How Do Countries’ Health Information Systems Perform in Assessing Asylum Seekers’ Health Situation? Developing a Health Information Assessment Tool on Asylum Seekers (HIATUS) and Piloting It in Two European Countries
Abstract
1. Introduction
2. Materials and Methods
2.1. Development Process of the Assessment Tool
2.2. Dimensions and Sub-Scales of the Tool
- (D1)
- Data sources and data availability: measures the availability of data related to asylum seekers across HIS data sources as well as the extent of details available across five subscales.
- (D2)
- Resources and capacity: measures HIS resources and (monitoring) capacity focusing on the areas of coordination, planning and policies related to health monitoring in asylum seekers.
- (D3)
- Published indicators and reports: measures the general coverage and timeliness of published information on selected key indicators across six sub-scales (self-reported health indicators, non-communicable diseases, infectious diseases, mental health, socio-economic position, and health-related behaviours) in the last 10 years.
2.3. Pilot Test and Cross-Country Comparison
- (1)
- Absolute gaps in capacity within countries: the difference between achieved HIATUS score of a given country and the maximum achievable HIATUS score.
- (2)
- Relative gaps in capacity within countries: calculated as the absolute gap relative to the maximum achievable HIATUS score
- (3)
- Absolute gaps between countries: the difference in HIATUS scores between two countries in absolute terms.
3. Results
4. Discussion
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
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D1—Data Sources & Availability |
D1.1—Population based records |
Are asylum seekers represented and identifiable in: |
the population registry? |
population census or demographic data obtained by census-like approaches? |
the death registry? Can a distinction be made by cause of death? |
nationally representative health interview surveys? |
D1.2—Health records |
Are asylum seekers represented and identifiable in: |
claims data or other service utilisation data based on (routine or specific) registries in the health system? |
any disease registers for specific non-communicable diseases? |
notification-systems for infectious diseases? Is it possible to obtain information on denominator data to calculate incidence or prevalence rates? |
D1.3—Sub-group specific records |
Are there records that allow assessing the health status of or access to health care for: |
victims of torture or violence? |
unaccompanied minors? |
pregnant women? |
accompanied children/minors? |
D1.4—Resource records |
Are data available on: |
the volume of health facilities and key health services specifically provided to asylum seekers (e.g., number, size, distribution)? |
human resources for health specifically concerned with asylum seekers (e.g., density, composition and distribution)? |
financing and expenditure for health services specifically provided to asylum seekers? |
D1.5—Microdata |
Are microdata (i.e., individual level data) practically available for researchers or policy makers (e.g., upon request) from: |
population registry? |
death registry? |
population surveys, e.g., health interview surveys? |
claims data or other routine data of the health care system? |
disease registers? |
infectious disease notification systems? |
records on resources and health services inputs? |
D2—HIS Resources & Capacity |
D2.1 Coordination, Planning and Policies |
Is there a: |
written plan in active use to comprehensively monitor the health status or health care access of asylum seekers? |
functioning national organisation responsible for coordination, planning and implementation of HIS for asylum seekers? |
D3—Published Indicators and Reports |
D3.1—Self-reported health |
Are there any published indicators, statistics or reports of studies covering self-reported health indicators in the last 10 years such as: |
self-rated general health (from poor to very good)? |
self-reported access to health care services? |
self-reported impairments of disabilities? |
self-reported longstanding chronic illnesses? |
D3.2—Non-communicable diseases |
Are there any published indicators, statistics or reports of studies covering non-communicable diseases in the last 10 years such as: |
cardiovascular diseases (e.g., stroke, ischemic diseases, myocardial infarction, angina pectoris or heart failure)? |
diabetes? |
obesity/overweight or under-nutrition? |
cancer types? |
musculoskeletal diseases? |
accidents and injuries (excluding suicidal behaviour)? |
D3.3—Infectious diseases |
Are there any published indicators, statistics or reports of studies covering infectious diseases in the last 10 years such as: |
tuberculosis? |
HIV/AIDS? |
hepatitis B or C? |
vaccine preventable diseases? |
D3.4—Mental health |
Are there any published indicators, statistics or reports of studies covering mental health conditions in the last 10 years such as: |
depression (including depressive symptoms)? |
anxiety disorders? |
post-traumatic stress disorder (PTSD)? |
suicidal behaviour including death from suicide? |
D3.5—Socio-economic status |
Are there any published statistics or reports covering any indicators of socio-economic status in the last 10 years such as: |
level of educational achievement of adult asylum seekers? |
employment and type of occupation among asylum seekers? |
income, welfare transfers or poverty among asylum seekers? |
D3.6—Health behaviour |
Are there any published indicators, statistics or reports covering health-related behaviours in the last 10 years such as: |
alcohol intake (amount, frequency)? |
smoking (current status, amount)? |
physical activity (type of activity, amount)? |
unsafe sex? |
Measure | Country | |||||
---|---|---|---|---|---|---|
The Netherlands | Germany | |||||
Inter-item correlations by dimension | rho | p-value | N | rho | p-value | N |
D1—Data sources & availability | 0.257 | 0.237 | 23 | 0.510 | 0.013 | 23 |
D2—HIS resources & capacity * | - | - | 2 | - | - | 2 |
D3—Published indicators & reports | 0.066 | 0.754 | 25 | 0.256 | 0.217 | 25 |
All HIATUS Items | 0.144 | 0.317 | 50 | 0.309 | 0.029 | 50 |
Intra-class correlation and inter-rater reliability, all HIATUS Items | The Netherlands | Germany | ||||
ICC (SE) | 0.026 (0.09) | 0.263 (0.27) | ||||
Estimated reliability of mean scores | 0.290 | 0.829 | ||||
R-squared | 0.06 | 0.20 | ||||
N | 50 | 50 |
The Netherlands (NL) | Germany (DE) | Between-Country Gap | ||||||
---|---|---|---|---|---|---|---|---|
within Country Gap | within Country Gap | |||||||
Dimensions | Maximum Achievable Score | Achieved Score | Abs. | % | Achieved Score | Abs. | % | Abs. (NL minus DE) |
D1—Data sources & availability | 39 | 28 | 11 | 28 | 3 | 36 | 92 | 25 |
D1.1—Population based records | 10 | 6 | 4 | 40 | 1 | 9 | 90 | 5 |
D1.2—Health records | 8 | 7 | 1 | 13 | 1 | 7 | 88 | 6 |
D1.3—Sub-group specific records | 8 | 3 | 5 | 63 | 0 | 8 | 100 | 3 |
D1.4—Resource records | 6 | 5 | 1 | 17 | 1 | 5 | 83 | 4 |
D1.5—Microdata | 7 * | 3.5 * | 3.5 | 50 | 0 * | 7 | 100 | 3.5 |
D2—HIS resources & capacity | 8 ** | 2 ** | 6 | 75 | 2 ** | 6 | 75 | 0 |
D2.1 Coordination, Planning and Policies | 8 ** | 2 ** | 33 | 66 | 2 ** | 40 | 80 | 0 |
D3—Published indicators and reports | 50 | 17 | 6 | 75 | 10 | 7 | 88 | 7 |
D3.1—Self-reported health | 8 | 2 | 9 | 75 | 1 | 12 | 100 | 1 |
D3.2—Non-communicable diseases | 12 | 3 | 5 | 63 | 0 | 5 | 63 | 3 |
D3.3—Infectious diseases | 8 | 3 | 3 | 38 | 3 | 4 | 50 | 0 |
D3.4—Mental health | 8 | 5 | 5 | 83 | 4 | 4 | 67 | 1 |
D3.5—Socio-economic status | 6 | 1 | 5 | 63 | 2 | 8 | 100 | −1 |
D3.6—Health behaviour | 8 | 3 | 50 | 52 | 0 | 82 | 85 | 3 |
Total HIATUS Score | 97 | 47 | 11 | 28 | 15 | 36 | 92 | 32 |
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Bozorgmehr, K.; Goosen, S.; Mohsenpour, A.; Kuehne, A.; Razum, O.; Kunst, A.E. How Do Countries’ Health Information Systems Perform in Assessing Asylum Seekers’ Health Situation? Developing a Health Information Assessment Tool on Asylum Seekers (HIATUS) and Piloting It in Two European Countries. Int. J. Environ. Res. Public Health 2017, 14, 894. https://doi.org/10.3390/ijerph14080894
Bozorgmehr K, Goosen S, Mohsenpour A, Kuehne A, Razum O, Kunst AE. How Do Countries’ Health Information Systems Perform in Assessing Asylum Seekers’ Health Situation? Developing a Health Information Assessment Tool on Asylum Seekers (HIATUS) and Piloting It in Two European Countries. International Journal of Environmental Research and Public Health. 2017; 14(8):894. https://doi.org/10.3390/ijerph14080894
Chicago/Turabian StyleBozorgmehr, Kayvan, Simone Goosen, Amir Mohsenpour, Anna Kuehne, Oliver Razum, and Anton E. Kunst. 2017. "How Do Countries’ Health Information Systems Perform in Assessing Asylum Seekers’ Health Situation? Developing a Health Information Assessment Tool on Asylum Seekers (HIATUS) and Piloting It in Two European Countries" International Journal of Environmental Research and Public Health 14, no. 8: 894. https://doi.org/10.3390/ijerph14080894
APA StyleBozorgmehr, K., Goosen, S., Mohsenpour, A., Kuehne, A., Razum, O., & Kunst, A. E. (2017). How Do Countries’ Health Information Systems Perform in Assessing Asylum Seekers’ Health Situation? Developing a Health Information Assessment Tool on Asylum Seekers (HIATUS) and Piloting It in Two European Countries. International Journal of Environmental Research and Public Health, 14(8), 894. https://doi.org/10.3390/ijerph14080894