Hospital Network Development Plan hospitals

DEFINITIONS

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 inpatient 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 hospitalized 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 hospitalized.

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 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.

Hospital admission – hospitalization 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.

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 nursing staff – 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.

Nurses and midwives – persons who have completed a programme of basic nursing education (at least three years), i.e., nurses and midwives.

Nursing personnel – persons who have completed a programme of basic nursing education (at least 3 years), i.e., qualified nurses and midwives.

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 (see the definition of Other health care personnel with higher 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 inpatient facility is not needed.

Outpatient consultation – a general term meaning the outpatient contact, including an outpatient visit to the doctor’s or nurse’s office and home visits, excluding contacts by phone.

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.

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 providers (except family doctor's offices) must have an activity licence issued by the Health Board (Health Care Board until 1 January 2010).

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).

METHODOLOGY

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.

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 vistis

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 institutions providing different health care services according to the location of activities of an institution.

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

The statistics on outpatient visits and home visits is collected per year, and also per quarter (until 2016).

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 nursing personnel. 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.

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 in accordance with the type of health care service provider and the way the service is rendered.

The following tables included in the report “Health Care Institution“ 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 in accordance with the way the service is rendered, the type of institution, and the county.

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

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.

Each month, all inpatient health care providers are required to submit a report “Hospital beds and hospitalization“.

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 Institution” 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:

Therefore the 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 inpatient 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 institutions. Licensed but not employed in healthcare facilities and on parental leave are not included in those figures.

CLASSIFICATIONS

Classification of occupations of the health care system

The classification is used for grouping the occupations of the health care system. The classification is available on the webpage of the NIHD (in Estonian).

List of specialities of physicians

List of Specialities of Physicians decree (in Estonian), issued by the Minister of Social Affairs on 28 November 2001, serves as the basis for the classification of doctor’s and dentist’s specialities.

List of nursing specialities

List of Nursing Specialities decree (in Estonian), issued by the Minister of Social Affairs on 11 June 2001, serves as the basis for the classification of nursing specialities.

PUBLICATIONS

National Institute for Health Development of Estonia, The National Health Service of Latvia, Health Information Centre, Institute of Hygiene, Lithuania (2018). Health in the Baltic Countries 2016. National Institute for Health Development, Tallinn. Report is available here in pdf-format

National Institute for Health Development of Estonia, The National Health Service of Latvia, Health Information Centre, Institute of Hygiene, Lithuania (2017). Health in the Baltic Countries 2015. National Institute for Health Development, Tallinn. Report is available here in pdf-format

Anderson, E. (2017). Independent outpatient visits of nurses 2005–2015. National Institute for Health Development, Tallinn. Analysis is available here in pdf-format

Liivlaid, H. (2016). Hourly wages of health care personnel, March 2016. National Institute for Health Development, Tallinn. Analysis is available here in pdf-format

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

CONTACTS

Health care providers' revenues and costs

Reet Nestor

Department of Health Statistics

National Institute for Health Development

Phone: +372 6593 819

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

Health care personnel's wages

Kai Maasoo

Department of Health Statistics

National Institute for Health Development

Phone: +372 6593 821

E-mail: Kai.Maasoo[at]tai.ee

Hospital beds / Health care personnel

Katrin Tomson

Department of Health Statistics

National Institute for Health Development

Phone: +372 6593 820

E-mail: Katrin.Tomson[at]tai.ee

Diagnostics and therapeutic procedures

Marika Inno

Department of Health Statistics

National Institute for Health Development

Phone: +372 6593 816

E-mail: Marika.Inno[at]tai.ee

Outpatient and home visits

Eva Anderson

Department of Health Statistics

National Institute for Health Development

Phone: +372 6593 812

E-mail: Eva.Anderson[at]tai.ee

Emergency care and high-tech devices

Gettrin Kivisild

Department of Health Statistics

National Institute for Health Development

Phone: +372 659 3813

E-mail: Gettrin.Kivisild[at]tai.ee

Surgical procedures

Merike Rätsep

Department of Health Statistics

National Institute for Health Development

Phone: +372 6593 817

E-mail: Merike.Ratsep[at]tai.ee

 

Updated: 26.06.2020