Central Statistical Bureau of Latvia (CSB of Latvia).

Social Statistics Data Compilation and Analysis Section, the CSB of Latvia. 

Lāčplēša iela 1, Rīga, LV-1010,  

Statistics on healthcare non-expenditure provide information on healthcare human resources, healthcare facilities, and healthcare utilisation.

- The people active in the healthcare sector (doctors, dentists, nurses, etc.) and their status (graduates, practising, migration of doctors and nurses, etc.);

- The available healthcare technical resources and facilities (hospital beds, beds in residential care facilities, medical technology, etc.);

- The health activities or patient contacts undertaken (hospital discharges, surgical procedures, ambulatory care data, etc.).

Annual national and regional data are provided in absolute numbers or as a rate of a relevant population.

Data are based mainly on administrative records (see section 18.1 ‘Source data’ for more information).

For the collection data on healthcare non- expenditure, the classifications used in the System of Health Accounts (SHA) and its related set of International Classification for the Health Accounts (https://www.oecd.org/health/health-systems/1841456.pdf ) are applied.

For hospital discharges, the International Shortlist for Hospital Morbidity Tabulation (ISHMT) is used. (https://circabc.europa.eu/ui/group/c1b49c83-24a7-4ff2-951c-621ac0a89fd8/library/6ff71dd5-8200-4fe4-a610-a7707cd47c4d )

For diseases diagnoses coding the International Classification of Diseases (ICD), WHO is used: https://icd.who.int/browse10/2019/en 

For data collection on hospital beds, the National classification on hospital beds profiles is used: https://www.spkc.gov.lv/lv/stacionaro-gultu-profilu-klasifikators

For Surgical procedures coding the Shortlist of Surgical Procedures is used. The codes of NOMESCO Classification of Surgical Procedures are connected with ICD-9-CM codes of the shortlist.

For coding specialities of medical practitioners the National classification of medical practitioners is used. https://likumi.lv/ta/id/282367-arstniecibas-personu-un-arstniecibas-atbalsta-personu-registra-izveides-papildinasanas-un-uzturesanas-kartiba

For Health Employment, the Directive 2005/36/EC of the European Parliament and of the Council of 7 September 2005 on the recognition of professional qualifications apply (https://eur-lex.europa.eu/eli/dir/2005/36/2020-04-24 ).

Definitions of mandatory variables are laid down in Commission Regulation (EU) 2022/2294.

Where possible, the statistics are separated by sex (male/female), age group and NUTS2 region.

The Eurostat manual on healthcare non-expenditure statistics provides an overview of the classifications, both for mandatory variables and variables provided on voluntary basis.

Public health and Long-term care.

The healthcare non-expenditure statistics describe the public health sector from a non-monetary perspective. The statistics explain the number or rate of different healthcare resources, facilities and utilisations. A wide range of indicators are collected from a multitude of sources.

Definitions of mandatory variables are laid down in Commission Regulation (EU) 2022/2294.

The Eurostat manual on healthcare non-expenditure statistics provides an overview of the classifications, both for mandatory variables and variables provided on voluntary basis.

National changes of statistical concepts and national definitions deviating from Regulation (EU) 2022/2294: see Annex at the bottom of the page.

Several statistical units have been used in data collection.

Healthcare human resources: healthcare utilisation Registered health professionals; Graduates; Work force migration;

Healthcare facilities: Registered health care facility categories; Hospital technical resources; 

Healthcare utilisation: Hospital beds; Medical technologies; Consultations in the health care facilities;

Patient hospital discharges;

Diagnostic exams;

Surgical procedures;

Screening;

Immunisation;

(1) all health care staff

(2) all available beds or equipment in hospitals or nursing and residential care facilities

(3) all discharges or procedures performed in all hospitals

(4) all outpatient consultations and equipment in all outpatient clinics

(5) Population of Latvia, irrespective of income level and health insurance contributions, who have the right to receive statutory health care services under the state compulsory health insurance

Complete national territory.

The length of time for which data are available is different, for example:

For practising physicians - from 1990

For practising nurses - from 1989

For practising dentists - from 1992

Number of hospitals - from 1985

Day-care places - from 2002

Outpatient consultations - from 1980

Inpatient hospital discharges - from 1980

Diagnostic exams - from 2004

Immunisation of influenza - from 2007

Not applicable

Absolute numbers at end of reference period/average number during reference period.

Rate of phenomenon per reference population (e.g. doctor/ dentist consultations per capita).

Rate of people aged 65 and older who have been immunised against influenza (%)

Rate of women aged between 50 and 69 screened for breast cancer (%)

Rate of women aged 20-69 screened for cervical cancer (%)

Rate of female/male/total population screened for colorectal cancer (%)

Average Length of Stay in days

Calendar year. 

Graduates are reported for the academic year (e.g. 2022/2023).

Regulation on Community statistics on public health and health and safety at work (EC) No 1338/2008 

Commission Regulation (EU) 2022/2294 on statistics on healthcare facilities, healthcare human resources and healthcare utilisation 

Gentlemen’s agreement

National legal acts:

Statistics Law https://likumi.lv/ta/en/en/id/274749-statistics-law

Regulations on the Official Statistics Programme https://likumi.lv/ta/id/347449-noteikumi-par-oficialas-statistikas-programmu-20242026gadam

Regulations on forms for official statistics in the field of health care https://likumi.lv/ta/id/303520-noteikumi-par-oficialas-statistikas-veidlapu-paraugiem-veselibas-aprupes-joma

Joint Questionnaire on Non-Monetary Health Care Statistics, which is carried by Eurostat, OECD and WHO-Europe.

Document Interdepartmental Agreement on Information Exchange concluded between Centre for Disease Prevention and Control and  Central Statistical Bureau of Latvia.

Statistics Law https://likumi.lv/ta/en/en/id/274749-statistics-law

Freedom of Information Law https://likumi.lv/ta/en/en/id/50601-freedom-of-information-law

Personal Data Processing Law https://likumi.lv/ta/en/en/id/300099

State Administration Structure Law https://likumi.lv/ta/en/en/id/63545

Statistics Law https://likumi.lv/ta/en/en/id/274749-statistics-law

National release calendar for Central Statistics Bureau: The statistics published by the Central Statistical Bureau of Latvia in the publications and official statistics portal thereof is based on the data of the Centre for Disease Prevention and Control and complies with the publication terms of the data providers https://stat.gov.lv/en/calendar?Dates=%22Next%20year%22

National release calendar for Centre for Disease Prevention and Control: https://www.spkc.gov.lv/lv/media/18333/download?attachment

National release calendar for Central Statistics Bureau: https://stat.gov.lv/en/calendar?Dates=%22Next%20year%22

National release calendar for Centre for Disease Prevention and Control: https://www.spkc.gov.lv/lv/media/18333/download?attachment

The Release calendar contains the following information:

-Topic
-Indicator number according to the Official Statistics Program
-Data period
-Scheduled publication date
-The number of tables in the Health statistics database

The frequency of dissemination of the European statistics is on yearly basis.

The frequency of dissemination of the National statistics is on weekly, monthly, yearly basis.

Centre for Disease Prevention and Control has regular press releases linked to the data on its homepage https://www.spkc.gov.lv/lv/jaunumi

Centre for Disease Prevention and Control do not publish any statistical publications in paper format since 2018 https://www.spkc.gov.lv/lv/latvijas-veselibas-aprupes-statistikas-gadagramata, as online Health Statistics Database was set up in 2019. Publisher- Centre for Disease Prevention and Control https://statistika.spkc.gov.lv/pxweb/lv/Health/

Health Statistics Database (set up in 2019). Publisher- Centre for Disease Prevention and Control https://statistika.spkc.gov.lv/pxweb/lv/Health/

Official Statistics Portal https://stat.gov.lv/en

Micro-data are accessible only on written request, which contain the reason why such data are necessary. The data are not available online.

The dissemination of data to Eurostat and other international organisations (WHO, OECD) are only in aggregated format. No micro-data are sent yet.

Metadata are published in the Health Statistics Database available forthe public.

Self-Assessment Questionnaire for Other National Authorities developing, producing and disseminating European statistics.

Self-Assessment Questionnaire for Other National Authorities developing, producing and disseminating European statistics.

The CSB issued an order on common quality requirements by which all Statistical Institutions in Latvia shall produce official statistics (including national, European and international official statistics) in accordance with requirements of European Statistics Code of Practice.

Guidelines for Implementation of European Statistics Code of Practice (Guidelines for general quality requirements) developed to facilitate common perception and understanding of the requirements imposed by the Code of Practice. Based on the situation in Latvia, the Guidelines explain principles of the Code, as well as indicators and statistical terms used, moreover, requirements are supplemented with binding national legislation, explanatory information, and examples of good practice.

ES Code of Practice requirements mentioned in the CSB Quality Guidelines that determines general principles for statistics production.

Quality Guidelines is an informative document describing the CSB and the main aspects of its activity: stages, methods and organizational principles of producing the national statistics, policy of data protection and dissemination. The purpose of these Guidelines is to promote the implementation of the CSB’s operational strategy by involving in this process every employee of the CSB, developing the communication with society and extending the knowledge of every interested person – respondent, data user and all society – about the activity of CSB.

European Statistical System Peer Reviews, Third round: 2021-2023. Peer Reviews visit in Latvia in February 21-24, 2023.

Concerning European statistics – needs of national users are found out annually during the preparation of the Official Statistics Program. Concerning national statistics, the same as for European statistics, statistical working groups are organized, the members of which are not only experts (representatives from the Ministry of Health, higher education institutions, professional associations), but also data users. Practical usefulness of existing statistics and compliance with users’ needs are evaluated during the working group meetings. The actual needs and priorities of data users are evaluated as well. There is satisfaction survey of data users (cooperation partners) performed (the last survey was performed in 2022). Centre provides public health statistic in the scope of its competence according to annually published regulations of the Cabinet of Ministers ''Regulations on the Official Statistics Program''. European statistics priorities are set according to Eurostat.

The periodicity with which the data for official indicators are being collected and the periodicity with which these indicators are being computed and reported is adequate and meets the needs of policy makers.

Between 01.10.2019 and 15.12.2019 were sent 21 invitations to various respondents to provide feedback on the experience of receiving the services provided by the Center for Disease Prevention and Control.

Conclusions:

1. The statistical and research data has the most interest of the users;

2. 75% of respondents were very satisfied with the service received, 18.5% satisfied, 6.3% neutral. None of the respondents expressed dissatisfaction or very high dissatisfaction;

3. 68.8% of respondents were very satisfied or satisfied with the service delivery period (18.8%), one neutral and one very negative answer was received;

4. The quality of the provided service has satisfied the customers very much in 75% of cases, in two cases it was rather satisfactory, one neutral and one rather negative answer was received;

5. The number of comments is still too small to collect them;

6. Evaluation of services shall be continued on an ongoing basis to be re-evaluated after one year.

The data collection is done with regards to Official Statistics Programme https://likumi.lv/ta/id/347449-noteikumi-par-oficialas-statistikas-programmu-20242026gadam.

In the case the requirements are not fully met, the necessary information is included in the Official Statistics Programme, if the changes are accepted by the working group. The Programme is updated every year.

The data input process contains logical controls of information, data checks before data entry, data verification on a monthly basis, the quality control of data from other administrative sources.  

Evaluation of sampling and non-sampling errors is performed on a regular basis. The evaluation results are published together with the survey summary. Standard formulas are used for the data error calculation. The necessity for data auditing is assessed regularly. Exceptional data revisions are applied, e.g., re-estimation of indicators using the new number of population after Population Census. Users are informed about such revisions.  

Not applicable.

Not applicable.

Activities of the CDPC are aligned with the ''Regulations on the Official Statistics Program''. There are included data distribution deadlines according to the European standards. The CDPC works considering these deadlines. Calendar of statistical data publication is published in the CDPC website. Data release time is specified. There are no explanations available for data users in case of deviation from the schedule of statistical data publication. There is no special revision policy. Data are revised according to the changes in their methodology. In practice, the CDPC circulates preliminary data to National Health Authorities for the urgent and temporary needs of health policy assessment (the rates are calculated using the number of the previous year’s population), if this preliminary information is considered to be useful. The Official Statistics Program specifies frequency of statistical data publication. The necessity of frequency of data collection is discussed in statistical working groups. The needs of data users are taken into account, too. 

Member States are required to transmit their data to Eurostat in compliance with the Commission Regulation 2022/2294 transmission deadlines. 

The percentage of releases delivered on time is not recorded yet. However, most of data is released in time. The main reason why data release is not in time is absence of necessary data.

The main efforts to get necessary data is discussion with institutions which are responsible for data submission to do it in time.

Statistical data are prepared in compliance with European and other international standards (classifications, definitions). Due to this the statistical data are comparable between regions and countries. Data users are informed about any non-compliance with definitions. If there are planned methodological changes, it is assessed how these changes would affect the comparability of data. Information about methodological changes is published if some deviations in data comparability have been observed. Statistics are produced from data, which are collected using uniform standards. Common standards on statistical data are applied to all state and local government institutions producing official statistics. Officially approved classifications are listed in Regulations of the Cabinet of Ministers No.2 „Regulations Regarding the List of Statistical Classifications and the Procedures for the Implementation, Maintenance and Publishing of the Statistical Classifications Included Therein" (January 3, 2017). The CDPC publishes comparable series. In most cases statistics from different sources and different frequency are comparable. However, there are methodological differences between different sources, which should be taken into account. Data users are informed about differences in methodology or definitions. The CDPC follows up the statistics regulating normative documents. The personnel of the CDPC participate in the working groups, collaborate with Member States, and share their experiences.

The periodicity with which the data for official indicators are being collected and the periodicity with which these indicators are being computed and reported is adequate and statistics are comparable over a reasonable period of time. Data could be disaggregated, depending on the type of survey, by various characteristics, giving the opportunity to analyse it very broadly.

The data is compared with databases of similar content as far as possible to ensure the improvement of information quality.

The data is collected based on the legislative acts, which define the data format, structure and applicable classifications.

A wide range of information systems and databases is used in data collection, processing and distribution. The CDPC manages national information systems:

Register of Patients with Particular Diseases,

Newborns Register,

National Genome Register,

Register of Causes of Death,

Database of Hospital Beds’ Utilization,

State Surveillance and Monitoring System for Infectious Diseases,

The Database of State Statistical Reports for the Health Care Sector,

The Database of Clinical Guidelines,

Health Personalised Data Guidebook for Health Care Monitoring Datalink.

The CDPC has introduced standardized solutions to improve the efficiency and productivity of usage of resources - all information systems collect statistical data based on standardized data forms determined by regulatory frameworks. The description of the work organization for accounting and finance department includes internal measures, which are used to control the usage of institution’s resources. The auditing process as an external measure is applied, too.

Data revisions are performed in practice, but there is no approved formal standard procedure. 

Data revisions are performed in practice, but there is no approved formal standard procedure. Data revisions are announced in advance. They are carried out as soon as possible when the institution receives the necessary information. As a result of the data revision, the institution ensures the availability of qualitative statistics. 

Source data for the different variables are given in the Annex at the bottom of the page.

Annual.

There are two main data collection methods used:

Data collection with annual Official Statistics Reports;

Data collection with registry cards;

Submitted information is checked by logical controls and comparison with data of previous year and other available data sources.

Not applicable.

The collected data definitions provide national and international standards. There are no difference in collected data how this information is used - for national statistics or international.

No comments