Hospital Network Development Plan hospitals

Average (annual) number of hospital beds (also see hospital bed and day care bed) – average number of hospital beds during a certain period, which have been available for the admission of a patient.

Bed day – in case of in-patient care, 24 hours, within which the admitted patient has received treatment. The day of admission and the day of discharge are considered as one day.

Bed occupancy rate – number of days when a hospital bed was used as a percentage of all days in the observed period.

Bed turnover – average number of patients per hospital bed. In the formula, those having been in hospital is equal to the half-sum of hospitalised and discharged. Intensive care bed is an exception. In case of these beds those moved to another ward within the same hospital are included in the number of discharged and those brought from another ward of the same hospital are included in the number of hospitalised.

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

Emergency care – health care offered by a health care provider in the context of inevitable care and / or outside the waiting list.

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.

Full-time equivalent employment (FTE) – one FTE is equivalent to one employee working full-time equals normally to 40 hours per week.

Group of occupation – forming by similar occupations. A specific set of tasks and responsibilities in the organization or institution for specific job.

Group of profession – forming by similar professions.

Health care personnel – employees who are directly related to provision of health care services (physicians, dentists, nurses and midwives and other health care specialists).

Health care provider 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).

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 in-patient 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 in-patient facility is not needed.
• Outpatient surgery service – a surgical procedure, after which the patient does not need any special medical supervision in a medical care bed.
• 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.
• Day surgery service – carrying out a surgical procedure, after which a patient needs supervision in a hospital bed for a certain number of hours. In the evening/at night the patient goes home.
• In-patient health care service, or hospital care – health care service, in case of which a patient needs to stay in hospital for 24 hours.
• In-patient surgery service – carrying out a surgical procedure, after which a patient needs supervision in a hospital bed for at least one night.

Hospital admission – hospitalisation of a patient in an in-patient facility, normally involving a stay of at least 24 hours (admitted patient).

Hospital bed specialty – determined through the health care services provided in connection with the hospital bed. The list of specialities is introduced with the legal acts regulating the health care system of the country. Hospital beds are divided into curative (acute) care and long-term care beds.

• Curative (acute) care beds (also short-term care beds) – intensive care; surgical; dermatological and venerological; infectious diseases, neurological; otorhinolaryngological; radiological; ophtalmological; obstetrics and gynaecology; rehabilitation; therapeutic beds. According to OECD methodology, the average length of stay in curative care beds is up to 18 days. Beds for intensive care include level I-III intensive care beds. Surgical beds contain following specialities: burns, cardiosurgery, general surgery, neurosurgery, orthopaedics, stomatology and oral surgery, thoractic surgery, traumatology, urology, vascular surgery and surgery for children. Therapeutic beds include specialities such as cardiology, endocrinology, haematology, gastroenterology, internal medicine, nephrology, occupational diseases, oncology, pediatrics, pulmonology and rheumatology. Beds for obstetrics and gynaecology comprise beds for pregnancy pathology as well.
• Long-term care beds – a general term which covers beds for tuberculosis, nursing care beds and psychiatric beds. Beds for psychiatric treatments include psychiatric beds for children and adults as well as beds for acute psychiatry.

Hospital included in the Hospital Network Development Plan – Hospital Network Development Plan, prescribed by the Government of the Republic Regulation No 105 of 2 April 2003, includes 3 regional hospitals, 4 central hospitals, 11 general hospitals, 1 local and 1 rehabilitation hospital.

Independent work of the nurses and midwives – independent consultation of a patient or a home visit on the part of a nurse or a midwife.

Main surgical procedure – the largest and the most resource-consuming procedure out of several simultaneously carried out procedures. Simultaneously carried out procedures are ranked according to their importance if there is no corresponding code for a complex procedure.

Occupation – set of jobs whose main tasks and duties are characterised by a high degree of similarity. This review of occupations is based on the classification of occupations of the health care system (see Classifications).

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. I.e emergency care in first-aid station or emergency admittance in psychiatry, paediatrics, ophthalmology, gynaecology (excluding all deliveries, since statistics do not consider them as emergency), etc.

Other health care personnel – includes clinical laboratory assistants, medical statisticians, caring nurses, emergency care technicians, dental technicians, dental assistants, radiology technician, optometrists, assistant nurses and other health care personnel with higher medical education.

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 in-patient facility is not needed.

Outpatient visit – outpatient contact of a person who needs medical consultation during the doctor’s or nurse’s working time in the office.

Profession – particular skills and deep knowledge what is needed to work by a specific occupations.

Speciality – knowledge and skills acquired by an educational institution, latest qualifications or speciality. Classification of medical specialities in the health care system is based on the List of Specialities of Physicians and the List of Nursing Specialities (see Classifications).

The data are collected from facilities and enterprises 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.

To publish selected indicators by Hospital Network Development Plan hospitals written approvals have received from Hospital Network Development Plan hospitals' managements.

Health care providers' revenues and costs

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 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.

Outpatient and home visits

The aim of the collection and production of outpatient care statistics is to obtain an overview of the volume of work performed by health care facilities providing different health care services according to the location of activities of an facility.

Outpatient health care service statistics are based on the following reports submitted by health care service providers:

• the annual report 'Outpatient visits and home visits' since 2021 ('Outpatient consultations' 2017-2020, until 2016, the quarterly report 'Physicians' outpatient visits and home visits' and table 'Outpatient care' of the annual report 'Health care provider');
• the annual report 'Dentist's report'.

The statistics on outpatient visits and home visits is collected per year, and until 2016 also per quarter. Each quarter, health care service providers submitted a report about the number of outpatient visits and home visits made by doctors and dentists. Quarterly reports did not include the information about the independent work of the nurses and midwives. On the basis of quarterly reports the yearly reports on the total number of outpatient visits and home visits by specialties were prepared. The short-term statistics were produced on the basis of quarterly reports for 2008–2016.

Wages of health care personnel

The aim of the wage survey is to provide a detailed overview of the average hourly and median hourly and monthly wages of health care personnel across different occupation groups and types of health care providers. The wages of health care workers have been analysed annually since 2002. In the initial years of the survey, data were only collected from hospitals, but since 2006 the survey includes all health care service providers.

The data is collected from health care providers that have been issued activity licenses for the provision of health care services, pursuant to the Health Services Organisation Act and the derived Regulation of the Minister of Social Affairs.

The data is collected using the report form “Hourly wages of health care workers”, which shall 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. The data is collected each year for March. Service providers shall submit reports to the National Institute for Health Development (NIHD) via the online data collection platform A-veeb by April 15.

The hourly wage data includes both full-time and part-time employees, i.e. employees who work full-time or part-time and also those who were partially absent from work in March (were on vacation, incapacity for work or care leave).

Monthly wage data only includes data for full-time employees who worked the entire survey month, were not sick or on vacation. The salaries of employees with an employment contract are not reflected in the data.

Emergency care

The aim of the collection and production of emergency care statistics is to provide an overview of the patients of the emergency health care departments (ED) in hospitals.

Hospitals’ emergency department statistics for each calendar year are presented in the 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 and other emergency rooms / first-aid stations. Statistical data does not include the information about planned patients admitted to hospital.

Diagnostics and therapeutic procedures

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 following tables included in the report “Health Care Facility“ serve as the basis for the production of diagnostics and treatment statistics: "Radioisotope diagnostics", "Ultrasonography", "X-ray examinations", "Computerized tomography and magnetic resonance imaging".

Surgical procedures

The aim of the collection and production of surgical procedure statistics is to get an overview of the volume of surgical work done by health care service providers.

The following report forms serve as the basis for the production of surgical procedures statistics:

• Annual report "Hospital", tables "Surgical work" and "Emergency surgery"
• Annual report "Day Care", tables "Surgical work" and "Emergency surgery"
• Annual report "Health Care Facility", table "Outpatient surgical procedures"

The data about all procedures coded on the basis of NCSP chapters A–H, J–N, P, Q and auxiliary chapters T, Y has been collected. The total number of surgical procedures includes both main and follow-up procedures. If a patient is undergoing several surgeries at a time, he/she is only included in the Main Procedure row. If a patient who died had previously undergone several surgeries at a time, he/she is only included in the Main Procedure row in the column containing the number of dead persons.

The data about emergency surgery is submitted according to the diagnosis on the basis of ICD-10.

Hospital beds

The aim of collection of data about day care beds and hospital beds is to get an overview of health care system resources and their utilization. Until 2018, each month, all in-patient health care providers (hospitals) were required to submit a report “Hospital beds and hospitalisation“. Starting from 2019, hospitals submit hospital beds statistics with an annual report "Hospital". The data are published in absolute numbers and in rates per 100,000 inhabitants.

High-tech devices

The purpose of collecting and producing statistical information on high-tech devices is to obtain an overview of the number and location of such equipment.

Compilation of the statistics on high-tech equipment is based on table “Medical devices” in the “Health Care Facility” report. The data are collected as of 31st of December. Until 2014 data for hybrid devices is considered multiple times according to equipment's function. From 2015 data is collected by new methodology – hybrid devices counts as one according to EUROSTAT directions:

• gamma camera - CT scanner (SPET+CT) counts as gamma camera
• PET scanner - CT scanner (PET+CT) counts as PET scanner
• PET scanner - MRI scanner (PET+MRI) counts as PET scanner

Therefore the starting from 2015 data is not comparable with previous years. In Estonia, medical hybrid devices are in use since 2007.

Health care personnel

The purpose of collecting statistical data on health care professionals is to provide an overview of the health care professionals and of the full-time equivalent employment in the Estonian health care system.

Two indicators are used in the publication of statistics on health care personnel: number of health care personnel by occupation and number of full-time equivalent employment.

The data on full-time equivalent and on persons working in medical occupations are collected with the “Health Care Personnel” report, which should be submitted by all legal institutions that provide in-patient and/or outpatient health care services.

The data on full-time equivalent and on persons working in medical occupations reflects all persons employed in health care providers. Licensed but not employed in healthcare facilities and on parental leave are not included in those figures.