Diagnostics and therapeutic procedures

Age group – in the statistics of diagnostics and therapeutic procedures, data is collected on persons aged 0-14 and persons aged 15 and older

Assisted reproductive technology (ART) – all treatments or procedures that include the in vitro handling of both human oocytes and sperm or of embryos for the purpose of establishing a pregnancy.

County – location of health care service provider. It is classified according to the Classification of Administrative and Settlement Units of Estonia (EHAK) (see classifications). Until 2017, data by the counties is distributed by the administrative division that existed before administrative reform (October 2017). Data starting from 2018 is distributed by new administrative division.

Embryo – the product of the division of the zygote to the end ofthe embryonic stage, 8 weeks after fertilization.

Health care provider or health care facility – a legal person whose principal or ancillary activity is to provide health care services. Health care providers must have an activity licence issued by the Health Board.

Health care service – activities of health care personnel (doctor, dentist, nurse, midwife), aimed at preventing, diagnosing or curing a disease, an injury or poisoning, at alleviating human suffering, at preventing the state of health of a patient from worsening or exacerbating and at improving the patient’s health.

Health care services are divided into three types: outpatient health care service, or outpatient care, day care and inpatient health care service, or hospital care.

• Outpatient health care service, or outpatient care – outpatient health care service, when a patient’s visit to a health care institution is confined to a few hours and accommodation overnight in an inpatient facility is not needed. The patient who has been provided with outpatient health care service is called an outpatient. The outpatient of a certain hospital – the attending physician of the outpatient is an employer of an institution carrying out the research.
• Day care – outpatient health care service which requires the patient to stay in a hospital bed under medical supervision for a period of several hours due to treatment or examination. In the evening/at night the patient goes home. The patient who has been provided with day care service is called a day care patient. The day care patient of a certain hospital – the attending physician of the day care patient is an employer of an institution carrying out the research.
• Inpatient health care service, or hospital care – health care service, in case of which a patient needs to stay in hospital for 24 hours. The patient who has been provided with hospital care service is called a hospital patient. The hospital patient of a certain hospital – the attending physician of the hospital patient is an employer of an institution carrying out the research.

In vitro fertilisation – an ART procedure that includes following stages:

• puncture of ovaries and removing ova from the womenn ovaries and sperm preparation;
• in vitro fertilisation;
• freezing of leftover embryos.

Not one's own patient – the attending physician of the patient is not an employer of an institution carrying out the research.

Type of provider of health care services – health care providers are divided into the following types: hospitals, family doctor's offices, specialist health care providers, dental care providers, emergency medical care providers, rehabilitation care providers, diagnostics providers, nursing care providers and other providers (see classifications).

The aim of the collection and production of diagnostics and treatment statistics is to provide an overview of the volume of work done by health care service providers.

The data is collected from all facilities providing health care services which hold a relevant activity licence and from family physicians working with practice lists 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 following tables included in the annual health care statistics report “Health Care Facility“ serve as the basis for the production of diagnostics and treatment statistics:

• table "Procedures"
• table "Radiotherapy"
• table "Radioisotope diagnostics"
• table "Functional diagnostics"
• table "Ultrasonography"
• tables "Endoscopy, men" and "Endoscopy, women"
• table "X-ray examinations"
• table "Computer tomography and magnetic resonance imaging"
• table "Interventional radiology"
• table "Laboratory analyses"

The data source for morphological analyses is annual health care statistics report "Hospital".

Accountable persons are all legal persons conducting relevant research and providing treatment (in laboratory analysis statistics: all facilities which make or buy analyses), excluding blood centres, emergency medical care and dental care providers. The information about the research conducted and treatment provided by blood centres, emergency medical care and dental care institutions is available in the relevant sections of the Health Statistics and Health Research Database.

For the period 2011–2013, the National Institute for Health Development collected artificial insemination data from health care providers. The statistics on artificial insemination in the following years are based on data collected by the State Agency of Medicines.

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. Until 2017, data by the counties is distributed by the administrative division that existed before administrative reform (October 2017). Data starting from 2018 is distributed by new administrative division. This classification system is available on the webpage of the Statistics Estonia in the "List of classifications" section (in Estonian).

List of health care services compiled by Estonian Health Insurance Fund (EHIF)

It is used to classify laboratory analyses. List is available at Riigi Teataja (in Estonian).

List 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.

Surgical procedures classification NOMESCO, version 1.6 (NCSP).

This classification is used to code and submit endoscopic diagnostic procedures. The classification is available on the webpage of the Nordic Centre for Classifications in Health Care.

List of health care service provider

On the basis of the type of provided health care service the health care service providers are divided in the following way:

• Hospital – a health care provider which complies with the requirements related to location, construction, administrative organisation and staff, aimed at providing inpatient medical care in medical specialties. As a rule, in addition to inpatient health care service, hospitals also provide outpatient and day care services.
• Family doctor’s office – a health care provider in which outpatient health care services are provided by a medical practitioner specialised as a family doctor operating based on his/her practice list.
• Specialist health care provider – a health care provider in which outpatient health care services are provided by a medical specialist and health care professionals working with him/her. These include the facilities providing occupational health services.
• Dental care provider – a health care provider in which outpatient health care services are provided by a dentist and health care professionals working with him/her.
• Emergency medical care provider – outpatient health care provider for the initial diagnosis and treatment of a life-threatening disease, injury or poisoning and, if necessary, for the transport of the person in need of assistance to a hospital. Emergency medical care providers only encompass independent emergency medical care providers.
• Rehabilitation care provider – a health care provider which provides outpatient health care services with the aim of improving people’s condition of health and in case of which the health-related limits to everyday life either arise from an injury or the chronic nature of the disease.
• Diagnostics provider – a provider of outpatient health services for the assessment of the patient’s state of health with the help of laboratory tests and diagnostic examinations.
• Nursing care provider – a health care provider in which independent outpatient or inpatient health care services are provided only by nurses and/or midwives.
• Other provider – this group includes providers which have not been mentioned above, but which hold an activity licence enabling them to provide health care services, e.g., Estonian Defence Forces, facilities providing school health care service, prison outpatient medical departments and also the providers which deal with the organisation of first aid courses, hold telephone medical consultations and provide support staff for family physicians.

The health care service providers mentioned above are classified in descending order of rank, i.e., if one facility provides several health care services, it is classified as an facility providing a relevant service mentioned afore in the list.

Katrin Tomson

Department of Health Statistics

National Institute for Health Development

E-mail: katrin.tomson[at]tai.ee

Updated: 16.11.2023