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Hospital discharges (hlth_hosd)

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Reference Metadata in Euro SDMX Metadata Structure (ESMS)

Compiling agency: Eurostat, the statistical office of the European Union.

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Healthcare data play a crucial role in public health, detailing the available resources for various types of care and identifying potential bottlenecks. The quantity and quality of healthcare services provided and the work sharing established between the different institutions are subjects of ongoing debate. Healthcare data are primarily used to assess sustainability in healthcare, ensuring there are sufficient financial and human resources. They also help address the challenges presented by aging populations.

Data on hospital discharges by diagnosis can be used to monitor/analyse/measure healthcare provision and services as well for epidemiological purposes. Data are available by main diagnosis at discharge for hospital discharges of in-patients and day cases, as well as inpatient bed-days and average length of stay of in-patients.

A hospital discharge occurs when a hospital patient is formally released after an episode of care. The reasons for discharge include finalisation of treatment, signing out against medical advice, transfer to another healthcare institution, or because of death. The data cover all types of hospitals, including general hospitals, mental health hospitals and other specialised hospitals, with some national variations that can be consulted in the section ‘Annex’. All types of diagnosis and treatment are covered, excluding discharges of healthy new-borns. The diagnosis refers to the principal diagnosis, in other words, the main condition diagnosed at the end of a patient's hospitalisation. The main condition is the one primarily responsible for the patient's need for treatment or investigation.

Annual national and regional data by NUTS2 region of residence of the patient are provided in absolute numbers, percentages, and in population-standardised rates (per 100 000 inhabitants). For non-resident patients, country of residence is reported.

Hospital discharge data are split into datasets based on residency (residents and non-residents, inpatient discharges, day cases, bed-days and average length of stay. EU-aggregates can be calculated for total discharges (resident + non-resident), but splitting between resident and non-resident categories is complex as non-residents in one EU country might be residents in another EU country or resident outside the EU.

Data are provided by age-groups to limit the need for suppression of data due to small counts. Suppressed cells are flagged ‘c’ for ‘confidential’. For hospital discharges, the International Shortlist for Hospital Morbidity Tabulation (ISHMT) is used to disseminate data, aggregating diagnoses into groups.

These healthcare data are based on administrative data sources in the countries. Therefore, they reflect the country-specific way of organising healthcare and may not always be completely comparable (please consult the national reference metadata in the section ‘Annex’).

15 December 2025

The data cover hospital discharges by diagnosis, inpatients, day-cases and bed-days.

‘Inpatient’ means a patient who receives treatment and/or care in a healthcare facility, who is formally admitted and who requires an overnight stay. 

‘Day case’ means a patient who receives planned medical and paramedical services delivered in a healthcare facility and who is formally admitted for diagnosis, treatment or other types of healthcare and is discharged on the same day.

‘Hospital inpatient discharge’ means the discharge (formal release) of an inpatient from a hospital. Healthy newborns are excluded.

‘Hospital inpatient bed-days’ means the days that an inpatient spends in a hospital. Healthy newborns are excluded.

‘Hospital day case discharge’ means the discharge of a day case. It is the release of a patient who was formally admitted in a hospital for receiving planned medical and paramedical services, and who was discharged on the same day. Healthy newborns are excluded.

‘Resident’ means a usual resident of a geographical area, that is either (i) a person who has lived in his/her place of usual residence for a continuous period of at least 12 months before the reference date; or (ii) a person who arrived in his/her place of usual residence during the 12 months before the reference date with the intention of staying there for at least 1 year. Where the circumstances described in point (i) or (ii) cannot be established, ‘usual residence’ shall mean the place of legal or registered residence.

‘Non-resident’ means a person who is a not a resident of the reporting country.

‘Average length of stay’ (ALOS) is computed by dividing the number of hospital days (or bed-days or in-patient days) from the date of admission in an in-patient institution (date of discharge minus date of admission) by the number of discharges (including deaths) during the year. 

The respective data are based on different, mainly administrative sources. This may lead to differences in the coverage of time series and/or in the geographical coverage; data validity, reliability and comparability may vary. Furthermore, it may not always be possible to have the healthcare system, implicitly underpinning the data collection, being consistently defined across data sources.

Data on hospital discharges are collected according to the region of residence of the patient discharged (by NUTS2 regions). Data are disseminated in datasets aggregated by residents, non-residents.

Next to absolute numbers, density rates are provided for hospital discharges. Density rates are used to describe the frequency of services rendered, expressed in per 100 000 inhabitants. They are calculated by dividing the absolute number of hospital discharges in a given period by the respective population in the same period and then multiplied by 100 000.

Administrative data sources refer to registered patients treated and discharged, this excludes healthy newborns. Data are collected on diagnosis, sex, age group (less than 1, 1-4, 5-9, 10-14, 15-19, 20-24, 25-29, 30-34, 35-39, 40-44, 45-49, 50-54, 55-59, 60-64, 65-69, 70-74, 75-79, 80-84, 85-89, 90-94, 95 and older), and geographical dimension (NUTS2 region of patient, unless specified otherwise or country of residence for non-resident patients).
The underlying totality of institutions, for which data collections are available, may differ. 

If the combination of a referance area/region, sex, age group and diagnosis has no records (i.e. there were no discharges or 0 discharges) the value shown is ‘:’ = not available (for datasets related to total population and resident population). 

The target population for hospital discharges is all discharges performed in all hospitals (HP.1); some countries are not able to cover the whole HP.1 category. Information on country-specific coverage is available in the national reference metadata in the section ‘Annex’.

EU Member States, Iceland, Liechtenstein, Norway, Switzerland, Montenegro, North Macedonia, Albania, Moldova, Serbia and Turkey.
Transmission of data on hospital discharges are voluntary for candidate countries.

Calendar year.

The accuracy of healthcare non-expenditure is dependent on the accuracy of the data received from the countries. Data sources are mainly administrative and register-based data. Accuracy concerns may arise from issues of coverage and deviations from the definitions outlined in Commission Regulation (EU) 2022/2294 and the Eurostat manual on healthcare non-expenditure statistics. For the detailed information on accuracy by countries, see the national reference metadata in the section ‘Annex’.

Accuracy and harmonisation issues are regularly discussed at the annual Technical Group on Healthcare non-expenditure meeting. The Technical Group continues to work on improving the harmonisation of hospital discharge data. 

The data are published in absolute numbers and rate per 100,000 inhabitants. Data on non-residents among all hospital discharges are published as percentages.
The EU aggregates are computed as the sum of the country numbers.

The absolute numbers for EU aggregates are the sum of the country numbers. For the density rates these EU totals are divided by the corresponding total EU population.

Hospital discharge data are mainly derived from administrative sources, such as hospital registries and national insurance reimbursements; these sources may vary by country and by variable. Some countries are unable to cover all providers of care (for private providers or care provided and military institutions may not be included for some countries). Sources for each country are mentioned in the national reference metadata in the section ‘Annex’. 
Please note that the data sources used may not have been created initially for statistical purposes, and that the initial purpose of a data source may differ across countries. Both facts may influence the validity and comparability of results.

Annual.

Regulation (EU) 2022/2294 fixes the deadline for data delivery of hospital discharge data at N+20 months for the year N.

The comparability of the data across different countries may be limited by the fact that the quality of national data is subject to the way in which healthcare provision is organised in countries, and which information is available to and collected by the respective institutions. The periodically updated Eurostat manual on healthcare non-expenditure statistics assists countries in harmonising their data.

Some countries are unable to cover all providers of care (the inclusion of private providers seems particularly difficult).

Sometimes regional data cannot be made available as the available breakdown does not coincide with the requested NUTS2 classification level of detail. Countries without NUTS2 breakdowns should still provide the NUTS2 code for the patient.

Some countries are not able to provide the NUTS2 region of residence of the patient or the country of residence for non-resident patients. They may instead provide the residence of the hospital. For countries not able to report non-resident patients by country of residence, these cases are reported as unknown country of residence. More information on national coverage and definitions can be found in the national reference metadata in the section ‘Annex’.

Ongoing work to increase quality, comparability and coverage is reported to Eurostat's Expert Group ‘Public Health Statistics’.

Currently, no comparability checks are conducted for this data collection, as data are only available for a few reference years following the adoption of the implementing regulation. Comparability checks over time will be developed when longer time series have become available.