Ambulance and emergency medicine care

DEFINITIONS

Ambulance crew — a 3-member team which is competent in emergency medicine and which provides emergency care. An ambulance crew may include an emergency health care physician or anaesthetist and an emergency health care nurse and emergency care technician.

Conservative care — a treatment option which provides comfort care, if it’s decided to let the disease run its natural course.

County — in emergency medical care statistics the county division shows the persons who made emergency calls and were aided by emergency medical care according to the location of ambulance crews.

Emergency Department (ED) — a department at a hospital with the instruments and furnishings conforming to requirements which provides all emergency care services. Compare: other emergency room / first-aid station.

Emergency medical care — outpatient health care service for the initial diagnosis and treatment of life-threatening diseases, injuries and intoxication and, if necessary, for the transportation of the person requiring care to a hospital.

Emergency medicine — the health care service provided for the initial diagnosis and treatment of life-threatening diseases, injuries, intoxication, etc., aimed at preventing the death or incapacity for work of the patients. Emergency health care service is provided by ambulance outside of the hospital and by the Emergency Department in hospital.

Emergency surgical care — a treatment option which provides emergency surgical care. Here: emergency patients who have transmitted for surgical care in 24 hours, and who are not considered as patients with scheduled operation (also patients with scheduled cesarean section). The data is coded on the basis of NOMESCO surgical procedures classification NCSP; excluding chapters T, U and X procedures.

Hospital admission — hospitalization of a patient by ambulance crew.

Ineffective call — emergency call, during the course of which the person requiring care was not found, since he/she had left the scene of an accident, or it was a false call.

Intensive care bed in ED — in use II or III category inpatient intensive care bed located in hospital's Emergency Department.

Observation bed in ED or other emergency room / first-aid station — place in observation room, which includes equipment for monitoring patient's vital parameters.

Outpatient health care service or outpatient care — outpatient health care service, when a patient’s visit to a health care provider is confined to a few hours and accommodation overnight in an inpatient facility is not needed.

Other emergency room / first-aid station — a department/room for the admittance of emergency patients that does not have to conform to the requirements of an emergency department (including specialised emergency care, e.g. ophthalmology, psychiatry, gynaecology etc.).

Total number of calls — includes fulfilled, cancelled and ineffective emergency calls.

METHODOLOGY

The aim of the collection and production of emergency care statistics is to provide an overview of the volume of work of the emergency health care providers, reasons for provision of emergency care and patients who require emergency care.

Emergency medicine statistics covers the data about the activities of 1) emergency health care providers providing emergency medical care service and 2) hospitals’ emergency departments (ED).

1) Emergency medical care (ambulance) statistics were collected on a quarterly basis until 2014. Data about the emergency calls, reasons for the use of emergency medical care services and its resources (ambulance crews, number of ambulance cars, and number of personnel) was collected with aggregated reports. All emergency medical care service providers submitted aggregated reports electronically to the Health Board, which forwarded the aggregated data for each calendar year to the Department of Health Statistics at the National Institute for Health Development. The data is published in absolute and relative numbers (rate per 1000 inhabitants). Related to the transition to the E-ambulance data system in 2015, technical problems occur in production of ambulance statistics.

Statistical data about emergency medical care personnel is available in the relevant subdivision of the section 'Health Care Personnel', while statistical data about ambulance cars and crews is available in the section 'Health Care Providers' under subject 'Health care resources and their use'.

2) Hospitals’ emergency department statistics for each calendar year are presented in the aggregated report “Hospital“, which must be submitted by all hospitals having facilities for the admission of emergency patients (including 24-hour admission). The reports include information about the number of EDs and describe the arriving and leaving of patients to/from EDs or other emergency room / first-aid station. Statistical data does not include the information about planned patients admitted to hospital. The data is collected in accordance with the Health Care Services Organisation Act (HCSOA) and decree by the Minister of Social Affairs on the basis of the HCSOA. The data is published in absolute numbers.

Methodological change since 2016 in statistics of the way patients arrive to emergency department: If previously arrival types 'directed by same hospital's health care workers' and 'emergency department callbacks' were counted under value "Directed from another medical institution" then since 2016 these are included under value "Arrived in other way" (see table KE32).

In 2016, emergency medical service according to the category of triage was added to the Health Insurance Fund's service list, and therefore the number of directed patients to inpatient care and number of cured patients in emergency intensive care beds decreased (see table KE33).

CLASSIFICATIONS

Classification of Administrative and Settlement Units of Estonia (EHAK)

This classification is used upon submission of regional statistics. Regional health care statistics are submitted by 15 counties. Information about Tallinn and Tartu is submitted separately. This classification system is available on the webpage of the Statistics Estonia in the Classifications section (in Estonian).

Classification of hospitals

On the basis of the services they provide hospitals are divided into seven types: regional hospitals, central hospitals, general hospitals, local hospitals, special hospitals, rehabilitation hospitals and nursing care hospitals. Requirements for different hospital types are laid down in Decree No. 103 Requirements for Hospital Types, issued by the Minister of Social Affairs on 19 August 2004 (in Estonian).

PUBLICATIONS

National Institute for Health Development of Estonia, The National Health Service of Latvia, Health Information Centre, Institute of Hygiene, Lithuania. Health in the Baltic Countries. 2014. Tallinn: National Institute for Health Development; 2016. Report is available here in pdf-format

National Institute for Health Development. Tervisestatistika Eestis ja Euroopas 2007, 2009 ja 2011. Health statistics in Estonia and Europe 2007, 2009 and 2011. Tallinn: National Institute for Health Development; 2013. Publication is available here in pdf-format

National Institute for Health Development. Tervisestatistika Eestis ja Euroopas 2007. (3. trükk). Health statistics in Estonia and Europe 2007. (3rd edition). Tallinn: National Institute for Health Development; 2010. Publication is available here in pdf-format

National Institute for Health Development. Eesti tervisestatistika raamat. Estonian health statistics book 2005–2008. Tallinn: National Institute for Health Development; 2010. Publication is available here in pdf-format

LINKS

Anderson E. Quality Report on the Statistics of Emergency and Reception Departments Work. Reporting period: 2018. Tallinn: National Institute for Health Development; 2019. Report is available here in pdf-format

CONTACTS

Contact of hospitals’ emergency department statistics

Gettrin Kivisild

Department of Health Statistics

National Institute for Health Development

Phone: +372 659 3822

E-mail: Gettrin.Kivisild[ät]tai.ee

 

Contact of emergency medical care (ambulance) statistics (data until 2014)

Kalev Pahla

Health Board

E-mail: Kalev.Pahla[ät]terviseamet.ee

 

Updated: 12.05.2022