Health monitoring in sentinel practice networks: the contribution of primary care.

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.