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European primary care surveillance networks: an overview of structure and operation.

Deckers, J.G.M., Paget, W.J., Schellevis, F.G., Fleming, D.M. European primary care surveillance networks: an overview of structure and operation. European Journal of Public Health: 2004, 14(4 Suppl.) 58. Abstract. 12 th Annual EUPHA meeting: Urbanisation and health: new challenges in health promotion and prevention in Oslo, Norway, 7-9 october 2004.
In many European countries, primary care networks have a important role in public health
surveillance. The networks are organised and function differently in EU member states. Their
information is a potential source for a European health information and monitoring system as
envisaged in the European Public Health Programme. A pan-European surveillance system using primary
care networks already exists for influenza (EISS). Aim: A detailed description of each network,
including its setting and function within the healthcare system, the recording arrangements, and
data processing procedures is a prerequisite to ensure validity and quality of the data and to make
valid comparisons. Our objective was to report on the organisation and function of participating
networks in a standardised way. Methods: We made an inventory of active primary care networks
collecting morbidity data on a continuous basis. Site visits were made to eight networks. A
standardised questionnaire was used to investigate aspects of function and recording quality.
Results: We sent out 75 questionnaires and received 55 responses (73% response rate). A total of 33
networks fitted our selection criteria for
a primary care surveillance network. Eight primary care networks in Belgium, England & Wales, France
(two networks), Germany, the Netherlands, Portugal and Spain deliver basic epidemiological
information on a variety of diseases mainly managed in primary care. Most are funded by their
respective Ministries of Health, some by governmental research funds. In general, the networks
comprise a stable group of general practitioners and monitor a representative sample of the general
population. Some networks monitor all diagnoses presented and others a limited selection of
diseases. Many of the networks use disease-specific questionnaires to provide enhanced data on
selected diseases. The frequency of reporting
varies from daily to annually, reflecting the purpose for which the network was established.
Conclusions: Primary care surveillance networks are an important tool for public health surveillance
in Europe. Their value has been already shown
in the European surveillance of influenza, but the challenge is now to extend their use to other
diseases. Organisations running a primary care network can learn from networks in other countries
and where necessary improve their own. When all networks fulfil identical minimal criteria they can
provide comparable estimates of morbidity and this will ultimately lead to improved surveillance
nationally and on a European level.