CELEX: 51996PC0222
Language: en
Date: 1996-05-15
Title: Amended proposal for a EUROPEAN PARLIAMENT AND COUNCIL DECISION adopting a programme of Community action on healht monitoring in the context of the framework for action in the field of public health

COMMISSION OF THE EUROPEAN COMMUNITIES
                                                    Brussels, 15.05.1996
                                                    COM(96) 222 final
                                                    95/0238 (COD)
                                Amended proposal for a
              EUROPEAN PARLIAMENT AND COUNCIL DECISION
                                      adopting a
programme of Community action on health monitoring in the context of the framework for
                          action in the field of public health
              (presented by the Commission pursuant to Article 189 a (2)
                                   of the EC-Treaty)
 ---pagebreak---  ---pagebreak---                                 EXPLANATORY STATEMENT
Amended proposal for a European Parliament and Council decision adopting a programme of
Community action on health monitoring in the context of the framework for action in the field
of public health (1997-2001)
1.     The initial proposal for a European Parliament and Council decision adopting a
       programme of Community action on health monitoring was adopted by the
       Commission on 16 October 1995.
2.     The Economic and Social Committee1 and the Committee of the Regions2 delivered
       favourable opinions on this initial Commission proposal.
3.     In light of the European Parliament's opinion after its first reading on 17 April 1996,
       an amended proposal for a decision was submitted by the Commission in accordance
       with Article 189A of the Treaty. The text incorporates essentially two types of
       amendments:
               amendments that clarify or broaden the recitals
               amendments that clarify and broaden the actions covered by the programme.
               In particular, a feasibility study of a health observatory has been included, and
               an Annex (II) has been added, containing a list of potential domains in which
               the health indicators may be established.
4.     The European Parliament adopted 44 amendments when it voted on 17 April 1996, of
       which 28 were acceptable in toto (12, 16-18, 20, 23, and 29) or in part (1, 3, 4, 6-11,
       13, 19, 25, 33-40, and 42) by the Commission.
5.     The amendments which are not acceptable by the Commission can be divided into 5
       groups:
               amendments that pose legal problems because they do not conform with the
               wording or intent of Art. 129 (15, 21, 31), or because they are inconsistent with
               the analogous provisions of the other public health programmes (43, 46, 47)
               amendments that propose changes which fall outside the scope of the proposed
               programme (2, 32)
               amendments that propose a less flexible wording than that proposed by the
               Commission and/or which unduly limite-the scope of the proposed programme
               (5, 14, 30, and 45)
               amendments that are covered elsewhere (26-28)
               one amendment (22) that would result in difficulties over budgetary matters.
    1
       Opinion delivered on 27 March 1996.
    2
       Opinion delivered on 18 January 1996.
 ---pagebreak--- Amended proposal for a European Parliament and Council decision adopting a
 programme of Community action on health monitoring in the context of the
            framework for action in the field of public health
 ---pagebreak---                COM(95) 449                   AMENDED PROPOSAL
THE EUROPEAN PARLIAMENT AND
THE COUNCIL OF THE EUROPEAN
UNION,
Having regard to the treaty establishing the
European Community, and in particular
Article 129 thereof,
Having regard to the proposal from the
Commission1,
Having regard to the opinion of the
Economic and Social Committee2,
Having regard to the opinion of the
Committee of the Regions3,
Acting in according with the procedures
referred to in Article 189b of the Treaty,
1. Whereas, in accordance with point (o) of
Article 3 of the Treaty, Community action
must include a contribution of the
Community towards the achievement of a
high level of health protection; whereas
Article 129 expressly provides for
Community competence in this field, in
particular by encouraging cooperation
between the Member States and, if
necessary, lending support to their action;
2. Whereas the Council, in its resolution4
of 27 May 1993 on future action in the
field of public health, considered that
improved collection, analysis and
distribution of health data, as well as an
improvement in the quality and
compatibility of available data, are
essential for the preparation of future
programmes;
i
        OJNo.
2
        OJNo.
3
        OJ No.
4
        OJNo. C 174, 25.6.1993, p.l
 ---pagebreak--- 3. Whereas, the European Parliament, in its   3. Whereas, the European Parliament, in its
report on public health policy after          resolution on public health policy after
Maastricht5, has stressed the importance of   Maastricht5, has stressed the importance of
having sufficient and relevant information    having sufficient and relevant information
as a basis for the development of             as a basis for the development of
Community actions in the field of public      Community actions in the field of public
health; whereas the European Parliament       health; whereas it called on the
called on the Commission to collect and       Commission to collect and examine health
examine health data from Member States        data from the Member States in order to
and analyse trends and assess the effects of  assess the effects of public health policies,
public health policies, as well as the impact as well as the impact of other policies, on
of other policies;                            the state of health in the European
                                              Community.
4. Whereas the Commission, in its
Communication of 24 November 1993 on
the framework for action in the field of
public health6, identified          increased
cooperation on standardisation and
collection of comparable/compatible data
on health, and the promotion of systems of
health monitoring and surveillance as a
prerequesite for the establishment of a
framework for supporting Member States'
policies and programmes; and whereas the
area of health monitoring, including health
data and indicators, has been identified as
a priority area for proposals on multi-
annual Community programmmes in the
field of public health;
        OJ No. C 329, 6.12.1993, p.375                OJNo. C 329, 6.12.1993, p.375
        COM(93) 559 final
 ---pagebreak--- 5. Whereas in its resolution of 2 June
1994, the Council7 indicated that the
collection of health data should be
accorded priority and invited the
Commission to present relevant proposals;
whereas the Council considered that data
and indicators used should include
measures relating to the quality of life of
the population, accurate assessments of
health needs, estimations of the avoidable
deaths from the prevention of diseases,
socio-economic factors in health among
different population groups, and, where
appropriate and if the Member States judge
it necessary, health aid, medical practices,
and the impact of reforms;
6. Whereas health monitoring at the
Community level is essential for the
planning, monitoring, and assessment of
Community actions in the field of public
health, and the monitoring and assessment
of the health impact of other Community
policies;
                                             6a. (new)      Whereas on the basis, inter
                                             alia, of knowledge of the facts of public
                                             health in Europe, obtained by setting up a
                                             Community health monitoring system, it
                                             will be possible to monitor public health
                                             trends and define public health priorities
                                             and objectives;
7. Whereas health monitoring, in this
context, encompasses the establishment of
Community       health indicators, the
collection, dissemination, and analysis of
Community health data and indicators;
        OJNo. C 165, 17.6.94, p. 1
 ---pagebreak--- 8. Whereas in its Decision on the
framework programme for priority actions
in the field of statistical information 1993
to 1997 the Council8 has identified under
the heading "health and safety" analysis of
mortality and morbidity by cause as one of
the fields of priority actions under the
sectoral programmes for social policy, for
economic and social cohesion and
consumer protection;
9. Whereas the Council9 in its Decision
adopting a specific programme on research
and technological development, including
demonstration, in the field of biomedicine
and health (1994-1998) identified a specific
research task on coordination and
comparison of European health data,
including nutritional data, from the
Member States, and whereas this was taken
up in the relevant research work
programme;
 10. Whereas health monitoring at
Community level             should enable
measurements of health status, trends and
determinants to be carried out, facilitate the
planning, monitoring and evaluation of
Community programmes and actions, and
provide Member States with health
information supporting the development
and evaluation of their health policies;
 11. Whereas, in order to give full effect to
requirements and expectations in this area
 a Community health monitoring system
 should be developed, comprising the
 establishment of health indicators and the
 collection of health data, a network for
transmission and sharing of health data and
 indicators, and a capacity for analysis and
 dissemination of health information;
         OJNo. L219, 28.8.93, p. 1
         OJNo. L361, 31.12.94, p. 40
 ---pagebreak---  12. Whereas available options and           12.    Whereas available options and
possibilities for developing the various    possibilities for developing the various
parts of a Community health monitoring      parts of a Community health monitoring
system should be carefully assessed with    system, including that of enhancing
respect to the desired performance,         existing capabilities and/or setting up an
flexibility and the costs and benefits      observatory, should be examined with
involved; whereas a Community health        respect to the desired performance, and the
monitoring system should include the        costs and benefits involved; and whereas a
definition of sets of Community health      flexible system is required which can
indicators and the collection of the data   incorporate features which are valuable at
necessary for the establishment of such     present while adapting to new requirements
indicators;                                 or other priorities; whereas a Community
                                            health monitoring system should include
                                            the definition of sets of Community health
                                            indicators and the collection of the data
                                            necessary for the establishment of such
                                            indicators;
13. Whereas, Community health data and      13.     Whereas Community health data
indicators should draw from readily         and indicators should draw from existing
available European data and indicators,     European data and indicators, such as
such as those held by Member States or      those held by Member States and/or
transmitted by them to international        transmitted by them to international
organisations, so as to avoid unnecessary   organisations, so as to avoid unnecessary
duplication of work;                        duplication;
                                            13a. (new)      Whereas the situation with
                                            regard to the collection of data varies from
                                            Member State to Member State:
14. Whereas a Community health              14.     Whereas the Community health
monitoring system would benefit from the    monitoring system would benefit from
establishment of a network, the backbone    being based on a network, the backbone of
of which relies on telematics, for the      which relies on telematics, for the
collection and distribution of Community    collection and distribution of Community
health data and indicators;                 health data and indicators;
15. Whereas a Community health              15.     Whereas the health monitoring
monitoring system should be capable of      system should provide material for regular
encouraging and assisting in the production reports on health status in the European
of analyses of health status, trends, and   Community, analyses of trends, and health
health     problems      throughout     the problems, and assist in the availability and
Community, and in the availability and      dissemination of health information;
dissemination of health information;
 ---pagebreak---                                              15a. (new)      Whereas importance must be
                                             attached to cooperation in the field of
                                             health and occupational health and safety,
                                             from which a picture of the prevalence of
                                             occupational diseases and accidents at work
                                             can be built up;
16. Whereas overriding considerations in      16.    Whereas it is necessary to ensure
the development of a Community health        the respect of legislative provisions on data
monitoring system are the respect of         protection, and the implementation of
legislative provisions on data protection,   appropriate confidentiality and security
and the implementation of appropriate        arrangements;
confidentiality and security arrangements;
 17. Whereas a multiannual programme
should be launched within the context of
the framework for action in the field of
public health, in order to permit the
development of a Community health
monitoring system and of appropriate
mechanisms for its evaluation;
18. Whereas, by reason of its scale and
effects, Community action in support of
health monitoring enables the desired
objectives to be reached more effectively;
 19. Whereas policies and programmes
formulated and implemented at Community
level, in particular those undertaken in the
context of the framework for action in the
field of public health, should be compatible
with the targets and objectives of
Community action on health monitoring;
whereas the implementation of Community
actions on health monitoring should be
coordinated with and take account of
relevant research activities under the
Community's Framework Programme for
Research and Technological Development;
whereas projects on telematics applications
in the health field under the Community's
RTD Framework must be closely
coordinated with Community actions on
health monitoring; whereas actions under
the Community's framework programme
for statistical information, the Community
projects in the field of telematic
 ---pagebreak--- interchange of data between administrations
(IDA) and G-7 health-related projects must
be closely coordinated with the
implementation of Community actions on
health monitoring; whereas the work
undertaken by the specialised European
agencies, such as the EMCDDA and the
European Environment Agency, should be
taken into account;
20. Whereas cooperation in this area with
the competent international organisations
and with third countries should be fostered;
                                                 20a. (previously recital 23) Whereas, from
                                                 an operational point of view, the
                                                 investments made in the past both in terms
                                                 of the development of Community
                                                 networks and cooperation with international
                                                 organisations competent in this field should
                                                 be safeguarded and further developed;
21. Whereas it is important that the             21.     Whereas it is important that the
Commission ensure implementation of the          Commission implement this programme in
programme in close cooperation with the          close cooperation with the Member States;
Member States;
 22. Whereas an agreement on a "modus
vivendi" between the European Parliament,
the Council and the Commission
 concerning measures implementing acts
 adopted in accordance with the procedure
 laid down in Article 189b of the EC Treaty
 was reached on 20 December 1994;
 23. Whereas, from an operational point of       23.     Deleted
 view, the investments made in the past
 both in terms of the development of
 Community networks and cooperation with
 international organisations competent in
 this field should be safeguarded and further
 developed;
                                              10
 ---pagebreak--- 24. Whereas unnecessary duplication of           24.     Whereas at present data are
effort should be avoided by the joint            insufficiently comparable, and unnecessary
development of methodologies, comparison         duplication of effort should be avoided by
and conversion criteria and techniques,          the joint development of methodologies,
progressively harmonised data collection         comparison and conversion criteria and
tools such as surveys, questionnaires or         techniques, progressively harmonized data
parts thereof, and content specifications for    collection tools such as surveys,
health information to be shared using in         questionnaires or parts thereof, and content
particular a telematics network;                 specifications for health information to be
                                                 shared using in particular a telematics
                                                 network;
25. Whereas, in order to increase the value
and impact of the programme, a continuous
assessment of the measures undertaken
should be carried out, with particular
regard to their effectiveness and the
achievement of objectives both at national
and Community level and, where
appropriate, the necessary adjustments
should be made;
26. Whereas this Decision lays down, for
the entire duration of the programme, a
financial framework constituting the
principal point of reference, within the
meaning of point 1 of the Declaration of
the European Parliament, the Council and
Commission of 6 March 1995, for the
budgetary authority during the annual
budgetary procedure;
27. Whereas this programme must be of
five-year duration in order to allow
sufficient time for actions to be
implemented to achieve the objectives set,
HAVE DECIDED AS FOLLOWS:
Article 1
Establishment of the programme
 1. A programme of Community action on
health monitoring, hereinafter referred to as
 "this programme", is hereby adopted for
the period 1 January 1997 to 31 December
 2001 within the framework for action in
the field of public health.
                                              11
 ---pagebreak--- 2. The aim of this programme is to
establish a Community health monitoring
system which allows the measuring of
health status, trends and determinants
throughout the Community, facilitates the
planning, monitoring, and evaluation of
Community programmes and actions, and
provides Member States with appropriate
health information to make comparisions
and to support their national health
policies.
3. The actions to be implemented under          3.      The actions to be implemented
this programme and their specific               under this programme and their specific
objectives are set out in the Annex under       objectives are set out in Annex 1 under the
the headings:                                   headings:
A.       Establishment of Community health
         indicators
B.       Development of a Community-wide
         network for sharing health data
C.       Analyses and reporting
Article 2
Implementation
1. The Commission shall ensure                  1. The Commission            shall ensure
implementation, in close cooperation with       implementation, in close cooperation with
the Member States, of the actions set out in    the Member States, of the actions set out in
the Annex in accordance with Article 5.         Annex I in accordance with Article 5.
2. The Commission shall cooperate with
institutions and organisations active in the
field of health monitoring.
Article 3
Budget
1. The total          appropriation      for
implementation of this programme for the
period referred to in Article 1 shall be
ECU 13.8 Million.
                                             12
 ---pagebreak--- 2. The annual appropriations shall be
established by the Budgetary Authority in
accordance with the financial perspectives.
Article 4
Consistency and complementarity
The Commission and the Member States              The Commission shall ensure that there is
shall ensure that there is consistency and        consistency and complementarity between
complementarity between actions to be             actions to be implemented under this
implemented under this programme and              programme and other relevant Community
other relevant Community programmes and           programmes and initiatives, including the
initiatives, including the framework              framework programme for statistical
programme for statistical information, the        information, the projects in the field of
projects in the field of telematic                telematic interchange of data between
interchange         of data         between       administrations, and the framework
administrations, and the framework                programme for research and technological
programme for research and technological          development and in particular the
development and in particular the                 telematics applications of the latter.
telematics applications of the latter.
Article 5
Committee
1. The Commission shall be assisted by a          1. The Commission shall be assisted by a
Committee composed of two members                 Committee of an advisory nature.
designated by each Member State and               composed of two members designated by
chaired by a representative of the                each Member State and chaired by a
Commission, hereinafter referred to as "the       representative of the Commission,
Committee".                                       hereinafter referred to as "the Committee".
2. The representative of the Commission
shall submit to the Committee draft
measures concerning, in particular:
(a)      the Committee's rules of procedure;
(b)      an annual work programme
         indicating the priorities for action;
                                               13
 ---pagebreak--- (c)     the arrangements, criteria, and
        procedures for selecting and
        financing projects under this
        programme, including those
        involving     cooperation      with
        international      organisations
        competent in the field of public
        health and participation of the
        countries mentioned in Article 6(2);
(d)     the evaluation procedure;
(e)     the arrangements for reporting,
        conversion, and harmonisation of
        the data;
(f)     the arrangements for the definition
        and selection of indicators;
(g)     the arrangements for the content
        specifications necessary for the
        development and operation of the
        relevant networks.
3. In addition, the Commission may consult
the Committee on any other matter
concerning the implementation of this
programme.
The representative of the Commission shall
submit to the Committee a draft of the
measures to be taken. The committee shall
deliver its opinion on the draft within a
time limit which the chairperson may lay
down according to the urgency of the
matter, if necessary by taking a vote.
The opinion shall be recorded in the
minutes; in addition, each Member State
shall have the right to ask to have its
opinion recorded in the minutes.
The Commission shall take the utmost
account of the opinion delivered by the
Committee. It shall inform the Committee
of the manner in which its opinion has
been taken into account.
                                             14
 ---pagebreak--- 4. The representative of the Commission
shall keep the Committee regularly
informed about:
         financial assistance granted under
         this programme (amounts, duration,
         breakdown, and recipients);
         Commission proposals or
         Community initiatives and the
         implementation of programmes in
         other policy areas which are
         relevant to the achievement of the
         objectives of this programme, with
         a view to ensure the consistency
         and complementarity required under
         Article 4.
Article 6
International cooperation
 1. In the course of implementing this           1.     In the course of implementing this
 programme, cooperation with non-member          programme, cooperation with third
 countries and with international                countries and with international
 organisations competent in the field of         organisations competent in the field of
 public health, in particular the World          public health, in particular the World
Health Organization and the Organization         Health Organization and the Organization
 for Economic           Cooperation and          for Economic         Cooperation and
 Development shall be fostered and               Development, shall be fostered and
 implemented in accordance with Article 5.       implemented in accordance with Article 5.
 2. This programme shall be open to
 participation by the associated countries of
 Central and Eastern Europe (CCEE), in
 accordance with the conditions laid down
 in the Additional Protocols to the
 Association Agreements relating to
 participation in Community programmes to
 be concluded with those countries. This
 programme shall be open to participation
 by Cyprus and Malta on the basis of
 additional appropriations in accordance
 with the same rules as those applied to the
 EFTA countries, in accordance with
 procedures to be agreed with those
 countries.
                                              15
 ---pagebreak--- Article 7
Monitoring and evaluation
1. The Community, taking into account the
reports drawn up by the Member States
and with the participation, where necessary,
of independent experts, shall ensure that an
evaluation is made of the actions
undertaken.
2. The Commission shall submit to the
European Parliament and the Council an
interim report halfway through, and a final
report on completion of this programme. It
shall incorporate into these reports
information on Communityfinancingin the
various fields of action and on
complementarity with the other actions
referred to in Article 4, as well as the
results of the evaluations. It shall also send
them to the Economic and Social
Committee and the Committee of the
Regions.
ANNEX                                             ANNEX I
SPECIFIC OBJECTIVES AND ACTIONS
A.      ESTABLISHMENT                      OF
        COMMUNITY                HEALTH
        INDICATORS
Objective:      To establish Community
                health indicators by a
                critical review of existing
                health data and indicators,
                and develop appropriate
                methods for the collection
                of     comparable          and
                progressively harmonised
                health data.
                                               16
 ---pagebreak--- 1. Carrying out an identification, review
and critical analysis of existing health
indicators and data at the European and
Member States' level in order to identify
their relevance, quality and coverage with
regard to the establishment of Community
indicators.
2. Creation of a set of Community health        2.      Creation of a set of Community
indicators, including a sub-set of core         health indicators, including a sub-set of
indicators for the monitoring of                core indicators for the monitoring of
Community programmes actions in public          Community programmes actions in public
health, and a sub-set of background             health, and a sub-set of background
indicators for the monitoring of other          indicators for the monitoring of other
Community policies programmes and               Community policies programmes and
actions, and for providing Member States        actions, and for providing Member States
with common measures for making                 with common measures for making
comparisons.                                    comparisons.
                                                Details of these indicators are given in
                                                Annex II to this programme.
3. Development of the routine collection of
comparable and/or           progressively
harmonised data in the Member States,
including support for the elaboration of
data dictionaries, and the establishment of
appropriate conversion methods and rules.
4. Contributing to the collection of
comparable data by supporting the
elaboration     of    surveys     including
Community-wide surveys in support of
Community policies, or modules or agreed
forms of words for questions in existing
surveys.
5. Foster co-operation with international
organizations competent in the field of
European health data and indicators and
networks for the exchange of health data
covering specific areas in public health, in
order to enhance comparability of data.
                                             17
 ---pagebreak---  6. Support for the assessment of the              assessment of the feasibility and cost-
 feasibility and cost-effectiveness of             effectiveness of developing standardised
 developing standardised health resource          health resource statistics with the aim of
 statistics with the aim of including them in     including them in the Community health
 a future Community health monitoring             monitoring system.
 system.
B.        DEVELOPMENT                OF A
          COMMUNITY-WIDE NETWORK
          FOR SHARING HEALTH DATA
Objective:        To enable the establishment
                  of effective and reliable
                 transfer and sharing of
                 health data and indicators
                 using telematic interchange
                  of data as the principal
                 means.
7. Encourage and support the development          7.       Encouragement of and support for
of a network for sharing health data,             the development of a network for
mainly using telematic interchanges and a         transferring and sharing health data, mainly
system of distributed databases, in               using telematic interchanges and a system
particular by the establishment of data           of distributed databases, in particular by the
specifications and of procedures with             establishment of data specifications and of
regard the to the access, retrieval,              procedures with regard to the access,
confidentiality and security for the different    retrieval, confidentiality and security for
types of information to be included in the        the different types of information to be
system.                                           included in the system.
C.       ANALYSES AND REPORTING
Objective:       To develop methods and
                 tools necessary for analysis
                 and reporting, and support
                 analyses and reporting on
                 health status, trends,
                 determinants, and the effect
                 of policies on health.
                                               18
 ---pagebreak--- 8. Encourage the development of a capacity    8.      Encouragement of and support for
for analyses, including comparative and       the development of a capacity for analyses,
predictive methodologies and tools, the       enhancing existing capabilities, and for
testing of hypotheses and models and the      feasibility studies for possible new
evaluation of health scenarios and            structures, comparative and predictive
outcomes.                                     methodologies and tools, the testing of
                                              hypotheses and models and the evaluation
                                              of health scenarios and outcomes.
9. Support for the analysis and evaluation    9.       Support for the analysis,.
of the impact of Community actions and        preparation, and dissemination of reports
programmes in public health.                  evaluating the impact of Community action
                                              and programmes in the field of public
                                              health.
10. Support for the production and            10.      Support for the preparation.
dissemination of reports and other            production and dissemination of reports
information material on health status and     and other information material on health
trends, health determinants and the impact    status and trends, health determinants and
on health of other policies.                  the impact on health of other policies.
                                              ANNEX II
                                              Non-Exhaustive list of domains in which
                                              health indicators may be established under
                                              the Community health monitoring system
                                                       Health Status
                                                       1.  Life expectancy:
                                                           - life expectancy at certain
                                                              ages
                                                           - health expectancies
                                                      2.   Mortality:
                                                           - overall
                                                           - causes of death
                                                           - disease-specific survival
                                                      3.   Morbidity:
                                                           - disease-specific morbidity
                                                           - co-morbidity
                                                      4.   Functioning and quality of life:
                                                           - self-perceived health
                                                           - physical disability
                                                           - activity limitations
                                                           - functional status/ability
                                                           - health-related work loss
                                           19
 ---pagebreak---            - mental health
      5.   Anthropometric characteristics
   B. Life Style and Health Habits
      1.   Tobacco consumption
      2.   Alcohol consumption
      3.   Illicit drug consumption
      4.  Physical activities
      5.   Diet
      6.   Sexual behaviour
      7.   Other health promotion-related
           activities
   C. Living and working conditions
      1.   Employment/unemployment:
           - occupation
      2.  Work environment:
           - accidents
           - exposure to carcinogenic
               and other        dangerous
               substances
           - occupational health
      3.  Housing conditions
      4.  Home and leisure activities:
           - accidents at home
           - leisure
      5.   Transport:
           - automobile accidents
      6.  External environment:
           - air pollution
           - water pollution
           - other types of pollution
           - radiation
           - exposure to carcinogenic
               and other        dangerous
               substances outside the work
               environment
   D. Health Protection
      1.   Sources of financing
      2.  Facilities / Manpower
20
 ---pagebreak---           - Health resource utilisation
          - Health care personnel
          Cost / Expenditure
          - In patient care
          - Out patient care
          - Pharmaceutical products
          Consumption / uses
          - In patient care
          - Out patient care
          - Pharmaceutical products
          Health promotion and disease
          prevention
   £. Demographic and Other Social
      Factors
      1.  Gender
      2.  Age
      3.  Civil status
      4.  Region of residence
      5.  Education
      6.  Income
      7.  Population subgroups
      8.  Health insurance status
   F.     Miscellaneous
      1. Product safety
      2. Others
21
 ---pagebreak---  ---pagebreak---                                                                     ISSN 0254-1475
                                                             COM(96) 222 final
                                              DOCUMENTS
EN                                                                             05
                                     Catalogue number : CB-CO-96-232-EN-C
                                                              ISBN 92-78-04220-X
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