THURSDAY, NOVEMBER 4, 1999

8:30 a.m.

WELCOME/INTRODUCTIONS/GOALS OF THE WORKSHOP

Edward Perrin, University of Washington, Workshop Chair

Margaret Hamburg, Assistant Secretary for Planning and Evaluation, DHHS, and Co-chair, DHHS Data Council

Edward Sondik, Director, National Center for Health Statistics and DHHS Statistical Advisor

8:45–9:30 a.m.

OVERVIEW PAPER/PRESENTATION

8:45 a.m.

Health Statistics: Past, Present, and Future

Presenter: Dorothy Rice, University of California, San Francisco

This session will provide an overview and historical perspective on the elements of the nation’s health statistics system.

• Who has used health statistics, and what have their information needs been?

• How do the various producers of health data

and statistics collectively comprise the nation’s health statistics system?

• What have been some of the main challenges (technical, operational, resources, etc.) in producing health statistics? Have health statistics been fully utilized? Have they been responsive to information needs? What efforts have been made to deal with limitations in the health statistics system? How successful have they been?

9:10 a.m.

Comments from invited discussant

Janet Norwood, former U.S. Commissioner of Labor Statistics

9:20 a.m.

Questions/Discussion

9:30–11:45 a.m.

BACKGROUND PAPERS/PRESENTATIONS

9:30 a.m.

Health Statistics Systems in Other Countries

Jennifer Zelmer, Canadian Institute for Health Information

This presentation will be based on a paper comparing how different countries organize their health statistics systems. The focus will be on Canada, Australia, and the United Kingdom. The paper will identify common models, trends, and future directions in the evolution of the vision for and management of national health statistics in these countries. (NCVHS commissioned paper)

9:45 a.m.

From National Health Statistics to Health Information Systems

Charlyn Black, University of Manitoba

This presentation will be based on a paper discussing key assumptions and critical components of a health information system; outlines the importance of being able to make

links across key areas and to examine various types and levels of investment in medical care for different populations; describes the Manitoba experience with the POPULIS system; and discusses possibilities for developing such systems in the future. (NCVHS commissioned paper)

10:00 a.m.

Discussion

10:30–10:45 a.m.

Break

10:45 a.m.

The Numbers We Need: Health Statistics and Health Policy

Richard Kronick, University of California at San Diego

This presentation will focus on the health statistics needed for improving health policy, emphasizing the financing and delivery of care to the uninsured, and policy concerning managed care. The need for timely and detailed measurement of health-related quality of life will be considered. (NCVHS commissioned paper)

11:00a.m.

The Children’s Health Insurance Program and Other Efforts to Respond to Children’s Health Needs

Lorraine Klerman, University of Alabama at Birmingham

This presentation will use the State Children’s Health Insurance Program (SCHIP) to illustrate the role health statistics played in determining a need for SCHIP and developing its provisions. Also discussed will be the health statistics that policy makers at the state and federal levels believe will be essential to demonstrate the impact of SCHIP. The need for additional statistics about children’s health status and use of services will be considered. (NCVHS commissioned paper)

11:15 a.m.

Discussion

11:45 a.m.–1:00p.m.

Lunch

1:00–5:00 p.m.

DEVELOPMENTS SHAPING FUTURE NEEDS FOR HEALTH STATISTICS

Moderator: Edward Perrin, Workshop Chair

In each session, these 15-minute presentations will highlight new developments, changing priorities, newly emerging concerns, and specific opportunities and challenges for the health statistics system in the 21st century. The presentations are intended to combine a “visionary” consideration of these issues with observations on how current research or operational experience relates to these views of the future.

1:00 p.m.

Health Status and the Determinants of Health

• Population-based assessments of health status, surveillance of illness, assessing well-being (positive health, psychosocial aspects of health, physical environment)

• Presentations:

Determinants of health: Clyde Hertzman, University of British Columbia

Positive health: Burton Singer, Princeton University

Disease and risk factor surveillance: David Fleming, Oregon Health Division

Health status assessment/instruments: Robert Kaplan, University of California at San Diego

2:00 p.m.

Discussion

2:20 p.m.

Organization, Delivery, and Financing of Health Services

• Supporting the management and analysis of the organization, delivery, and financing of personal and population-based health services and their relationship to health status and health outcomes

• Presentations:

Health economics: Joseph Newhouse, Harvard University

Health system change: Merwyn Greenlick, Oregon Health Sciences University

Proprietary databases: Jacqueline Kosecoff, Protocarey Inc.

3:20 p.m.

Discussion

3:40–4:00 p.m.

Break

4:00 p.m.

The Data Policy and Technology Environment

• Innovations in information technology for collecting, analyzing, and disseminating health data; issues of privacy, confidentiality, and security of health data

• Presentations:

Survey methods: Sandra Berry, RAND

Information technologies: William Eddy, Carnegie Mellon University

Data policy issues: John Eisenberg, Agency for Healthcare Research and Quality

Privacy and confidentiality issues: George Duncan, Carnegie Mellon University

5:00 p.m.

Discussion

5:20 p.m.

ADJOURN

FRIDAY, NOVEMBER 5, 1999

8:15–9:45 a.m.

PANEL DISCUSSION

Changing Roles and Responsibilities in the Health Statistics System

Moderator: Edward Perrin, Workshop Chair

This panel will bring together panelists from several segments of the health statistics system to address priorities for

• changes in the health statistics system to meet new and continuing information needs and to respond to changing roles and responsibilities;

• research to respond to changing needs in the health statistics system.

Panelists will be asked to present for discussion specific proposals regarding steps that might be taken to meet evolving needs for health statistics. Panelists should consider needs/requirements of users and producers of health statistics and should draw on the background papers, the previous day’s discussions, and their own experiences in framing their proposals.

The moderator will guide the discussion toward specific conclusions that can contribute to framing an overall agenda for steps to ready the health statistics system for the 21 st century.

Panelists (from federal, state, local, and private sectors)

Edward Sondik, Director, National Center for Health Statistics, and DHHS Statistical Advisor

John Lumpkin, Illinois Department of Public Health

Kenneth Thorpe, Rollins School of Public Health, Emory University

Eileen Peterson, United Health Group

9:45–10:00 a.m.

Break

10:00 a.m.–1:15 p.m.

WRAP-UP SESSION

Developing an Agenda for the Health Statistics System in the 21st Century

Moderator: Edward Perrin, Workshop Chair

10:00–10:15 a.m.

Reviewing the Issues

Presenter: Miron Straf, Director (on leave), Committee on National Statistics

This session will provide a brief overview of the key issues covered during the workshop sessions, setting the stage for discussion of opportunities for change and research needs.

10:15–11:15 a.m.

Comments from Invited Discussants

Invited discussants will reflect on implications of emerging health data needs for the health statistics system (15 minutes each).

Discussants:

Dorothy Rice, University of California, San Francisco

Richard Kronick, University of California at San Diego

Daniel Friedman, Massachusetts Department of Public Health

Michael Wolfson, Statistics Canada

11:15–1:15 p.m.

Identifying Opportunities for Change and Research Needs

Discussion by all workshop participants to outline

• an agenda for key changes to respond to needs across the health statistics system

• a research agenda to respond to needs across the health statistics system

• priorities for HHS and its agencies engaged in health statistics activities

1:15 p.m.

ADJOURN