Vom "Reporting" zum "Surveillance": Die Fehlbildungsdokumentation im Rahmen der Perinatalerhebung - Ein sensibles Instrumentarium zum Monitoring neuer Technologien?

Analysis of the Hamburg perinatal quality assurance programme shows a dramatic increase in congenital abnormalities of the bones, joints and muscles from 45.29 per 10000 live births in 1990 to 106.32 in 1994. Comparisons with other perinatal quality assurance programme data reveal almost the same trend. In fact, there is no real increase in these specific congenital abnormalities, but there is an effect, which can be explained by the introduction of ultrasound hip screening in infancy signalling overdiagnostics due to the new technology. This example demonstrates that the perinatal quality assurance programme is a suitable instrument for registering congenital abnormalities and monitoring new technologies and interventions. These results support the proposal by the association of the leading state health officers (AGLMB) to use the already well-established quality assurance programmes which are analysed on state level for a systematic nation-wide documentation and "surveillance" of congenital abnormalities. In addition, it becomes clear that surveillance, understood as a further development of health reporting, offers an opportunity to effect both an assessment and a better orientation in respect of health policies.