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This paper discusses the work of the EUHPID Project to develop a European Health Promotion Monitoring System based on a common set of health promotion indicators. The Project has established three working groups to progress this task -- health promotion policy and practice-driven, data-driven and theory-driven. The work of the latter group is reviewed in particular. EUHPID has taken a systems theory approach in order to develop a model as a common frame of reference and a rational basis for the selection, organization and interpretation of health promotion indicators. After reviewing the strengths and weaknesses of those health promotion models currently proposed for indicator development, the paper proposes a general systems model of health development, and specific analytical, socio-ecological models related to public health and health promotion. These are described and discussed in detail. Taking the Ottawa Charter as the preferred framework for health promotion, the socio-ecological model for health promotion adopts its five action areas to form five types of systems. The structure and processes for each of these five systems are proposed to form the basis of a classification system for health promotion indicators. The paper goes on to illustrate such a system with reference to indicators in the workplace setting. The EUHPID Consortium suggest that their socio-ecological model could become a common reference point for the public health field generally, and offer an invitation to interested readers to contribute to this development. [ABSTRACT FROM AUTHOR]

Background As digitalization is progressively permeating all aspects of society, how can be it fruitfully employed to sustain the public health goals of quality, accessibility, efficiency and equity in health care and prevention? In this paper, we reflect on the potential of applying digital tools to public health and discuss some key challenges. Methods We first define 'digitalization' in its broader sense, as well as applied to public health. We then build a conceptual framework where key public health domains are associated to available digital technologies in a matrix that help to identify digital features that bolster public health action. We also provide illustrative data and evidence on the application of digital solutions on selected public health areas. In the second part, we identify the strategic pillars for a successful European strategy for public health digitalization and we outline how the approach being pursued by the European Public Health Association (EUPHA) applies to digital health. Results From a public health perspective, digitalization is being touted as providing several potential benefits and advantages, including support for the transition from cure to prevention, helping to put people and patients at the center of care delivery, supporting patient empowerment and making healthcare system more efficient, safer and cheaper. These benefits are enabled through the following features of digital technologies: (i) Personalization and precision; (ii) Automation; (iii) Prediction; (iv) Data analytics and (v) Interaction. Conclusion A successful European strategy for public health digitalization should integrate the following pillars: political commitment, normative frameworks, technical infrastructure, targeted economic investments, education, research, monitoring and evaluation. EUPHA acknowledges digitalization is an asset for public health and is working both to promote the culture of "public health digitalization", as well as to enable its planning, implementation and evaluation at the research, practice and policy level. [ABSTRACT FROM AUTHOR]

Background: The health monitoring programme of the European Commission has proposed a set of health indicators whereby the health status of member states can be measured. As part of that programme we considered how primary care might contribute relevant data. Methods: Using a questionnaire distributed to personal contacts and health authorities, we investigated the activities of sentinel practice networks and sought opinions on the place of primary care as a provider of information on health indicators. Studies on the prevalence of diabetes mellitus and on the incidence of chickenpox were undertaken within selected networks. Results: 33 networks were found who provided relevant information on a timely and continuing basis. Contributions varied; some were limited to monitoring influenza but others recorded morbidity data from every consultation. Recording methods ranged from the paper based to fully automated systems in which all morbidity was coded electronically at data entry. The study of diabetes mellitus showed less variation between national networks than currently suggested on the WHO database. For chickenpox we estimated the incidence of cases not presenting to general practitioners ranged between 3 and 27%. Conclusions: Information on health indicators needs to come from the place where relevant care is delivered; for many conditions that is from primary care. It can be delivered from appropriately resourced practices where the population is defined, the practice populations are nationally representative and data collection is automated. [ABSTRACT FROM AUTHOR]

Background In Europe, more than 15 million people live with heart failure (HF). It imposes an enormous social, organizational and economic burden. As a reaction to impending impact on healthcare provision, different country-specific structures for HF-care have been established. The aim of this report is to provide an overview and compare the HF-care approaches of Germany, Ireland, the Netherlands and the UK, and to open the possibility of learning from each other's experience. Methods A mixed methods approach was implemented that included a literature analysis, interviews and questionnaires with HF-patients and caregivers, and expert interviews with representatives from healthcare, health service research and medical informatics. Results The models of HF-care in all countries analyzed are based on the European Society of Cardiology guidelines for diagnosis and treatment of HF. Even though the HF-models differed in design and implementation in practice, key challenges were similar: (i) unequal distribution of care between urban and rural areas, (ii) long waiting times, (iii) unequal access to and provision of healthcare services, (iv) information and communication gaps and (v) inadequate implementation and financing of digital applications. Conclusion Although promising approaches exist to structure and improve HF-care, across the four countries, implementation was reluctant to embrace novel methods. A lack of financial resources and insufficient digitalization making it difficult to adopt new concepts. Integration of HF-nurses seems to be an effective way of improving current models of HF-care. Digital solutions offer further opportunities to overcome communication and coordination gaps and to strengthen self-management skills. [ABSTRACT FROM AUTHOR]

Background: COVID-19 has reinforced the centrality of health workers at the core of a well performing and resilient health system. It has concomitantly exposed the risks of staffing and skills shortages and the importance of protecting the health workforce. This paper focuses on highlighting some of the lessons learnt, challenges and future needs of the health workforce in Europe in the context of COVID-19. Methods: We use secondary sources and expert information. Results: During the pandemic innovative and flexible approaches were implemented to meet increasing demand for health workers and new skills and responsibilities were adopted over a short period of time. We have seen the rapid adaptation and use of new technologies to deliver care. The pandemic has underlined the importance of valuing, protecting and caring for our health workforce and the need to invest appropriately and adequately in the health workforce to have sufficient, capable and wellmotivated health workers. Some of the main challenges that lie ahead of us include the imperative for better investment, to need to improve recruitment and retraining whilst better retaining health workers, a focus on domestic sustainability, redeploying and developing new skills and competences among health workers, enabling more effective multi-professional collaboration and team work, improving the quality of education and training, increasing the public health focus and promoting ethical and sustainable international recruitment of health workers. Conclusions: The WHO European Region through its European Programme of Work 2020-2025 is fully committed to support countries in their efforts to continue to respond to COVID-19 and whilst addressing upcoming health workforce challenges. [ABSTRACT FROM AUTHOR]

The article presents a viewpoint on the issues with the European health strategy, which was intended to provide an overarching strategic framework, spanning core issues in health. Accordingly, the new health strategy has been structured as four principles and three objectives that are closely similar to the three of the first health strategy, given the fact that medical care as well as health systems are clearly included and also the health promotion and protection. It is being noted that strategy proposes two main dimensions for implementation such as structured cooperation between Member States and finance. However, the author stresses that while these existing strands of health policy have become embodied within the Strategy, a new theme has become politically significant.

Presents the abstract of the study "Beyond Bismarck and Beveridge: Towards a Research Agenda for Health Systems Research," by Diana Delnoij presented at the 11th Annual Conference of the European Public Health Association in November 2003.

Presents a study that investigated the status of health services in central and eastern Europe. Differences between the countries in the region; Methodology used in the study; Discussion on the results of the study; Conclusion.

Describes European responses to the gap between the demand for health care and the ability to pay for care and to do so in an ethical way. Lack of ability of the described responses to reduce the gap; Ethical problems of the gaps; Proposal on managing the gap between health care resources and demand.

Background: Comparisons of outcomes of health care in different systems can be used to inform health policy. The EuroHOPE (European Healthcare Outcomes, Performance and Efficiency) project investigated the feasibility of comparing routine data on selected conditions including breast cancer across participating European countries. Methods: Routine data on incidence, treatment and mortality by age and clinical characteristics for breast cancer in women over 24years of age were obtained (for a calendar year) from linked hospital discharge records, cancer and death registers from Finland, the Turin metropolitan area, Scotland and Sweden (all 2005), Hungary (2006) and Norway (2009). Age-adjusted breast cancer incidence and 1-year survival were estimated for each country/region. Results: In total, 24576 invasive breast cancer cases were identified from cancer registries from over 13 million women. Age-adjusted incidence ranged from 151.1 (95%CI 147.2-155.0) in Hungary to 234.7 (95%CI 227.4-242.0)/100 000 in Scotland. One-year survival ranged from 94.1% (95%CI 93.5-94.7%) in Scotland to 97.1% (95%CI 96.298.1%) in Italy. Scotland had the highest proportions of poor prognostic factors in terms of tumour size, nodal status and metastases. Significant variations in data completeness for prognostic factors prevented adjustment for case mix. Conclusion: Incidence of and survival from breast cancer showed large differences between countries. Substantial improvements in the use of internationally recognised common terminology, standardised data coding and data completeness for prognostic indicators are required before international comparisons of routine data can be used to inform health policy. [ABSTRACT FROM AUTHOR]

Background: In order to provide effective primary care for refugees and to develop interventions tailored to them, we must know their needs. Little is known of the health needs and experiences of recently arrived refugees and other migrants throughout their journey through Europe. We aimed to gain insight into their health needs, barriers in access and wishes regarding primary health care. Methods: In the spring of 2016, we conducted a qualitative, comparative case study in seven EU countries in a centre of first arrival, two transit centres, two intermediate-stay centres and two longer-stay centres using a Participatory Learning and Action research methodology. A total of 98 refugees and 25 healthcare workers participated in 43 sessions. Transcripts and sessions reports were coded and thematically analyzed by local researchers using the same format at all sites; data were synthesized and further analyzed by two other researchers independently. Results: The main health problems of the participants related to war and to their harsh journey like common infections and psychological distress. They encountered important barriers in accessing healthcare: time pressure, linguistic and cultural differences and lack of continuity of care. They wish for compassionate, culturally sensitive healthcare workers and for more information on procedures and health promotion. Conclusion: Health of refugees on the move in Europe is jeopardized by their bad living circumstances and barriers in access to healthcare. To address their needs, healthcare workers have to be trained in providing integrated, compassionate and cultural competent healthcare. [ABSTRACT FROM AUTHOR]

In this article the author discusses the low cross-border healthcare which was responsible for only 1% of public expenditure on healthcare in Europe. He is critical on the increased cooperation of European healthcare providers and policy makers in cross-border healthcare. Also stated is the European citizen's series of cases to the European Court of Justice (ECJ) to seek rights to reimbursement.

Background: With the goal of achieving greater unity and coherence, the Council of Europe developed a national palliative care (PC) policy framework--Recommendation (2003) 24. Although directed at member states, the policy spread to the wider World Health Organisation (WHO) European Region. This article aims to present the current situation relating to national PC health policies in European countries. Methods: A cross-sectional survey was conducted in 53 European countries of the WHO European Region. Relevant data reported (i) the existence of official documents concerning the provision of PC; (ii) the role of health departments and policymakers in the evaluation of PC provision and (iii) the availability of financial resources for PC provision. Results: In total, 46/53 (87%) EU and non-EU countries responded. PC legislation is established in 20 (71%) EU and nine (50%) non-EU countries. A total of 12 (43%) EU countries possess a PC plan or strategy in comparison with six (33%) non-EU countries. Individuals from Departments of Health and designated policymakers have established collaborative PC efforts. Quality systems have been initiated in 15 (54%) EU and four (22%) non-EU countries. Significant differences were not found in the reporting of payments for PC services between European regions. Conclusion: An improvement in national PC policy in both EU and non-EU countries was observed. Future priorities include potential initiatives to improve relationships with policymakers, establish quality control programmes and ensure financial support for PC. [ABSTRACT FROM AUTHOR]

Background: The European population is aging. The main drivers of public spending on health care for people of 65 years and older are hospital admission and admission to long-term care facilities. High quality community care can be a cost-effective and quality solution to respond to the impact of ageing populations on health-care systems. It is unclear how well countries are equipped to provide affordable and quality community care. The aim of this article is to describe and compare community care delivery with care-dependent older people in Europe. Methods: This study is conducted within the European Union-financed IBenC project [Identifying best practices for care-dependent elderly by Benchmarking Costs and outcomes of community care (FP7)] in which six European countries are involved. To compare the community care delivery with care-dependent older people in these countries, we performed a systematic comparison of macro indicators using metadata complemented with data from multinational surveys. Results: Data on the following dimensions are described and compared: population of the country, governmental expenditures on health, sources of community health services funding, governmental vision and regulation on community care, community care organisations and care professionals, eligibility criteria for and equity in receiving care and the involvement of informal care. Conclusion: Because of the variations in the European community care contexts, the growing demand for community care as a cost-effective and quality solution to the care burden of aging populations will have country-specific impacts. When learning from other countries' best practices, in addition to researchers, policy makers should take full account of local and national care contexts. [ABSTRACT FROM AUTHOR]

The article presents abstracts on medical topics which include developing and validating disease management evaluation methods for European health-care systems, innovative issues in public health education and training devoted to strategic management, and the relationship between family income and postponement of needed medical care.

Presents abstracts of studies on social and socio-demographic inequalities which were presented at the 11th Annual Conference of the European Public Health Association in November 2003. "Health inequalities: Survey data compared to doctor defined data," by Gert P. Westert and Francois G. Schellevis; "Economic strain and health among lone mothers in Sweden 1979-1998," by Sara Ålander and Bo Burström; "Cultural differences in self-rated health in ethnic groups in the Netherlands," by W. Deville and G. Westert.

Background: Within the EU Health Monitoring Programme (HMP), the ECHI project has proposed a comprehensive list of 'European Community Health Indicators'. Methods: In the design of the indicator set, a set of explicit criteria was applied. These included: i) be comprehensive and coherent, i.e. cover all domains of the public health field; ii) take account of earlier work, especially that by WHO-Europe, OECD and Eurostat; and iii) cover the priority areas that Member States and Community health policies currently pursue. Flexibility is an important characteristic of the present proposal. In ECHI, this has been emphasized by the definition of 'user-windows'. These are subsets from the overall indicator list, each of which should reflect a specific user's requirement or interest. Results: The proposed indicators are, in most cases, defined as generic indicators, i.e. their actual operational definitions have not yet been attempted. This work has been, and is being carried out to a large part by other projects financed under the HMP, which cover specific areas of public health or areas of data collection. Apart from indicators covered by regularly available data, indicators (or issues) have been proposed for which data are currently difficult to collect but which from a policy point of view would be needed. Conclusion: All this points to the fact that establishing an indicator list which is actually used by Member States is a continuously developing process. This process is now continued by the first strand of the new EU Public Health Action Programme. [ABSTRACT FROM AUTHOR]

Background: The ability to measure and compare hospital activity between EU member states is important for policy, planning, financing and assessment of population health. Earlier initiatives in this area have been largely directed at standardising high-level indicator definitions without proper account of differences in health systems and health information systems. The Hospital Data Project (HDP) develops a methodology for improved comparability of hospital inpatient and day case activity data across Europe and produces a pilot common data set. All EU members, Iceland and the World Health Organisation are participants. Methods: The approach comprises a detailed inventory of patient-level hospital data, identification of common areas, specification of data transformations and production of pilot data sets and metadata in a common format. An expert group developed a new diagnosis shortlist based on ICD-10. The project takes account of current work in the area of health care and morbidity indictors and applies the functional specification of health systems developed by the OECD. Results: Seventeen countries have submitted data and metadata in the common format for a single year. Data on inpatients and day cases are classified by age, gender, diagnosis and type of admission. Numbers of hospital discharges, mean and median lengths of stay and population rates are reported. Test data on selected hospital procedures has also been collected. The full data set contains approximately 500,000 records, and software has been designed to facilitate validation and use. Conclusion: Results to date are promising. It is a first step in a complex area, and further work is required to extend and refine this approach. [ABSTRACT FROM AUTHOR]

Presents a classification of past public and private arrangements in European health systems. Assessments of the central notion behind the concept of privatization of health services; Anomalies in European health system arrangements; Issue pointed out by proponents and opponents of privatization.

Presents several abstracts on health, health care system and rehabilitation in Europe. Patient orientation and the health care system in Europe; Comorbidity in patients with musculoskeletal and cardiovascular diseases; Assessment of needs in rehabilitation.

Presents several abstracts on public health and health care in Europe. Effect of hospital volume on short- and long-term survival after Acute Myocardial Infarction; Impact of the introduction of Diagnosis Related Groups on the German health system; Evaluation of clinical charts quality using factorial analysis.

Presents several abstracts on public health and health services in Europe. Access and quality of health care for ethnic minorities; Management of diabetes mellitus; Nutrition behavior of children.

Focuses on a study that analyzed the patterns of reported preventive practices in a number of European countries. Information on the burden caused by chronic diseases; Geographical areas where health surveys were carried out; Scarcity of studies comparing preventive activities at primary health care level in European countries.

Focuses on how can the health and social care expenditures into a single statistic for policy-making purposes. Health and social care expenditures in Sweden; Implication on the growing number of aged population in Europe; Discussion on several methodological issues that must be addressed to deal with the problem.

Presents a study that examined the correlates of care seeking behavior for infertility treatment in different cultural and socio-economic settings in Europe. Analysis of frequency of infertility; Evaluation of social predictors of care seeking behavior; Comparison of care seeking and non-care seeking couples with infertility.

Presents a study on measuring performance of health care in European hospitals. Disadvantage of using summary measures in evaluating performance; Importance of distinguishing between influences that can be attributed to the hospitals and those which arise from differences in the patients they treat; Variations in the length of hospital stay of gynecology patients in Scotland.

The author reflects on the privatization of health care in Europe. He examines the reasons for privatization, such as dissatisfaction with poorly managed public service and patient rights to choice, diversity and quality healthcare. He also notes how the region deals with the challenges of privatizing health care, as well as its risks and possible precautionary measures. He cites the range problems being faced by modern healthcare system, such as consumer-driven demand and quest for quality.

The article discusses key issues concerning the proposed new Cochrane Public Health Collaborative Review Group (PHCRG) in the area of public-health decision making in Europe. The PHCRG aims to provide editorial direction and leadership in the synthesis of evidence on public-health interventions that address health inequalities and upstream, population-level determinants of health. The scope of the PHCRG includes systematic reviews of public-health programs and interventions aimed at reducing health inequalities and improving health equity. Also cited are the issues' implications for public health.

Presents abstracts of studies related to health and medicine which were presented at the 11th Annual Conference of the European Public Health Association in November 2003. "Effects of virgin olive oil phenols on proliferation, cell cycle and apoptosis of tumor cell lines," by Roberto Fabiani, A. De Bartolomeo, P. Rosignoli, M. Servili, G.F. Montedoro and G. Morozzi; "Occurrence of organic chlorinated pollutants in seafood," by T. Cirillo, V. Viscardi, D. Perrone and R. Amodio Cocchieri; "Benzene outdoor and indoor pollution in Rome: Citizens exposure study," by Umberto Moscato, G. La Torre, F. La Torre and Ricciardi G.

Presents abstracts of studies on health service research which were presented at the 11th Annual Conference of the European Public Health Association in November 2003. "Promoting clinical and organizational appropriateness of tonsillectomy in Italy," by E. Materia, G. Baglio, D. Canonaco, T. Jefferson, A. Mele, P. Marchisio, R. Di Domenicantonio and G. Guasticchi; "Hospital at home in an evidence based perspective: An opportunity for hospital changing in Europe," by G. Damiani, L. Pinnarelli, A. Cataldo and G. Ricciardi; "Results of the third panel survey on public use of, knowledge of, and perception of social and health services in Armenia," by Anna Grigoryan.

Presents abstracts of studies on health care presented at the 11th Annual Conference of the European Public Health Association in November 2003. "An Excellence Award in health care," by G. Caracci, V. Fabio, C. Mantuano, A. Gangale, L. Casertano, F. Gillespie, P. Scansano and G. Guasticchi; "Health Care Reports and GIS adoption at community level: An analysis on three Italian local health units (LHUs)," by Alberto Zucchi, A.G. de Belvis and G. Ricciardi; "Patient status in the Romanian health care system," by Ana-Claudia Bara and Wim van den Heuvel.

Presents abstracts of studies on public health issues on migrant and ethnic minorities which were presented at one of the parallel sessions during the 11th Annual Conference of the European Public Health Association in November 2003. "Migrant-friendly hospitals: A European initiative to promote health and health literacy of migrants and ethnic minorities," by J.M. Pelikan, M. Juergen, K. Krajic, B. Schulze and U. Trummer; "Deteriorating health satisfaction among immigrants from Eastern Europe to Germany," by U. Ronellenfitsch and O. Razum; "Quality or cost-containment in health care for asylum seekers?" by L. Toscani, K. Mouzoune, O. Lampert, L. Muggah and L. Loutah.

Presents abstracts of studies on health service research presented at a parallel session during the 11th Annual Conference of the European Public Health Association in November 2003. "Practice guidelines, Did they reduce medical practice variation?" by J.D. De Jong, G.P. Westert, F. Schellevis and P.P. Groenewegen; "Flexible and mobile doctors as a strategy for capacity problems," by P. Heiligers and N. Van der Vange; "Who is responsible for metropolitan health systems: The limitations of managed competition," by T. Plochg, D.M.J. Delnoij and N.S. Klazinga.

Comments on the guidelines on coverage and subsequent uptake rates for the influenza vaccination across European countries. Common problem to all health care systems; Information on recommendation target groups for influenza vaccination in several European countries; Influenza vaccination as an effective public health care intervention.

Editorial. Focuses on clinical practice guidelines aimed at improving the process and outcome of health care in Europe. Definition of quality care; Illustration of inappropriate use of medical care in Europe; Benefit of promoting a concerted international effort on the improvement of health care.

Editorial. Discusses the adoption of medical savings accounts (MSA) in European health care systems. Background on the development of MSA; Principle behind MSA; Creation of positive financial incentives for individuals.

The author reflects on the contribution of public health to health care services. According to the author every health service in Europe still faces several problems which include variation in quality, waste of resources and poor patient experience. He feels that public health professionals can deliver many benefits to health care in Europe but it is detached from health care provision.

Presents abstracts of studies on public health issues in migrant ethnic minorities and refugees which were presented at the 11th Annual Conference of the European Public Health Association in November 2003. "Time trends in AIDS incidence among immigrants in Italy," by L. Cacciani, A. Rosano, S. Boros, L. Camoni, A. Colucci, G. Guasticchi, G. Rezza, R. Urciuoli, G. Baglio and P. Pezzotti; "Recruitment and follow up of ethnic minority patients in clinical studies," by Liselotte Visser and Paul Uitewaal; "The status of health and health-behavior of the adult Roma population in Hungary," by Kinga Lampek and M. Törcsik.

Presents abstracts of studies related to public health which were presented at one of the parallel sessions during the 11th Annual Conference of the European Public Health Association in November 2003. "Trends in development of CAM practitioners in UK and Germany," by S. Weinbrenner, A. Riesberg, A. Dixon, O. Saka, J. LeGrand and R. Busse; "Children leukemia as cause of family separation," by G. Varchetta, M. Esposito, G. Messina, F. Lofiego and N. Nante; "Organized breast cancer screening program in a liberal system: The example of the French community, Belgium," by M. Puddu and A. Vandenbroucke.

Presents abstracts of studies dealing with informed patients and use of health services which were presented at one of the parallel sessions during the 11th Annual Conference of the European Public Health Association in November 2003. "Does educational level play a role in determining length of hospital stay?" by L. Rossi, L. Cacciani, G. Baglio, G. Guasticchi and E. Materia; "A large proportion of Swedish citizens refrain from seeking medical care: Lack of confidence in the medical services a plausible explanation," by M. Westin, A. Åhs and R. Westerling; "Informed patients: Legal fiction or reality?" by A. Van den Brink-Muinen, S. Van Dulmen and J. Bensing.

Presents abstracts of studies on health care which were presented at one of the parallel sessions during the 11th Annual Conference of the European Public Health Association in November 2003. "The health of nations: How much is attributable to health care?" by E. Nolte and M. McKee; "Health care costs in the last year of life," by J.J. Polder, G.J. Kommer and J.A.M. Van Oers; "Preferences for curative and preventive health care," by W.J. Meerding, M. Stuifbergen and M.L. Essink-Bot.

Presents abstracts of studies related to health services research presented at the 11th Annual Conference of the European Public Health Association in November 2003. "Introductory lecture: Studies of integrated in an international perspective," by Ingrid Mur-Veeman; "Using pooled budgets to integrate welfare systems: A comparison of collaboration between health services, social services and social insurance in England and Sweden," by Eva-Lisa Hultberg, Knut Lonnroth, Peter Allebeck and Caroline Glendinning; "The Local Health Systems (LHS) project in Belgium," by J.P. Unger, B. Criel, S. Dugas, J. Van der Vennet and M. Roland.

Provides news briefs on European public health as of December 1998. Information on the European Observatory on Health Care Systems organization; Start of the BIOMED Project Disability Weights for Diseases in Europe; Information on the International Hospital Federation.

Editorial. Discusses the search for appropriate balance between state and market in the funding and provision of health services in Europe. Indicator of health reform according to a study from the European Regional Office of the World Health Organization; Impact of the issues on public accountability and governance on national health policy decisions.

The article comments on the population-based and vulnerable-population approaches to public-health interventions in Europe. It includes an in-depth analysis of whether the two approaches complement or contradict each other, as well as a discussion on inequalities in the provision of health services that may be caused by the approaches to public health intervention. Also cited are the issues' implications for preventive medicine and public health.

Emphasizes the importance of National Health Information Systems (NHIS) in European decision-makers' efforts to identify and select the most valid and reliable health information. Support given by the World Health Organization to countries in Europe to search for better ways in developing their NHIS; Factors that challenge countries in developing NHIS.

Highlights the priorities of the World Health Organization's (WHO) European Office in the next five years starting January 2005. Importance of creating national health information systems; Public health initiative of the European Office of WHO; Details on the goals of the European Office.