Joint UNECE/WHO/Eurostat Meeting on the Measurement of Health Status, Geneva, May 24-26,2004

1. Joint UNECE/WHO/Eurostat Meeting on the Measurement of Health Status, Geneva, May 24-26,2004 Update presented by Marijke de Kleijn Washington Group on Disability Statistics, Bangkok, september 29 - October 1, 2004

2. Aim of the meeting • Continue the process • to achieve internationally comparable measurement • of population health states • within the framework of official statistics • taking into account work already done Washington Group on Disability Statistics, Bangkok, september 29 - October 1, 2004

3. Participants • Albania, Australia, Austria, • Belgium, Bosnia and Herzegovina, Bulgaria, • Canada, Croatia, Cyprus, Czech Republic, • Denmark, Estonia, Finland, Germany, • Hungary, Iceland, Ireland, Italy, • Latvia, Netherlands, New Zealand, Norway, • Poland, republic of Moldova, Romania, • Slovak Republic, Slovenia, Spain, Switzerland, • Turkey, United Kingdom, United States of America • EC, OECD, ILO, UNFPA, ESCWA, EuroReves and Partnership Health Washington Group on Disability Statistics, Bangkok, september 29 - October 1, 2004

4. Chair and speakers • Jennifer Madans • Speakers and discussants too much to mention here Washington Group on Disability Statistics, Bangkok, september 29 - October 1, 2004

5. Sessions • Framework to conceptualize health • Review of the work undertaken to achieve international comparability • Strategies for ensuring international comparability • Achievement of summary measures at population level • Implementation and coordination of health surveys in the region Washington Group on Disability Statistics, Bangkok, september 29 - October 1, 2004

6. Papers • See website http://www.unece.org/stats/documents/2004.05.health.htm Washington Group on Disability Statistics, Bangkok, september 29 - October 1, 2004

7. Minimum requirements • Minimum requirements for comparability in health state measurement include: • Conceptual clarity • Common set of domains/attributes • Comparable survey instruments incl translation of concepts and wording • Pre- and post harmonization • Survey design • Common reference period • Reliability and validity Washington Group on Disability Statistics, Bangkok, september 29 - October 1, 2004

8. Criteria for core domains • Feasibility in health interview surveys • Conceptually important and independent • Domains describing most variations in health states or valuations • Potential fro cross population comparability • Clear series of levels within each domain • Capacity (not performance) • Aspects “ within, on or close to the skin” • Suitable for preference measurements • Link with conceptual framework of ICF Washington Group on Disability Statistics, Bangkok, september 29 - October 1, 2004

9. Summary measures • Useful but no need to agree on a summary measure at this point • Main priority now to develop a common instrument Washington Group on Disability Statistics, Bangkok, september 29 - October 1, 2004

10. Future work • Core domains: • Mobility, Cognition, Seeing, • Pain/discomfort, Affect/anxiety • Vitality/fatigue, • Dexterity/self care? • Hearing? • Less agreement: • Interpersonal relationship • Social functioning Washington Group on Disability Statistics, Bangkok, september 29 - October 1, 2004

11. Future work (2) • Steering group: Canada, USA, WHO, Eurostat, ECE • Working group: Belgium, Canada, Estonia, Germany, Hungary, Italy, Netherlands,Norway, Spain, UK, USA, ECE, Eiurostat, WHO, EuroReves • Attention for prevention of duplication of work and controveral results (eg Washington Group) Washington Group on Disability Statistics, Bangkok, september 29 - October 1, 2004

12. Personal impression • UNECE/WHO/Eurostat: focus at health including functioning/ability • Washington Group: focus at functioning/disability • Possible overlap or controversy results • Avoid by cooperation and aim at complementary instruments • For our group now: continue and feed-back Washington Group on Disability Statistics, Bangkok, september 29 - October 1, 2004