Health care providers' economic activity

Acquisition cost at the beginning of the year – total acquisition cost of fixed assets, which have been purchased in previous years and are still included in the accounting records.

Acquisition cost at the end of the year – the acquisition cost of fixed assets at the end of the year.

Acquisitions – acquisition cost of fixed assets purchased in the accounting year (incl. non-monetary contributions, such as shares). This includes new fixed assets, i.e., assets that were commissioned for the first time in Estonia. Therefore, this category also includes assets that have been previously used in other countries. This also includes the acquisition cost of used fixed assets, the amount of mark-up of fixed assets, the increase in the value of fixed assets as a result of overhaul or renovation, and restructuring of fixed assets.

County – location of health care service provider. It is classified according to the Classification of Administrative and Settlement Units of Estonia (EHAK) (see classifications and lists). 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.

Divestment (other) – the amount of depreciation of fixed assets, restructuring of fixed assets.

Divestment (sale) – the acquisition cost of fixed assets sold during the accounting year (incl. non-monetary contributions, such as shares).

Divestment (write-off) – the acquisition cost of assets, which have been excluded from fixed assets by a write-off statement.

Expenses – outlays (reduction in economic benefits) during an accounting period, which take the form of a reduction in assets or an increase in liabilities and which reduce the owner’s equity of the accounting entity, except payments made to owners from owner’s equity.

Income – proceeds (increase in economic benefits) during the accounting period, except contributions to owner’s equity made by the owners, which take the form of an increase in assets or a reduction in liabilities and which increase the owner’s equity of the accounting entity.

Independent health care provider — a health care provider that is not an agency of another provider or its branch.

Legal form — the form of existence of persons, agencies and organisations and other legal subjects specified in the legislation of the Republic of Estonia. The legal forms include: self employed person, private limited company, public limited company, foundation and other legal forms (general partnership, limited partnership, commercial association, a branch of a foreign company, non-profit association, state entity, local government entity) (see classifications and lists).

Net sales – price of sold assets, excluding VAT.

Provider of health care services or a health care facility — a legal person whose principal or ancillary activity is to provide health care services. Health care provider must have an activity licence issued by the Health Board (Health Care Board until 1 January 2010).

Residual value at the end of the year – value of fixed assets at the end of the year: acquisition cost at the end of the year minus accumulated depreciation.

Total net gain/loss – the difference between income and expenses of the health care institution in the accounting period.

Type of hospital — seven types of hospitals are distinguished on the basis of provided health care services: regional hospital, central hospital, general hospital, local hospital, special hospital, rehabilitation hospital and nursing care hospital. The local hospital type was added in 2003 (see classifications and lists).

Type of owner — shows the ownership of an establishment either by the public sector (the capital share of the state and/or local government is 50% or more) or the private sector (the capital share of an Estonian private body and/or foreign private body is 50% or more) (see classifications and lists).

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 and lists).

The purpose of collecting data on economic activities associated with health care is to provide a detailed overview of the sources of income, expenses and investments in fixed assets of health care providers.

The data are collected from institutions that have been issued activity licences for the provision of health care services and from all family physicians with a practice list, pursuant to the Health Services Organisation Act and decree by the Minister of Social Affairs on the basis of the HCSOA.

The data are collected using the report format “Economic Activities Associated with Health Care”, which should be submitted by all independent health care providers, irrespective of the type of ownership or legal form. Independent health care providers submit aggregate reports on all of their subsidiary divisions/branches. Institutions where provision of health care is not the principal activity should only report the income, expenses, and changes in fixed assets associated with the provision of health care.

The income and expenses reports should be based on accrual method of accounting. Self-employed persons can complete the reports using either the accrual or cash method.

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 Classifications section (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.

Type of owner

Type of owner serves as the basis for the list of health care service providers according to whether they belong to state or private sector. This list is available on the webpage of the Statistics Estonia in the Classifications section (in Estonian).

Classification of legal forms

Classification of legal forms is used for the list of health care service providers on the basis of the legal form. This list is available on the webpage of the Statistics Estonia in the Classifications section (in Estonian).

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.

Reet Nestor

Department of Health Statistics

National Institute for Health Development

E-mail: Reet.Nestor[at]tai.ee

Updated: 16.11.2022