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Health services data component


Contents

Data collection procedures

The data collection procedures for the health services data component of the WHO MONICA Project are described in the MONICA Manual, Part II, Section 2.

Data on health facilities and selected services

Data archive format

The data were transferred from the MONICA Collaborating Centres (MCCs) to the MONICA Data Centre (MDC) and the MONICA Quality Control Centre for Health Services (MQC) in Perth, Australia, on paper forms: Medical care reporting form: facilities and services (Form UA, Version 1). In the Basic analysis data set of the MONICA Archive, the data on health facilities and selected services are given in a format, which is specified in the Data archive format - medical care: facilities and services (Form 13, Version 1). The Data archive format includes the data items of the Health facilities and services forms, except the name of the person providing the information and comments or reservations about the data provided.

Period of coverage

Individual returns were required for each Reporting Unit (RU) in each MCC for each year. In order to trace the early evolution of services, MCCs were asked to provide continuous data from 1980 to the end of event monitoring. This allowed a lead in period, generally of at least four years before the commencement of coronary event monitoring in which to categorize the levels of service in RUs. On reviewing trends on information available up to 1990, it became clear that further substantial improvement in services was unlikely. Moreover, information on trends in specific aspects of treatment such as thrombolysis, PTCA and CABG were being collected continuously for most MCCs as part of the Acute coronary care data, thus providing a more direct and quantifiable measure of evolution of treatment. In 1994, the MONICA Steering Committee endorsed a recommendation from the MQC that collection should not be pursued beyond 1993 even though event monitoring was not to finish in some centres until 1995. Despite this, some MCCs did supply returns beyond 1993 but these data have not been included in the Basic analysis data set of the MONICA Archive. The extent of annual coverage from each RU is shown in Table 3.

Quality of the data

The data were transferred from the MCCs both to the MDC and the MQC. The MDC and the MQC compared their data sets periodically, and resolved discrepancies.

Interim reports were prepared by the MQC to indicate aggregate trends in values for each variable, but in addition individual reports were prepared for each MCC showing the values of their responses for each variable by RU and year. The MCCs were invited to check the accuracy of the recording of each variable and were requested in addition to provide the information for missing years.

It was considered that while the provision of individual facilities and services might change over time, either through progressive development of services or even discontinuation of services, they were unlikely to fluctuate from year to year. Therefore, the MQC looked for anomalous results. The data for each RU and variable were scanned for single-year changes that did not appear to be consistent with longer-term trends. The MCCs were contacted periodically for clarification of these. Information held in the MQC was updated as the result of these responses.

When the MONICA Archive was prepared, the data sets in the MDC and the MQC were compared again, and any inconsistencies were clarified.

The data

The medical care: facilities and services data, in the format specified in the Data archive format - medical care: facilities and services (Form 13, Version 1), can be found in the file:

The MONICA Reporting Units and calendar years included in these data files are specified in Table 3. No data for MCC 39 are included in this sample analysis data set. Tabulations of the distributions of data included in this file are given in document Distributions of the data on form 13 - medical care: facilities and services.

Data on inpatient management of ischaemic heart disease

Data archive formats

The data were transferred from the MCCs to the MDC and the MQC on three paper forms:

The corresponding data archive formats for the MONICA Archive are:

The Data archive formats include the data items of Forms UB, UC and UD, except the name of the person providing the information and comments or reservations about the data provided.

The data

These data were mostly obtained from routinely collected hospital statistics. The available population coverage or age groups did not necessarily correspond to those used for other MONICA data components. Also, the aggregation of the available diagnostic categories varied between the Centres. Because these aspects of the data specification have not been documented and the quality of the data has not been assessed, the data were not included in this sample analysis data set.