The French national Global Burden of Disease (GBD) evaluation project

Abstract As in many countries, there is an urgent need to prioritize the issues in public health care and prevention in France. The French GBD project aims to offer a unique set of combined morbidity and mortality estimates to inform health policy makers in France, at the national level. However, because of the variability in health status and risk factors across geographical areas, policy makers need comparable estimates at the regional and local levels to target specific populations and to implement actions to improve health. Besides, although the accuracy of the indicators provided by the GBD has not been evaluated in the French context, it would be likely improved by enhancing and enriching the French data used as input. The French national health data system is one of the largest healthcare claims database in Europe. Based on these data, the French National Health Insurance (Cnam) and Santé publique France (SpFrance), in collaboration with clinicians and researchers, have developed a set of algorithms to identify diseases based on health care reimbursements, which could improve GBD estimates. Cnam and SpFrance both contribute to the definition, prioritization and evaluation of health policies in France and have therefore decided to pool their strengths and mutualize their resources to build a common rationale and provide consistent French Burden of Diseases estimates. A collaboration with the Institute of Health Metrics and Evaluation (IHME) has also been initiated, to allow Cnam and SpFrance benefiting from IHME's infrastructure and expertise and together seek to improve the estimates of the indicators using comparable methods at local and national levels, and consistent with the overall Global Burden of Disease project. Finally, beyond the ongoing production of the GBD metrics, another objective is the knowledge transfer to Cnam and SpFrance as learning organizations. The project has started with a framework between the three parties and the expression of interest.