Malta

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Healthcare System

Malta's healthcare system is a mix of public and private sectors, with a tax-supported publicly funded National Health Service (NHS) providing universal coverage to citizens and legal residents. The entire system is centrally managed by the Ministry for Health.

Through the NHS, citizens and legal residents have access to free primary care, hospital care, and specialist care, as well as prescription drugs and some dental care. Private health insurance is also available for those who wish to have access to additional services or prefer to seek treatment outside of the public system. That being said, Malta has one of the highest out-of-pocket expenditures in the European Union, with 70% of primary care being performed by private general practitioners.

To access healthcare benefits, individuals must present their Maltese ID card or residence permit, and healthcare services are available to them free of charge.

Most of Malta's health statistics are provided by the Directorate for Health Information and Research.

Registries

Database: DHIR National Cancer Register (Malta)

Sponsor, manager or home institution: Directorate for Health Information and Research; Ministry for Health.

Primary purpose: The primary purpose of the cancer registry is to collect data on cancer diagnoses, provide surveillance to examine trends, and facilitate epidemiological research to uncover the causes of cancer and evaluate the effects of control measures.

Type of information: Variables: DHIR National Cancer Register [1].

Available type of information: All cancers incidence (ICD-O-3 C00-C80); All deaths from Cancer (ICD-10: all C codes); Site; Sex; Year; Age [2].

Source of Information: Clinical notification; Copy of histology and cytology report; Copy of autopsy report; Death certificates; New referrals to the Oncology department.

Data level: Patient level.

Available data level: National level.

Number of Records: About 1,200 cases per year.

Date Range: Unknown.

Available data range: 2007 to 2019.

Cancer Areas of Interest: All malignant neoplasms; All ‘in-situ’ neoplasms (including all levels of CIN); Some neoplasms of uncertain or unknown behaviour (eg: Myelodyplastic Syndrome); Certain benign tumours (mainly those arising in the CNS).

Data access: Partially publicly available [3]. Instructions to request data for restricted content [4].

Contact information: Information [5].

Database: DHIR National Mortality Register

Sponsor, manager or home institution: Directorate for Health Information and Research; Ministry for Health.

Primary purpose: To collect and store internationally recognized data on deaths occurring on the Islands of Malta and Gozo, analyze it, and provide information for health policies, epidemiological studies, research, parliament, media, and international organizations.

Available type of information: Causes of death; Mortality rate; Type of place of death; Deaths due to malignancy; Leading causes of death; Age; Gender; Year. More information [6] in Annual Reports. Data dictionary is not publicly available.

Source of Information: Death certificates.

Data level: Patient level.

Available data level: National level.

Number of Records: Number of deaths each year available in the reports.

Date Range: 1872 onwards.

Available date range: 1998 to 2019.

Cancer Areas of Interest: Unknown.

Data access: Partially publicly available [7]. Instructions to request data for restricted content [8].

Contact information: Information [9].

Databases for Clinical Trials, Surveys and Biobanks

Survey: National Health Interview Survey 2002 (HIS 2002)

Sponsor, manager or home institution: Directorate for Health Information and Research; Ministry for Health.

Primary purpose: To obtain valuable information regarding the nation's health, including the burden of illness and knowledge and behaviors related to health, that cannot be obtained from routinely collected information such as national registries.

Type of information: Information on Sociodemographic characteristics; Anthropometric measurements; Self perceived health; Mental Health; Chronic conditions and symptoms; Short term disability/Activity limitations; Long term disability; Tobacco use; Alcohol use; Diet Physical activity; Knowledge/attitudes about healthy lifestyles; Accidents; Hospitalisation; GP/Specialist/Dentist encounters; Consumption of medicines; Health promotion and disease prevention; Dental health; Health insurance and health expenditure; Quality of life.

Source of Information: Survey responses.

Data level: Respondent level.

Available data level: National level.

Number of Records: 5510 respondents

Date Range: 2002.

Cancer Areas of Interest: Unknown.

Data access: Partially publicly available [10]. Instructions to request data for restricted content [11].

Contact information: Information [12].

Survey: European Health Interview Survey

Sponsor, manager or home institution: Directorate for Health Information and Research; Ministry for Health.

Primary purpose: To provide valuable, unique health data on Malta and Gozo, enabling evidence-based policy decisions and international comparisons to monitor trends and identify priorities.

Type of information: The survey is conducted through two distinct questionnaires. The initial questionnaire addresses a diverse range of topics, including quality of life, well-being, nutrition, physical activity, body weight and height, as well as physical and mental health, disabilities, and the utilization of healthcare services and medications, among other subjects. The subsequent, more concise questionnaire delves into more personal lifestyle aspects, such as tobacco, alcohol, and drug consumption.

Source of Information: Survey responses.

Data level: Respondent level.

Available data level: National level.

Number of Records: 4000 respondents.

Date Range: 2008, 2014, 2020.

Cancer Areas of Interest: Unknown.

Data access: Partially publicly available [13]. Instructions to request data for restricted content [14].

Contact information: Information [15].

Latest Policymaking Initiatives

Report: EU Country Cancer Profile 2023

Sponsor, manager or home institution: OECD and European Commission.

Primary purpose: To provide reliable data on cancer prevention and care, identifying trends, disparities, and inequalities among EU Member States and regions to guide interventions under Europe's Beating Cancer Plan.

Type of information: National cancer burden; Cancer incidence and mortality; Risk factors for cancer; Early detection programs (screenings); Cancer care performance, The impact of COVID-19 on cancer care.

Data level: National level.

Access to information: Access Information [16].

Cancer-related Patient Associations and Resources

Compilation: ESMO Patient Guides

Sponsor, manager or home institution: European Society for Medical Oncology

Primary purpose: To translate complex medical language into understandable information for patients.

Available guides: Bone Health in Cancer; Cancer Care During the COVID-19 Pandemic; Cancer Pain Management; Immunotherapy Side Effects; Personalized Cancer Medicine; Survivorship; AML; Biliary Tract Cancer; Bladder Cancer; Bone Sarcoma; Breast Cancer; Cervical Cancer; CML; Colorectal Cancer; Endometrial Cancer; Follicular Lymphoma; Glioma; Head and Neck Cancer; Hepatocellular Carcinoma; Multiple Myeloma; Non-Small-Cell Lung Cancer; Oesophageal Cancer; Ovarian Cancer; Pancreatic Cancer; Prostate Cancer; Soft Tissue Sarcoma; Stomach Cancer; Testicular Cancer.

Type of information: Information on each guide varies for each cancer type. Generally, guides provide definitions, explanations of causes, diagnosis, treatment, treatment options, and care after treatment, among others.

Access to information: List of guides [17].

Quality of Life and Palliative Care Research

List of Articles: Quality of Life [18] and Palliative Care [19].