Institute of Hygiene

Health Statistics Department of Health Information Centre

Studentų str. 45a, LT-08107 Vilnius

Non-expenditure health care data provide information on institutions providing health care, on resources used and on output produced in the framework of health care provision.

The resource-related data refer to both human and technical resources, i.e. they relate to:

- Health care staff: 'manpower' active in the health care sector (doctors, dentists, nurses, etc.);

- Heath workforce migration: migration movements of doctors and nurses;

- Health care facilities: technical capacity dimensions (hospital beds, beds in nursing and residential care facilities, etc.).

The output-related data ('activities') refer to contacts between patients and the health care system, and to the treatment thereby received. Data are available for hospital discharges of in-patients and day cases, average length of stay of in-patients and medical procedures performed in hospitals.

Health care data on resources are based on administrative data source of Compulsory Health Insurance Fund Information System (CHIF IS) and annual survey of health care establishments. Data on licenced pharmacies is provided by the State Medicines Control Agency. Data on health care activities is calculated from the administrative data source CHIF IS. 

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 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.

National deviations: see Annex at the bottom of the page.

Public health.

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 and therefore, details pertaining to individual variables are given in the Annex.

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 to this metadata file.

Registered health professionals or health care facility categories.

(1) all health care staff

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

(3) all discharges or procedures performed in all hospitals

Complete national territory

Employment: pgysicians – since 1965, physicians by age – since 2001, physicians by categories – since 1992, dentists and pharmacists – since 1980, midwives and nurses – since 1981, nurses by age – since 2021; caring personnel – since 2000, physiotherapists – since 1992.

Workforce migration – since 2014.

Hospital employment – since 2000.

Hospital beds – since 1960, nursing beds – since 1996.

Hospital – since 1980.

Discharges – since 1971, currative discharges – since 1993, non-resident discharges – since 2011.

Tedical technology – since 2000.

Consultation – since 1985.

Immunization against inluenza – since 2005

Screening: breast cancer – since 2006, cervical cancer – since 2010, colorectal cancer – since 2014.

Diagnostis exams – since 2006.

Surgical procedures – since 2005

Not applicable

Employment and workforce migration - in physical persons.

Hospital employment - in physical persons and FTE.

Hospital beds – in number of beds.

Hospital – in number of hopsitals.

Discharges – in number of dicharges.

Bed occupancy – in percentage.

Average length of stay – in days.

Beddayd – in number of beddays

Tedical technology – in number of units.

Consultation – in number per capita.

Immunization and screening – in percentage.

Diagnostis exams – in number of exams.

Surgical procedures - in number of procedures.

Calendar year.

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

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

In the process of statistical data collection, processing and analysis and dissemination of statistical information, the Institute of Hygiene fully guarantees the confidentiality of the data submitted by respondents as defined in the:

1. Regulation (EC) No 223/2009 of the European Parliament and of the Council of 11 March 2009 on European statistics and repealing Regulation (EC, Euratom) No 1101/2008 of the European Parliament and of the Council on the transmission of data subject to statistical confidentiality to the Statistical Office of the European Communities, Council Regulation (EC) No 322/97 on Community Statistics, and Council Decision 89/382/EEC, Euratom establishing a Committee on the Statistical Programmes of the European Communities (OJ 2009 L87, p. 164),
2. Republic of Lithuania Law on Official Statistics and State Data Governance,
3. Law on Legal Protection of Personal Data of the Republic of Lithuania.

The Rules of Statistical Information Publication and Revision, approved by Order No V-146 of 15 June 2015 of the Director of Institute of Hygiene (only in Lithuanian).

Personal data are available and provided for scientific purposes in accordance with permission of Bioethical Committee.

Statistical information is published on the Official Statistics Portal in accordance with an Official Statistics Calendar and on internet site of the Institute of Hygiene in accordance with the Health Statistics Release Calendar approved by the Institute of Hygiene.

Official Statistics Calendar,

Health Statistics Release calendar (only in Lithuanian).

Statistical information of the Institute of Hygiene is prepared and disseminated under the principle of impartiality and objectivity, i.e. in a systematic, reliable and unbiased manner, following professional and ethical standards (the European Statistics Code of Practice), and the policies and practices followed are transparent to users and survey respondents.

All users have equal access to statistical information. All statistical information is published at the same time – at 9 a.m. on the day of publication of statistical information as indicated in the calendar on the Official Statistics Portal.

Forms and methods of statistical information dissemination: electronic or paper statistical publications, news releases, predefined tables, indicators provided in the Database of Indicators and maps, database news, responses to user inquiries, messages on social networks and other possible forms.

Statistical information is published following the Official Statistics Dissemination Policy Guidelines and Statistical Information Dissemination and Communication Rules of Statistics Lithuania approved by Order No DĮ-176 of 2 July 2021 of the Director General of Statistics Lithuania (only in Lithuanian).

Statistical information is published on the Institute of Hygiene Internet Site, according to an approved Statistical Information Release Calendar pursuant to the Rules of Statistical Information Publication and Revision (only in Lithuanian), approved by Order No V-146 of 15 June 2015 of the Director of the Institute of Hygiene.

Yearly

News releases on-line on Institute of Hygiene internet site https://www.hi.lt/

Yeary publications:

“Health Statistics of Lithuania” (2001- 2022, English and Lithuanian), 

“Population Health and Activity of Healthcare Institutions in Lithuania“ (1999-2022, only in Lithuanian).

Statistical information is published in the Database of Indicators (Population and social statistics -> Health -> Health care -> Health care personnel; Population and social statistics -> Health -> Health care -> Health infrastructure; Population and social statistics -> Health -> Health care -> Inpatient care; Population and social statistics -> Health -> Health care -> Operations, procedures and treatment; Population and social statistics -> Health -> Health care -> Ambulatory health care services).

The Indicators Database page is for viewing and analyzing statistical information. For more information on the Indicators Database, see the Indicators Database User Guide.

Statistical indicators are also published in the Public Health Monitoring Information Sytem. 

Microdata are available and provided for scientific purposes on agreement base or according to request.

Statistical data is available on: Institute of Hygiene internet site; Eurostat data; WHO/EURO database; OECD database.

Statistical information is provided by individual requests as well.

Methodological documents are available on the Institute of Hygiene internet site Methodologies and Quality Reports of Surveys (only in Lithuanian).

Methodological documents are available on the Institute of Hygiene internet site Methodologies and Quality Reports of Surveys (only in Lithuanian).

Quality of statistical information and its production process is ensured by the provisions of the European Statistics Code of Practice and ESS Quality Assurance Framework.

Methodological documents are available on the Institute of Hygiene internet site Methodologies and Quality Reports of Surveys (only in Lithuanian).

The quality of the data meets the requirements for accuracy, timeliness and punctuality, comparability and consistency.

The results of the quality indicators of the Health Care Resources Statistical Survey are presented in parts 12–15 of this metadata description.

When evaluating statistical indicators, the quality of the obtained information is analyzed. The results of the calculation are compared with the results of the previous year. Outstanding values ​​of indicators are identified and analyzed. In the event of significant deviations, the data provider shall be contacted and the reasons for the deviation explained.

The main users of statistical information are State and management authorities, the media, business and research communities, international organisations, whose needs are satisfied without a breach of the confidentiality principle. Statistical information is needed for the analysis of health care resources, the evaluation of ongoing social and health programs, the implementation of public health monitoring programs, the analysis of research by researchers, students, etc.

In order to satisfied the user need for more detailed data the project of Open data is under implementation.

Statistics Portal of the Institute of Hygiene traffic is monitored, target user group opinion surveys are conducted. User satisfaction survey was conducted in 2022 (only in Lithuanian).

Data sources refer to all registered health human resources and health care facilties and their activities.

All indicators established by the legislation and their components are published. 

The source data, intermediate results and statistical outputs are assessed and validated regularly: visual control of register data, logical control during data entry process, computerised control after data entry, control of time-series of indicators.

The estimation of the values ​​of the missing indicators has no significant effect on the overall accuracy. Annual reports of health cate institutions are reconciled with data of Compulsory Health Insurance Fund Information System on employment of health care specialists.

Not applicable.

Not applicable.

On national level provisional data is published in the 5th month after the end of the reference year, final data - in the 8th month after the end of the reference year.

Data is provided to Eurostat for the year T+14 (resourcses) or T+20 (activities).

Statistical information is published in accordance with an Official Statistics Calendar and Health Statistics Release Calendar (only in Lithuanian).

In case of delay, users are notified in advance by indicating the reason and a new date of publication.

Statistical information is comparable between administrative units of Lithuania.

The comparability of the data across different Eu countries is limited by the fact that the quality of the country data is subject to the way in which health care provision is organised in countries, and which information is available to and collected by the respective institutions.

Comparability of time is ensured. Break in series are flagged and some information are given in the annexes of the metadata.

Health care data are also available in the database "Regional Statistics".

Data are coherent.

Health care resources study is a part of the Study of Health Care Institutions and their Activities. In 2022, 80 thousand Euro was spent on the Study of Health Care Institutions and their Activities.

Most of the data is collected from administrative data source Compulsory Health Insurance Fund Information System.

Response burden for annual report form No 1 “Yearly report on activities of health care institution” is 9.2 hours per respondent, No 3 „Yearly report on personnel“ is 4.2 hours per respondent, No 1-PR “Report on activities of private health care institutions” is 2.1 hours per respondent, No 25-PR “Report on activities of private dental care institutions” is 1.2 hours per respondent.

Data on licenced specialists and activities of health care institutions is calculated from administrative data source Compulsory Health Insurance Fund Information System.

Annual reports used in the Study of Health Care Institutions and their Activities are regularly revised. Reduction of the reports is made when data is available from information systems. Last reduction was done in 2020.

Revisions of statistical indicators are performed in accordance with The Rules of Statistical Information Publication and Revision, approved by Order No V-146 of 15 June 2015 of the Director of the Institute of Hygiene (only in Lithuanian).

Provisional and final data is published. The purpose of revisions of health care resources statistics is to provide users of statistical information with revised annual statistics on health resources. Revisions have been carried out since 2001.

Reasons for revision. The main reason for the revision of the statistical information of the Health Care Resources Survey is the supplementation and revision of the primary statistical data (the errors of the respondents is corrected, the data are revised by comparing them with other data sources, etc.).

Calendar of revisions. Revisions are carried out according to the Schedule of Revisions to Health Statistics, which revises annual statistics once a year.

Publishing of results to users. The revised data of the Health Care Resources Statistical Survey are published on the Official Statistics Portal, on the website of the Institute of Hygiene.

Users are informed about scheduled revisions in advance through a Calendar of Scheduled Revisions of Statistical Indicators (only in Lithuanian).

Unscheduled revisions are performed when legislation is changed or significant errors are detected. Users are informed immediately about results of unscheduled revisions.

Usually preliminary and final data is published. E. g. in 2022 the change in the statistical indicator “Hospital discharges per 1000 inhabitants” was -0.05 per cent, comparing the preliminary and final data.

Source data for the different variables are given in the Annex to this matadata file.

Annual.

Annual questionnaires of health care institutions are collected using Module of annual reports of the Public Health Monitoring System http://viss.hi.lt/, by mail and email.

The Questionnaire is published at the Statistical Reporting of Health Care Institutions (only in Lithuanian).

The National Health Insurance Fund provides depersonalized copy of Compulsory Health Insurance Fund Information System to the Institute of Hygiene on-line under the contract.

To ensure the quality of statistical data, data validation is done. The data determined during data recording meet the mathematical and logical control conditions. In the event of discrepancies, the statistics shall be corrected for the nature of the error and the data provider shall be contacted if necessary.

Analysis of the comparability and compatibility of the aggregated data is performed. The statistical information is compared with the statistical information of the previous period. The reasons for the biggest changes are explained. If inaccuracies are identified, the statistics are corrected and the validity of the data is confirmed.

Data presented for WHO/EUROSTAT/OECD is validated by the experts before publishing.

Statistical data on health care resources (excl. data on licenced specialists) are collected by carrying out annual exhaustive survey of health care institutions. Annual reports of health care institutions are reconciled Annual reports of health care institutions are reconciled with data of Compulsory Health Insurance Fund Information System on employment of health care specialists. Data on licenced specialists is collected from administrative data source: Compulsory Health Insurance Fund Information System. Data on licenced pharmacists is provided by the State Medicines Control Agency.

Data on consultation is calculated by combining data of annual survey of health care institutions (data for private institutions not having contract with Compulsory Health Insurance Fund) and Compulsory Health Insurance Fund Information System.

Primary statistics are aggregated by regions, counties, municipalities. The indicators are calculated using the number of population at the end of the year (for resources) or average number of population (for activities).

The process of compilation of statistical indicators is described more detail in the Methodology of Health Care Resources Survey  and Methodology of Health Care Activities Survey (only in Lithuanian).

No adjustments are made.

Concept difiniotion are presented in the Commission Regulation (EU) 2022/2294 of 23 November 2022 implementing Regulation (EC) No 1338/2008 of the European Parliament and of the Council as regards statistics on healthcare facilities, healthcare human resources and healthcare utilisation.

Additional comment on data sources and data calculations are presented in the annex to this metadata file.