Euro Health Consumer Index 2008: Austria, Belgium, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, FYR Macedonia, Germany, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, Switzerland, United Kingdom

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Euro Health Consumer Index

Euro Health Consumer Index foloseste sase sub-domenii esentiale: drepturile si informarea pacientului; informatizarea sistemului sanitar - prescrieri transfer de date medicale; timp de asteptare pentru prescrieri, tratamente obisnuite; rezultate statistice; varietatea si incidenta serviciilor oferite si medicamante. Euro Health Consumer Index a devenit o msuratoare standard a sistemelor de sntate din Europa, ajungnd s includ 33 de state i 38 de indicatori mprii n ase sub-domenii eseniale: Drepturile i informarea consumatorului, E-health, consumatorului E-health Timpul de ateptare pentru tratamente obinuite Rezultate Varietatea i obinuite, Rezultate, incidena serviciilor oferite i Acces la medicaie. Publicat pentru prima dat n 2005, Indexul este o compilaie ntre statistici publice, sondaje de opinie i cercetare i d independent condus d f d d d de fondatori, compania d analiz i i f i i de li i informare Health Consumer lh Powerhouse din Bruxelles. EHCI 2009 este centrat pe poziia consumatorului, ca toate indexurile produse de HCP, sprijinit n cercetarea legat de E-health de Comisia Europeana DG Information Society and Media i asistat de Preedinia suedez a Uniunii Europene. In 2008, Romania s-a clasat pe locul 27 din 31 de state (membrele UE plus Norvegia, Elvetia, Croatia si FYROM). Pentru sase sub-domenii si 34 de indicatori de performanta, Romania a acumulat doar 488 de puncte dintr-un maxim posibil de 1.000, rezultat ce o plaseaza, in 2008, in fata Bulgariei, dar mult in urma Ungariei (clasata pe locul 14 imediat dupa Regatul Unit) 14, Unit). In 2007 - Romania a ocupat pozitia 25, reusea sa adune 508 puncte pentru cele cinci subdomenii ale indicatorilor de performanta ai serviciilor medicale: drepturile si informarea pacientilor, timpul de asteptare pentru tratamente obisnuite, rezultatele sistemului de sanatate, generozitatea acestuia si accesul la medicamente. In acest an, Olanda conduce clasamentul cu 839 de puncte, urmata de Danemarca (care in 2008 a castigat si la Indexul pentru Diabet care ia in calcul mai multi indicatori de Diabet, performanta in cazul acestei afectiuni), Austria (castigatoarea EHCI in 2007), Luxemburg si Suedia. 10/16/2011 MSS MAPSS - 2011-2012

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The Euro Health Consumer Index 2009

is an attempt at measuring and ranking the performance of healthcare provision from a consumer viewpoint The viewpoint. results definitely contain information quality problems. There is a shortage of pan-European, uniform set procedures for data gathering. th i - the HCP finds it far better to present the results to the public, and to promote constructive discussion rather than staying with the only too common opinion that as long as healthcare information is not a hundred percent complete it should be kept in the closet. p - it is important to stress that the Index displays consumer information, not medically or individually sensitive data.

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The Euro H lth C Th E Health Consumer I d 2009 Index

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The Euro Health Consumer Index 2009

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13
13

Healthcare spends per capita in PPP dollars have been taken from the WHO HfA database (August 2009; latest available numbers, most frequently 2007); For countries not having a 2007 value
p y g in the database, the latest available number has been multiplied by the average % increase in the EU since the latest available year.

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2008 Romania
Shares the problem of unofficial payments to doctors with several of its neighbours. Good healthcare obtained this way unfortunately does not score in y f y the EHCI, apart from possibly improving Waiting times scores?

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HCP has now started up the work on the 6th updated edition of the Euro Health Consumer Index (EHCI 2011). The partially new Expert Reference Panel will meet on October 3. The Index will be published around Easter 2012, with some novel additional indicators, but still allowing longitudinal analysis. The nest EHCI i di t b t till ll i l it di l l i Th t edition will cover 34 European countries, Serbia being the latest addition.

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Surse de date (1) World Health Organization (WHO) WHO Statistical Information System (WHOSIS) y ( ) incorporated in Global Health Observatory (GHO) the WHO's portal providing access to WHO s data and analyses for monitoring the global health it ti h lth situation; it provides critical d t and id iti l data d analyses for key health themes, as well as direct access to the full database.

http://www.who.int/GHO/ htt // h i t/GHO/

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WHOSIS http://www.who.int/GHO/

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Surse de date (2): The ECHI (European Community Health Indicators)

The ECHI project was carried out in the framework of the Health Monitoring Programme and the Community Public Health Programme 2003-2008 The result is 2003-2008. a list of 'indicators' for the public health field arranged according to a conceptual view on health and health determinants. - the following criteria were applied in the selection of the indicators:
Comprehensiveness: all aspects of the public health field should be covered. Meeting user needs: the set should cover the main priorities in public health policies of the Commission and the Member States States. Being innovative: the set should not just be data-driven, but also indicate development needs. Using earlier work: the efforts of international institutions with Eurostat and other Commission Services as main providers but also OECD and the WHO-Europe in defining providers, WHO Europe, indicators and standard variables have been taken on board as much as possible. Using Health Monitoring Programme and Public Health Programme results: the results of projects should be included in the data where appropriate.

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The ECHI (European Community Health Indicators) project

Indicators are at the crossroads of policy questions and data sets. Indicators reflect a policy interest as well as a selected set of possibilities in terms of what can be calculated. Therefore they will on one hand be justified from the policy side and on the other hand a short characterisation of the data source it's added. ICHI (International Compendium of Health Indicators) is a web-based application containing the health indicators used by WHO-Europe OECD and Eurostat in their international WHO Europe, databases. ICHI provides a selection of the most relevant indicator names and definitions as listed by these organisations. It also includes the complete list of health indicators developed by the ECHI p j project. All indicators are arranged following the ECHI taxonomy. g g y The ECHI list and the ICHI website have been developed by the ECHI project (European Community Health Indicators, in two phases, 1998-2004) project, run under the EU Health Monitoring Programme. ICHI offers an easy entry to the indicator definitions used by the international organisations in their databases. This allows for a quick comparison between g q p indicators and their definitions, in one coherent and structured system.

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http://www.euro.who.int/en/what-we-do/data-and-evidence

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http://www.euro.who.int/en/what-we-do/data-andevidence/databases European Health for All database (HFA-DB)

HFA-DB is a central database of independent, comparable and up-to-date basic health statistics. http://data.euro.who.int/hfadb/ It has been a key source of information on health in the European Region since WHO/Europe launched it in the mid-1980s. It contains time series from 1970. HFA-DB is updated biannually and contains about 600 indicators for the 53 Member States in the Region. Region The indicators cover: basic demographics; health status (mortality, morbidity, maternal health and child health); health determinants (such as lifestyle and environment) health care (resources and utilization) utilization). HFA-DB allows country and intercountry analyses to be displayed as charts, curves or maps, which can be exported free of charge to other software programs.

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Databases http://www.euro.who.int/en/what-we-do/data-and-evidence/databases
This is WHO/Europes portal to health statistics and to detailed monitoring and assessment tools for key areas of health policy. These links provide access to a broad range of information systems: from international co pa so s o agg ega e d ca o s o e esu s o de a ed d sease su ve a ce a d e o o g o comparisons of aggregate indicators to the results of detailed disease surveillance and the monitoring of specialized areas of health policy. Users can browse the information online and present and analyse it in different formats (in tables, graphs and/or maps). European Health for All Database (HFA-DB)This is WHO/Europes prime data source for international comparisons. If offers a comprehensive set of more than 600 items covering 53 Member States for time series back to 1970. 1970 Mortality indicator database (MDB) This database allows age- and sex-specific analysis of mortality trends by broad disease-groups, as well as disaggregated to 67 specific causes of death. Data reach back to 1980. European detailed mortality database (DMDB) For a more detailed analysis, DMDB provides mortality data by three-digit codes of the International Classification of Diseases, disaggregated by five-year age groups, and series back to 1990. i b k 1990 European hospital morbidity database (HMDB) The HMDB is a unique tool for the analysis and international comparison of morbidity and hospital activity patterns, based on hospital-discharge data by detailed diagnosis, age and sex, since 1999. Centralized information system for infectious diseases (CISID) CISID is WHO/Europes main surveillance platform with information on communicable diseases, immunization coverage, and on recent outbreaks in Europe It allows detailed reviews and assessments of the situation regarding infectious diseases in the WHO European Region. It includes subnational level data for selected items. Tobacco control database This database contains data on smoking prevalence and various aspects of tobacco control policy in Member States in the WHO European Region. It allows to track and assess the tobacco-related situation in and across countries and has a special section on tobacco control legislation. European inventory of national policies for the prevention of violence and injuries Policy initiatives by different sectors i countries across the Region. in i h R i International inventory of documents on physical activity promotion Information and case studies on policies, strategies and approaches from European countries. 10/16/2011 MSS MAPSS - 2011-2012

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http://data.euro.who.int/hfadb/

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European Health for All database (HFA-DB)

01 DEMOGRAPHIC AND SOCIO-ECONOMIC INDICATORS 02 MORTALITY-BASED INDICATORS 03 MORBIDITY, DISABILITY AND HOSPITAL DISCHARGES 04 LIFE STYLES 05 ENVIRONMENT 06 HEALTH CARE RESOURCES 07 HEALTH CARE UTILIZATION AND EXPENDITURE 08 MATERNAL AND CHILD HEALTH 25

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Exemplificare extragere informatii http://data.euro.who.int/hfadb/ MORTALITY-BASED INDICATORS - Infant deaths per 1000 live birth
Infant deaths per 1000 live births
- a measure of the yearly rate of deaths in f h l fd h i children less than one year old. The denominator is the number of live births in the same year. Infant mortality rate = [(Number of deaths in f y [( f a year of children less than 1 year of age) / (Number of live births in the same year)] *1000 (ICD-10). Unfortunately, some countries are not able to ensure complete registration of all death cases and births. Therefore, infant mortality rates which are calculated using incomplete mortality data are lower than they actually are. In some cases under-registration of deaths may reach 20% or more and this has to be kept in mind when making comparisons between countries. Particularly high levels of mortality under- registration are observed in countries of central Asia and Caucasus, Albania and possibly some other coutries, like those of former Yugoslavia .

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MORTALITY-BASED MORTALITY BASED INDICATORS/ Infant d th per 1000 I f t deaths live birth

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MORTALITY-BASED INDICATORS/ Infant deaths per 1000 live birth

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Sursa de date (3) raportari EUROSTAT http://epp.eurostat.ec.europa.eu/portal/page/portal/statistics/themes

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Eurostat Population and social conditions HEALTH 2011

Health is a high priority for Europeans, who expect to have a long and healthy life, to be protected against illnesses pp p y and accidents and to receive appropriate health care. Accurate and detailed statistics on health have a key role for evidence based decisions by national and European authorities and are a major tool for monitoring health policies. Health statistics include: Public health issues such as health status, health problems and health determinants, health care provision and resources, health care expenditures and causes of death Health and safety at work issues such as accidents at work and work related health problems Strategy for Public Health The European Commission's current strategy 'Together for Health: A Strategic Approach for the EU 2008-2013' aims to improve citizens' prosperity, solidarity and security by: Promoting health to improve prosperity and solidarity Improving citizens health security Producing and distributing health knowledge Competence for the organisation and delivery of health services and healthcare is largely held by the Member States, although the EU has the responsibility to give added value through launching actions such as those in relation to cross-border health threats and patient mobility, as well as reducing health inequalities and addressing key health determinants. Strategy for Health and safety at work. The European Commission's current strategy "Improving quality and productivity at work: the Community strategy 2007-2012 on health and safety at work" aims to achieve a susta ed educt o o occupat o a acc de ts a d d seases t e U t oug va ous U a d at o a act o s. sustained reduction of occupational accidents and diseases in the EU through various EU and national actions. Legal basis for the statistics on health. In December 2008 the European Parliament and the Council adopted a framework Regulation for statistics concerning public health and health and safety at work. That regulation is addressing five domains: Health care, health status and health determinants, accidents at work, occupational diseases and other work-related health problems and causes of death. Both the Community action Programme on Public Health and the Community strategy on health and safety at work 2007-2012 as well as the Community Statistical Programme 2008-12 foresee the implementation of that Regulation as a key statistical element of a sustainable health monitoring system. 10/16/2011 MSS MAPSS - 2011-2012

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The collection Public health has been divided into three domains:
Health H lth care: health care expenditure: Health care expenditure data provide information on expenditure in the functionally defined area of health distinct by provider category (e.g. hospitals, general practitioners), function category (products and services) and financing agent (e g social security private insurance (e.g. security, company, household). The definitions and classifications of the System of Health Accounts (SHA) are followed. health care non-expenditure: Non expenditure Non-expenditure health care data cover 'health care human resources (physicians, health resources' dentists, nursing and caring professionals, etc) as well as hospital statistics (hospital beds, surgical procedures in hospitals, high-tech equipment and patient related data,i.e. hospital discharges by disease). health care indicators from surveys: tables on perceived unmet needs for medical or dental y p care, consultations of health care professionals, hospitalisation, cancer screening, etc. health status indicators from surveys: tables on self-perceived health, life styles and restrictions. Data on health conditions also play a role in the calculation of the "healthy life years expectancy". This collection includes also tables on employment of disabled persons based on a 2002 ad hoc module of the Labour Force survey. causes of death: Eurostat disseminates COD statistics according to a shortlist of 65 causes ('Causes of death European shortlist', based on the ICD International Statistical Classification of Diseases and Related Health Problems, WHO). Data are available at national and regional level (NUTS 2) for total number, crude death rates (CDR) and standardised death d i ll l f t t l b d d th t d t d di d d th rates (SDR), broken down by age groups and by sex.

http://epp.eurostat.ec.europa.eu/portal/page/portal/health/public_ health/data_public_health/main_tables

http://epp.eurostat.ec.europa.eu/portal/page/portal/health/publ ic_health/data_public_health/database

Health and safety at work

The collection Health and safety at work is divided into four chapters (groups): accidents at work (accidents at the workplace or in the course of an occupational activity); occupational diseases (recognised cases from national authorities); commuting accidents (on the journey to or from work); work-related health problems and accidental injuries (self-reported cases). The data Th d t presented i th t bl f th fi t th t d in the tables for the first three groups of th collection H lth and safety at f the ll ti Health d f t t work are based on national administrative sources, from declarations to the insurance (public insurance, social security scheme, or private insurance scheme) or to another competent authority (usually the labour inspectorate). y( y p ) The data for the last group of the collection Health and safety at work (work-related health problems and accidental injuries) were provided by an ad hoc module in the 1999 Community labour force survey.

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http://epp.eurostat.ec.europa.eu/portal/page/portal/health/he alth_safety_work _ y_

http://epp.eurostat.ec.europa.eu/portal/page/portal/health/healt h_safety_work/data/main_tables h f t k/d t / i t bl

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http://epp.eurostat.ec.europa.eu/portal/page/portal/health/ health_safety_work/data/database h lth f t k/d t /d t b

Sau cautare directa prin optiunea Database by themes http://epp.eurostat.ec.europa.eu/portal/page/portal/statistics/search_database

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Exemplificare cautare de informatii - Database by themes Public

health (hlth) Health care expenditure by provider (hlth_sha_hp)

Health care expenditure by provider [hlth_sha_hp]

Health care expenditure by provider [hlth_sha_hp]
12.00 10.00

8.00 % of GDP 6.00 4.00

2.00 0.00 2003 2004 2005 Romania 2006 Spain 2007 Switzerland 2008 2009

Health care expenditure by provider [hlth_sha_hp]

Sau cautare directa prin optiunea TABLES by themes http://epp.eurostat.ec.europa.eu/portal/page/portal/statistics/search_database

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Health care staff (hlth_staff) -> Health personnel (excluding nursing and caring professionals) (hlth_rs_prs): Health personnel (excluding nursing and caring professionals) - Absolute numbers and rate per 100,000 inhabitants

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Health personnel (excluding nursing and caring professionals) Absolute numbers and rate per 100,000 inhabitants

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Health personnel (excluding nursing and caring professionals) Absolute Ab l t numbers and rate per 100,000 inhabitants b d t 100 000 i h bit t

Health personnel (excluding nursing and caring professionals) [hlth_rs_prs]

400.0 350.0 300.0
Pe 100,000 inhabita er ants

379.9 379 9 331.8 290.9 249.3 249 3 208.1 217.4 215.8 212.3 221.5 y = 3.5752x + 185.47 R 2 = 0 8968 0.8968 293.5 287.3 308.5 311.0 328.3 305.1 340.1

365.4

368.3

378.6 378 6 352.2 354.8

250.0 200.0 150.0 100.0 50.0 0.0 00

188.2

192.8

199.6

196.0

199.6

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

Romania

Spain

Linear (Romania)

Romania (date disponibile)

Health personnel (excluding nursing and caring professionals)
230.0

221.5 221 5
220.0 P er 10 00,000 inhabi tants 210.0 210 0

217.4 208.1 199.6 199.6 196.0 192.8 188.2

215.8 212.3

200.0 190.0 190 0 180.0 170.0 1999

2000

2001

2002

2003 Romania

2004

2005

2006

2007

2008

Linear (Romania)

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Health personnel by region - rate per 100,000 inhabitants

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European Community health indicators (ECHI)

Health indicators are sets of data (tables, graphs, maps) on health status, determinants and care in EU member countries. They allow for monitoring and comparison, and serve as a b i f policymaking. basis for li ki Types of health indicator Out of a complete list of 88 health indicators, there are over 40 core European Community health indicators for which data is readily available and reasonably comparable. They are grouped under the f ll i h di d d h following headings. Wh Where appropriate, fi i figures are given b gender and i by d d age as well as by socio-economic status and regional level. Heading and Examples g p Demographic and socio-economic situation -- Population, birth rate, total unemployment Health status -- Infant mortality, HIV/AIDS, road traffic injuries Health determinants -- Regular smokers, consumption/availability of fruit Health interventions: health services -- Vaccination of children hospital beds health children, beds, expenditure Health interventions: health promotion -- Policies on healthy nutrition

ECHI - li t of indicators list f i di t

Demography and socio-economic situation 1. Population by sex/age (I) 2. Birth rate, crude (I) 3. Mother's age distribution (I) 4. 4 Total fertility rate (I) 5. Population projections (I) 6. Population by education (I) 7. Population by occupation (D) 8. Total unemployment (I) 9(a). Population below poverty line (I) 9(b). Income inequality (I) Health status 10. Life expectancy (I) 11. Infant mortality (I) 12. Perinatal mortality (D) European health indicator on perinatal mortality rate 13. Disease-specific mortality (I) 14. Drug-related deaths (I) 15. Smoking-related deaths (D) g ( ) 16. Alcohol-related deaths (D) 17. Excess mortality by heat waves (D) 18. Selected communicable diseases (I) European health indicator on communicable diseases 19. HIV/AIDS (D) European health indicator on HIV/AIDS 20. Cancer incidence (D) 21(a). Diabetes: self-reported prevalence (D) 21(b). Diabetes: register-based prevalence (D) ( ) g p ( ) 22. Dementia (D) European health indicator on dementia 23(a). Depression: self-reported prevalence (D) 23(b). Depression: register-based prevalence (D) 24. Acute myocardial infarction (AMI) (D) 25. Stroke (D) 26(a). Asthma: self-reported prevalence (D) 26(b). Asthma: register-based prevalence (D) 27(a). Chronic obstructive pulmonary disease (COPD): self-reported prevalence (D) 27(b). Chronic b t ti 27(b) Ch i obstructive pulmonary di l disease (COPD) register-based prevalence (COPD): it b d l (D) 28. Low birth weight (I) 29(a). Injuries: home, leisure, school: self-reported incidence (D) 29(b). Injuries: home, leisure, school: register-based incidence (D) 30(a). Injuries: road traffic: self-reported incidence (D) 30(b). Injuries: road traffic: register-based incidence (D) European health indicator on road accidents 31. Injuries: workplace (I) 32. Suicide attempt (D) 33. Self-perceived health (I) 34. Self-reported chronic morbidity (I) 35. Long-term activity limitations (I) 36. Physical and sensory functional limitations (D) 37. General musculoskeletal pain (D) 38. Psychological distress (D) 39. Psychological well-being (D)

Determinants of health 42. Body mass index (I) 43. Blood pressure (D) 44. Regular smokers (I) 45. Pregnant women smoking (D) 46. Total alcohol consumption (I) 47. Hazardous alcohol consumption (D) 48. Use of illicit drugs (I) 49. Consumption of fruit (I) 50. Consumption o vege ab es (I) Co su p o of vegetables ( ) 51. Breastfeeding (D) 52. Physical activity (D) 53. Work-related health risks (D) 54. Social support (D) 55. PM10 (particulate matter) exposure (I) Health interventions: health services 56. Vaccination coverage in children (I) 57. Influenza vaccination rate in elderly (I) y( ) 58. Breast cancer screening (D) European health indicator on breast cancer screening 59. Cervical cancer screening (D) European health indicator on cervical cancer screening 60. Colon cancer screening (D) 61. Timing of first antenatal visits among pregnant women (D) 62. Hospital beds (I) 63. Physicians employed (I) 64. Nurses employed (I) European health indicator on other health professionals p y () p p 65. Mobility of professionals (D) 66. Medical technologies: MRI units and CT scans (I) 67. Hospital in-patient discharges, limited diagnosis (I) 68. Hospital day cases, limited diagnosis (D) 69. Hospital day cases/in-patient discharge ratio, limited diagnoses (D) 70. Average length of stay (ALOS), limited diagnoses (I) 71(a). General p ( ) practitioner ( ) utilisation; self-reported visits ( ) (GP) ; p (D) 71(b). General practitioner (GP) utilisation; registered visits (D) 72(a). Selected outpatient visits: self-reported visits (D) European health indicator on self-reported visits to a dentist or orthodontist 72(b). Selected outpatient visits: registered visits (D) 73. Surgeries: PTCA, hip, cataract (I) 74. Medicine use, selected groups (D) 75. Patient mobility (D) 76. Insurance coverage (I) 76 I 77. Expenditures on health (D) 78. Survival rates cancer (D) 79. 30-day in-hospital case-fatality of AMI and stroke (D) 80. Equity of access to health care services (I) European health indicator on equity of access to dental care services 81. Waiting times for elective surgeries (D) 82. Surgical wound infections (D) 83. Cancer treatment quality (D) 84. Diabetes control (D) Health interventions: health promotion 85. Policies on environmental tobacco smoke (ETS) exposure (D) 86. Policies on healthy nutrition (D) 87. Policies and practices on healthy lifestyles (D) 88. Integrated programmes in setting, including workplace, schools, hospital (D)

ECHI (European Community Health Indicators)

Demographic and socio-economic factors g p
Population by gender/age - Data are provided by Eurostat and the US Bureau of the Census and are calculated as the number of inhabitants of a given area on 1 January of the year in question (or, in some cases, on 31 December of the previous year). The population is based on data from the most recent census adjusted by the components of population change produced since the last census or census, based on population registers. Age dependency ratio - Data are provided by Eurostat and defined as the ratio of the population defined as dependent (the population age 0-14 and 65 and over) divided by the population 15-64, multiplied by 100. 100 The indicator 'Old-age-dependency ratio' is the ratio between the total number of elderly persons of an age when they are generally economically inactive (aged 65 and over) and the number of persons of working age (from 15 to 64). Crude Birth rate - The crude birth rate relates the number of births during the year to the average population in that year. The value is expressed per 1000 inhabitants. Data are provided by Eurostat. When available, click on to show a graph of the indicator. Mother's age distribution (teenage pregnancies, aged mothers) - Data are provided by Eurostat. Life birth is th bi th i the complete expulsion or extraction from its mother of a product of conception, irrespective l t li t ti f it th f d t f ti i ti of the duration of the pregnancy, which, after such separation, breathes or shows any other evidence of life, such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles, whether or not the umbilical cord has been cut or the placenta is attached; each product of such a birth is considered live born. The age of the mother is defined as the age reached in the th year th event t k place. the t took l

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Exemplu: ECHI (European Community Health Indicators)

Fertility rate Data are provided by Eurostat as the mean number of children that would be born alive to a woman during her lifetime if she were to pass through her childbearing years conforming to the fertility rates by age of a given year. It is therefore the completed fertility of a hypothetical generation, computed by adding the fertility rates by age for women in a given year (the number of women at each age is assumed to be the same). The total fertility rate is also used to indicate the same) replacement level fertility; in more developed countries, a rate of 2.1 is considered to be replacement level. Population projections - Data are provided by Eurostat. Population is divided into age groups covering intervals of 1 year and a group of all ages. Forecasts beginning with 1995 2005 and then every fivefth years. Forecasts are based on assumptions on total fertility rate life expectancy and years rate, migration. Total unemployment Data are provided by Eurostat as the unemployed persons comprise persons aged 15 to 74 who were: without work during the reference week; currently available for work, i.e. were available for paid employment or self employment before the end of the two weeks following the self-employment reference week; actively seeking work, i.e. had taken specific steps in the four weeks period ending with the reference week to seek paid employment or self-employment or who found a job to start later, i.e. within a period of at most three months. When available, click on to show a graph of the indicator. Population below poverty line Data are provided by Eurostat as the share of persons with an equivalised disposable income below the risk-of-poverty threshold in the current year and in at least two of the preceding three years. The

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Eurostat Extragere informatii: Population and social conditions/Population projections/EUROPOP2008

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1 January population by sex and single year of age

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Extragere informatii - proj_08c2150p-1 January population by sex and single year of age

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1 January population by sex and single year of age

90000000 80000000 70000000 60000000 50000000 no. 40000000 30000000 20000000 10000000 0
08 14 12 18 20 22 42 10 16 24 44 26 28 50 34 30 36 40 32 46 48 52 38 54 56 58 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 60

Romania

Finland

Spain

year Germany (including ex-GDR from 1991)

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Rata de dependen (contributori/pensionari) sursa: RAPORT ANUAL DE PREVENIREA CRIZELOR , 2003

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Projected old-age dependency ratio - [tsdde511]%

This indicator is defined as the projected number of persons aged 65 and over expressed as a percentage of the projected number of persons aged between 15 and 64.

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Projected old-age dependency ratio - [tsdde511]%

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Projected old-age dependency ratio - [tsdde511]%

Projected old-age dependency ratio
70

65.27 60 62.67

50 45.69 43.89 40.64 40 64 40 % 36.75 31.73 30 25.7 25.9 28.26 25.67 20 21.34 22.54 31.05 29.11 29 11 30.32 34.23 38.04 35.37 42.07 40.75 48 45.51 45.06 45.36 47.77

52.45 50.42 47.51 46.61 54

53.47 49.3

10

0 2010 2015 2020 2025 2030 Romania 2035 2040 2045 Finland 2050 2055 2060

EU (27 countries)

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Population and social conditions/Population projections (t_proj)/Population

EXTRAGERE DE INFORMATII Eurostat:

projections (tps00002)

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Population projections - Population projections are what-if scenarios that aim to provide P l i j i
information about the likely future size and structure of the population. Eurostat's population projections is one of several possible population change scenarios based on assumptions for fertility, mortality and migration. The method used for population projections is the "cohort-component" method Population refers to 1st January cohort-component method. population for the respective years.

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Population projections 2010-2060

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Population projections 2010-2060

POPULATION PROJECTION
90,000,000.00

80,000,000.00

70,000,000.00

60,000,000.00

50,000,000.00

40,000,000.00

30,000,000.00

20,000,000.00

10,000,000.00

0.00

2010

2015 201

2020

2025 202

2030

2035 203

2040 20 0 Romania

2045 20 Finland

2050 20 0 Spain

2055 20

2060 Germany

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Population projection ROMANIA 2010-2060

POPULATION PROJECTION
22,000,000.00

21,000,000.00

21333838 21102552 20833786 20483994

20,000,000.00

20049059 19619064
19,000,000.00

19160713 18678793

18,000,000.00

18149247 17583927

17,000,000.00

16921425

y = -442627x + 2E+07
16,000,000.00 , ,

R = 0 9842 0.9842

15,000,000.00

2010

2015

2020

2025

2030

2035

2040

2045

2050 Romania

2055

2060

Linear (Romania)

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Population projections 2060

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Tema de discutie: Populatia Romaniei va scadea pana la 16 milioane in anul 2050

Populatia Romaniei va scadea pana la 16 milioane in anul 2050, din care mai mult de jumatate va avea peste 60 de ani, iar fiecare persoana activa va plati asigurarile sociale pentru noua persoane, releva un studiu dat publicitatii de catre Fondul ONU pentru Populatie (UNFPA)[1] Studiul UNFPA arata ca la finele perioadei vizate, daca fertilitatea se mentine la nivelul actual, populatia Romaniei va ajunge la 16 milioane Mai mult de jumatate vor avea peste 60 de ani vor fi mai putini milioane. ani, adulti si copii, iar raportul de dependenta intre populatia activa si persoanele vulnerabile (copii si varstnici) va fi de unu la noua. Populatia Romaniei a scazut cu un milion in perioada 1992-2005 si continua sa scada. Aceasta tendinta este determinata de fertilitatea scazuta (1,3 copii la o femeie, in loc de 2,1, care ar asigura inlocuirea populatiei) si de migratia externa mare (aproximativ doua milioane de romani se afla legal in strainatate dar numarul strainatate, celor plecati ilegal este necunoscut). Daca in prezent, din cele 21,6 milioane de locuitori, 10,5 milioane sunt adulti, cinci milioane sunt copii si sase milioane sunt varstnici, la mijlocul secolului XXI, pensionarii vor reprezenta mai mult de jumatate din populatie si vor fi putini copii si adulti. Pentru a nu se ajunge la aceasta situatie, UNFPA propune politicienilor si factorilor de decizie din Romania reformarea sistemului d sanatate, d educatie si d asigurari sociale, astfel i f it l i de t t de d ti i de i i i l tf l incat sa se i t incurajeze j natalitatea, scolarizarea si incadrarea pe piata muncii din Romania. "Fondul ONU pentru Populatie atrage atentia asupra seriozitatii acestei probleme pentru populatia din Romania si ofera politicienilor sprijin in identificarea problemelor si gasirea solutiilor", a spus ambasadorul UNFPA in , p p , j Romania, Peer Sieben. "Guvernul trebuie sa ia masuri de protectie a persoanelor varstnice, sa incurajeze femeile sa nasca si sa stopeze migratia externa. Aceasta nu este o problema cu care se confrunta doar Romania, ci toate tarile din aceasta regiune a Europei", a adaugat Peer Sieben. UNFPA propune ca, pentru a face fata procesului de imbatranire a populatiei, Romania trebuie sa sustina serviciile medicale cu politici sociale si sa promoveze activitatile fizice si implicarea varstnicilor in activitati sociale, care sa creasca respectul de sine, autonomia si independenta acestora.
[1] Sursa: Wall-Street, 02 Octombrie 2006

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Populatia Romaniei va scadea cu peste 20% pana in anul 2050 (studiu al Biroului de Statistica a Populatiei -PRB)[1]
Potrivit datelor P t i it d t l prezentate, populatia R t t l ti Romaniei se va di i i i diminua d l 21 6 milioane d persoane, cat se de la 21,6 ili de t inregistreaza in prezent, pana la 17,1 milioane in 2050. Numarul locuitorilor din Europa de Est va scadea si el de la 295 de milioane in acest an pana la 229 de milioane de persoane in 2050. La nivel mondial, populatia va creste de la 6.62 de miliarde, cat numara in prezent, pana la 9.29 de miliarde pana la mijlocul acestui secol secol. Studiul realizat de PRB indica faptul ca procentul mortalitatii infantile in Romania este cel mai ridicat dintre tarile Europei de est, respectiv de 14 morti la 1000 de nasteri, in timp ce in Republica Cehia se inregistreaza cel mai scazut nivel (3,3). In ceea ce priveste durata medie de viata in Romania studiul PRB afirma ca aceasta este de 71 de ani Romania, ani, mai mare la femei (75 de ani) decat la barbati (68 de ani). La nivel mondial, cea mai mare durata de viata se inregistreaza in Japonia (82 de ani), iar cea mai scazuta in Swaziland (33 de ani). Conform datelor statistice pana in anul 2050 India va depasi China ca si numar de locuitori Astfel statistice, 2050, locuitori. Astfel, daca in prezent India are o populatie de 1.13 miliarde de persoane, pana in 2050 acest numar va ajunge la 1.47 de miliarde. In China, populatia va creste de la 1.38 de miliarde pana la 1.43 miliarde de persoane. Studiul PRB confirma si el tendinta de imbatranire a populatiei la nivel mondial In tarile mondial. industrializate, numarul persoanelor de peste 65 de ani va creste, pana in 2050, de la 16% la 26%, cresteri similare inregistrandu-se si in Europa, Africa sau America de Nord.
[1] PRB este o organizatie non-guvernamentala fondata in SUA in 1929 care ofera informatii demografice Studiul sau demografice. anual World Population Data Sheet este considerat una dintre cele mai importante surse de informare despre populatia mondiala. 10/16/2011 MSS MAPSS - 2011-2012

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Tema de discutie - Previziune pe termen lung - Romania's population will fall by 4.5 million inhabitants by the year 2060, 2060 reaching 16 9 million i h bit t d hi 16.9 illi inhabitants; dependency ratio t d ti to triple to 65%
At EU level, the demographic projections show that EU's population will increase until 2035 (by natural means until 2015 and immigration-sustained until 2035) and will start to fall until 2060. Romania will have by the year 2060 the fourth sharpest decline in population among the 27 EU states: 21%, after Bulgaria (28%) Latvia (26%) and Lithuania (24%) (28%), (24%). the old-age dependency ratio in Romania will triple until 2060, from 21.3% in 2008 to 65.3% in 2060; Data by EUROSTAT shows that Romania will go from 4.7 working-age adults supporting one pensioneer in 2008 to just 1 5 working adults per pensioneer in 2060 1.5 2060.
-

Population projections are what-if scenarios that aim to provide information about the likely future size and structure of the population, and should therefore be considered with caution. The EUROPOP2008 convergence scenario is based on the population on 1st January 2008 and on the g p p y assumption that fertility, mortality and net migration will progressively converge between Member States in the long run. Alternative assumptions in a different conceptual framework would yield different results. Strongest population growth in Cyprus, Ireland, Luxembourg and the United Kingdom 30% of the EU27 population to be aged 65 or more in 2060

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Romania's population to fall by 4.5 mln. until 2060 STAT/08/119, 26 August 2008 Population projections 2008-2060; From 2015, deaths projected to outnumber births in the EU27; Almost three times as many people aged 80 or more in 2060

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the dependency ratio to triple to 65%

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Luare de pozitie - Valentin Lazea, noiembrie 2008

Economistul sef al BNR a exemplificat corelatia intre crestere economica si demografie printr-un printr un studiu al Bancii Mondiale, care arata ca doar sapte state si-au mentinut cresterea economica peste 5% mai mult de 20 de ani, printre acestea numarandu-se China, Guineea Ecuatoriala si Irlanda. Un sfert dintre romanii activi contribuie la PIB-ul altor tari PIB ul In ultima prognoza publicata de Comisia Nationala de Prognoza (CNP), institutia estimeaza o crestere aproape lineara a populatiei active - intre 15 si 64 de ani - din Romania, de la 9,608 milioane persoane in 2008 la 9,754 milioane in 2010, 9,91 milioane in 2015 si 10,007 milioane in 2020. , proieciile oficiului european de statistic vin s arate c viitorul sun prost: mortalitatea si emigraia vor face ca n 2060 romnii s nu fie mai muli dect n 1955 (17 milioane de locuitori). Valentin Lazea admite c bunstarea unei naiuni depinde de cresterea populaiei, dar respinge catastrofa demografic previzionat de Eurostat, dnd exemplul Italiei, care a reusit s compenseze sporul natural negativ cu ajutorul imigraiei. V. V Lazea - dup 2030 riscm s intrm ntr-o involuie exponenial, numrul asistailor sociali/ pensionarilor depsindu-l cu mult pe cel al populaiei active. - cifrele avansate de Eurostat trebuie tratate cu circumspecie, dat fiind c nici alte catastrofe demografice demografice prezise de aceast instituie nu s-au adeverit: cel mai recent caz este cel al Italiei, unde (datorit imigraiei) scderea populaiei previzionate de Eurostat nu a avut loc
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Care sunt, concret, ipotezele pe care si bazeaz Eurostat prognozele pesimiste?

Cel mai pesimist - grupul de ipoteze referitor la natalitate. Numrul nasterilor anuale din Romnia a sczut de la circa 315.000 n 1990 pn la 210.000 n 2002, dup care a nceput s creasc usor, spre p , p p , p 230.000. Or, ipoteza Eurostat este c, n medie, vor exista circa 158.000 de nasteri pe an n intervalul 2008-2060. Aceast cifr presupune cohorte tot mai mici de femei capabile si dispuse s nasc si o rat a fertilitii chiar mai mic de 1,37 copii/femeie, care a fost media ratei fertilitii n perioada 1990-2005. Exist totusi i E i t t t i si un anumit risc care poate f it i t face ca aceast prognoz nedorit s se d li t d it ndeplineasc, si anume i faptul c cea mai mare parte a emigraiei romnesti (peste 65% n anul 2007) o constituie femeile. Dac la aceasta adugm c aproximativ 63% din totalul emigraiei romnesti e reprezentat din persoane cu vrsta cuprins ntre 18 si 40 de ani (adic tocmai perioada de fertilitate), obinem imaginea unor nasteri care nu mai au loc sau au loc n strintate, vduvind Romnia de o surs g , important de crestere. De aceea, politicile de ocrotire a mamei si copilului trebuie s capete o mare importan, precum si politicile firmelor fa de salariatele aflate n situaia s nasc. Grupul de ipoteze privitor la mortalitate mi se pare foarte realist. Astfel, fa de o medie anual de 265.000 de decese n perioada 1990-2005, studiul prognozeaz o usoar scdere, la 251.000 de decese pe an pentru intervalul 2008 2060 aceasta si ca urmare a cresterii speranei de via 2008-2060, via. Dar al treilea grup de ipoteze, cel referitor la imigraie, mi se pare, din nou, excesiv de pesimist - Grecia, Portugalia si Spania au avut, fiecare, o rat de imigraie net nesemnificativ n primii 5-10 ani dup aderarea lor la Uniunea European. Odat trecut aceast perioad ns, imigraia net n aceste ri a crescut att de mult nct a compensat cu vrf si ndesat scderea natural a populaiei autohtone. p p p Astfel, cele trei ri au acum populaii n continu crestere, n pofida unui spor natural negativ. Cred c acelasi lucru se va ntmpla si cu Romnia, pe msur ce si va consolida economia si statutul de membru UE. Or, prognoza Eurostat prevede pentru Romnia, n perioada 2008-2060, o rat a imigraiei nete de numai 18,4 la mia de locuitori (sau 1,84 la sut), adic de trei ori mai puin, proporional, proporional dect Slovacia si de sapte ori mai puin dect Cehia O triplare a acestei rate ar aduce Cehia. Romniei un plus de peste un milion de persoane (imigrani) fa de prognoza Eurostat.
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