Use of health information systems in the Russian Federation in the assessment of environmental health effects

The Russian Federation has made an intensive effort to compile and use info rmation on the environment and human health. In 1996-1997, we evaluated the information that was collected and analyzed on the local (raion), regional (oblast), and federal levels with reference to its usefulness in the asses sment of environmental health effects. The Russian Federation maintains sta ndardized nationwide institutions that routinely collect health data in pol yclinics and hospitals and then report to the national offices. The allocat ions of the workforce and the broad range of surveyed health outcomes are e xtensive, but a lack of systematic control of information quality limits th e ability to take full advantage of these efforts. On the other hand, the h ierarchical system of data collection has advantages over more decentralize d or commercial health systems. A major weakness in the current reporting i s the aggregation and transformation of data. Although this may not disturb the generation of health statistics, it seriously limits the use of region al and federal level data in the assessment of health effects of environmen tal exposures. In spite of limitations, some revised approaches to the anal ysis of existing data may be both feasible and fruitful. Combining informat ion from routine data and newly collected data is likely to be the most eff ective way to assess the relationship between environmental exposures and d iseases. Although there is a strong and justifiable desire to rapidly trans late information of environmental health effects into policy alternatives, at present, it seems more useful to emphasize data quality, completeness, a nd plans for the use of data.