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For any question on data and metadata, please contact: Eurostat user support |
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1.1. Contact organisation | Hellenic Statistical Authority (ELSTAT) |
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1.2. Contact organisation unit | Division of Social Statistics Department of Health Statistics and Social Security and Protection |
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1.5. Contact mail address | 46 Peiraeus and Eponiton street 185 10, Peiraeus |
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2.1. Data description | |||
Health care expenditure quantifies the economic resources dedicated to health functions, excluding capital investment. Healthcare expenditure concerns itself primarily with healthcare goods and services that are consumed by resident units, irrespective of where that consumption takes place (it may be in the rest of the world) or who is paying for it. As such, exports of healthcare goods and services (to non-resident units) are excluded, whereas imports of healthcare goods and services for final use are included. It provides a set of revised classifications of health care functions, providers of health care goods and services and financing schemes. The SHA is currently used as a basis for a joint data collection by OECD, Eurostat and WHO on health care expenditure. The manual sets out in more detail the boundaries, the definitions and the concepts of health accounting – responding to health care systems around the globe with very different organisational and financing arrangements. Accounting period: Health expenditure and financing data pertain to the calendar year (1 January to 31 December). The definitions and classifications of the System of Health Accounts (SHA) are followed, e.g. International Classification for Health Accounts - Providers of health care (ICHA-HP). Data related to Health Expenditure are mainly collected from the administrative sources of the country, such as:
And, from ELSTAT’s survey results
ELSTAT publishes SHA2011 data on an annual basis, within the first quarter of the second year after the reference year of the data, according to the timetable of publications of the OECD and of Eurostat. Health care data on expenditure are mainly based on census and administrative (register) data sources (except for the HBS where sampling techniques are implemented by the respective Division of ELSTAT). The database is based on a co-operation between EUROSTAT, the OECD (Organisation for Economic Co-Operation and Development) and the WHO (World Health Organisation), executing a Joint Questionnaire on Health expenditure since 2005. Data based on SHA2011 methodology cover the years 2009 to 2017. |
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2.2. Classification system | |||
Healthcare expenditure is recorded in relation to the international classification for health accounts (ICHA) defining:
For all data on expenditure the source for classification is described in:
Data are classified at 2-digit level of SHA codes, thus fully covering the requirements of the international organizations. Moreover, there is correspondence between the functions of health activities as they are defined by SHA2011 (eg. In-patient, outpatient care etc.) with the international system of classification of general government COFOG (Classification of the Functions of Government) on an aggregated level. |
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2.3. Coverage - sector | |||
1. Household individual consumption on health, including the collective consumption with two exceptions: Health Expenditures of General Government, Private Households, Private Insurance Companies and the Rest of the World plus various NPISHs for health related expenditures. Production side of the health sector is not covered as SHA data do not compile the relevant SHA table. |
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2.4. Statistical concepts and definitions | |||
SHA concept is the consumption of health care goods and services. Summary tables provide data on:
Cross-classification tables refer to:
Health care statistics describe the process of providing and financing health care in Greece by referring to health care goods and services, its providers and financing. Current expenditure on health measures the economic resources spent by Greek residents on health care services and goods, including administration and insurance. For the collection of the data on health care expenditure the System of Health Accounts (SHA2011) comprises the goals of the System of National Accounts (SNA) to constitute an integrated system of comprehensive, internally consistent, and internationally comparable accounts, which should as far as possible be compatible with other aggregated economic and social statistical systems. |
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2.5. Statistical unit | |||
Commission Regulation 2015/359 concerns the collection of data on "current expenditure on healthcare" which is defined as the "final consumption expenditure of resident units on health care goods and services". SHA relies on three axes:
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2.6. Statistical population | |||
SHA focuses on the consumption of health care goods and services by the resident population irrespective of where this takes place. This implies the inclusion of imports (from non-resident providers) and the exclusion of exports (health care goods and services provided to non-residents). Data related to the provision of health goods and services consumed by domestic residents within the boundaries of domestic economy. |
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2.7. Reference area | |||
The data aims at providing a complete overview of expenditure on health care goods and services consumption of services and goods by the resident population on the national territory of a country. Covers the geographical area of Greece. |
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2.8. Coverage - Time | |||
ELSTAT publishes SHA2011 data on an annual basis, within the first quarter of the second year after the reference year of the data, according to the timetable of publications of the OECD and Eurostat. In particular, ELSTAT publishes statistical data of the System of Health Accounts (SHA2011) for the years 2009-2017 with first reference year, the year 2009. |
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2.9. Base period | |||
Not applicable. |
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3.1. Source data | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Several data sources are used (as of data notification in March 2018): - Surveys/census: 3 - Public administrative records: 6 - Financial reports: 0 - Other: 0
Surveys/censuses
Public administrative records
The data are collected, stored and disseminated via different tables (expenditure by provider, by financing agency and by function). The data are collected from the following agencies:
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3.2. Frequency of data collection | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Annual. |
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3.3. Data collection | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Data are collected through the joint health accounts questionnaire (JHAQ) that countries submit to Eurostat during the annual data collection exercise. There is a voluntary deadline to send the JHAQ questionnaire for the calendar year T by the 31st of March T+2. The joint health accounts questionnaire (JHAQ) is coordinated in agreement with the World Health Organisation (WHO) and the Organization of Economic Co-operation and Development (OECD). These three international organisations are known collectively as the International Health Accounts Team (IHAT). Countries submit data to Eurostat on the basis of Commission Regulation (EU) 2015/359 of 4 March 2015 implementing Regulation (EC) No 1338/2008 of the European Parliament and of the Council as regards statistics on healthcare expenditure and financing.
Data collection method relates to direct contact with the administrative sources aiming at the transmission of health expenditure data in the form that they are available from the administrative sources themselves. Data are collected from the Ministry of Health, Ministry of Education, Ministry of Defense, EOPYY (the main SSF in Greece since the year 2012 and afterwards), Household Budget Survey (HBS) from ELSTAT , Private Insurance Companies, various NPISHs and RoW health related data. Data are then given the relevant SHA2011 codification according to health financing sector, health provider and health care activity (HF, HP, HC, respectively). |
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3.4. Data validation | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
The 2018 JHAQ includes a number of features which allow national data correspondents to perform various quality checks before submitting the data. The embedded programmes allow the verification of:
2- Consistency of the data within tables,
Entries in the tables cannot be negative as they refer to the consumption of goods and services.
The atypical entries check provides information whether the data tables contain values in cells which are – if at all – only reported by very few countries and are thus atypical for health accounting.
3- The growth rates against the previous year and the magnitude of revisions as compared to previously submitted data. Results are grouped into three different categories:
Data are validated by Eurostat in co-operation with OECD and WHO health accountants. |
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3.5. Data compilation | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
SHA data is compiled both by a bottom-up approach as well as by a top-down approach, depending on the data source. Compilation is done by financing schemes and by different health care functions/task areas. The results of the several calculations are then aggregated. To gain the differentiation between the different SHA-dimensions (especially HC and HP) quotas and pro-rating and utilisation keys are applied on some spending items. For some spending items it is necessary to extra-/intrapolate data as there is no up-to-date data available or data is missing for certain years. For some other spending items, estimation methods have to be applied.
Several methods are normally used for estimations:
Data are compiled according to the Manual of the System of Health Accounts (SHA), 2011 edition. All expenditure items covering health and LTC are assigned a classification of provider and function. Data are included for military hospitals, and data for general population protection. Every effort is exercised to record data on an accrual basis and for this reason all data related to general government are compared with the respective health data of national accounts. Also COFOG data (health category GF07) are also taken into account, and compared with the SHA2011 data. Data are classified according to SHA2011 codification (categories HF,HP,HC) and are inserted on a unified working table covering all sectors, before being transferred to the formal JHAQ data. |
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3.6. Adjustment | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
No adjustment. |
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4.1. Quality assurance | |||
Authorities responsible for SHA data collection are working to ensure that the statistical practices used to compile national health accounts are in compliance with SHA methodological requirements and that good practices in the field are being followed, according to the methodology underlined in the SHA 2011 Manual and European Statistics Code of Practice respecting professional independence of the statistical authorities. Procedures are in place to plan and monitor the quality of the health care expenditure statistical production process. The quality assurance system is presented on ELSTAT’s website at: As well as within the European Statistics Code of Practice, which was established by the Statistical Programme Committee in February 24, 2005 and published as Commission Recommendation in May 25, 2005, regarding the independence, integrity and responsibility of national and community statistical Authorities after its revision which was adopted in September 28, 2011 by the Commission of the European Statistical System. |
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4.2. Quality management - assessment | |||
The basic advantages of the overall quality of the System of Health Accounts compilation refer to the availability of primary data sources form the official national administrative sources (Ministry of Health, Social Security Funds, ELSTAT, Church of Greece etc.). However, the need of a detailed classification of total health expenditures by provider and by health care activity defines the need of re-examining the total operational structure of the health sector in every data revision for each reference year. |
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5.1. Relevance - User Needs | |||
The basic users of the System of Health Accounts data are the Ministry of Health, various Universities and other scientific agencies (researchers, students etc.). |
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5.2. Relevance - User Satisfaction | |||
Currently, incidents of non-satisfaction by users have not been recorded referring to the published System of Health Accounts results. The last available results of the User’s Satisfaction Survey 2016, are presented on ELSTAT’s website at: http://www.statistics.gr/en/user-satisfaction-survey The Division of Statistical Information and Publications of ELSTAT, conducts the survey on User’s satisfaction. |
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5.3. Completeness | |||
The completeness rate of data is considered satisfactory. However some three digit codes are no feasible to be completed and their respective sub-category is included within its broader (two digit) health category. Also some categories of health related expenditures are at present unfeasible to be recorded (for example category of HC.2.4-Home based rehabilitative care) but these cases are mentioned within the SIMS documentation. |
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5.3.1. Data completeness - rate | |||
The completeness rate of data is considered satisfactory. However some three digit codes are no feasible to be completed and their respective sub-category is included within its broader (two digit) health category. Also some categories of health related expenditures are at present unfeasible to be recorded (for example category of HC.2.4-Home based rehabilitative care) but these cases are mentioned within the SIMS documentation. |
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6.1. Accuracy - overall | |||
Accuracy of the data that are related to administrative sources is checked by themselves as they refer to census data. Regarding the data that derive from ELSTAT’s Household Budget Survey (HBS), their accuracy is checked within the evaluation framework of the survey itself, conducted by the respective Division of ELSTAT. |
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6.2. Sampling error | |||
The survey is a census survey; there are no sampling errors. |
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6.2.1. Sampling error - indicators | |||
Errors related to non-coverage of the population (framework weaknesses), non-response errors of the respondents, response errors which are due to the respondents, response errors which are due to statistical interviewers and processing errors are checked by the involved administrative sources themselves, as well as by the Division of Population Statistics and Labour Market regarding data related to HBS. |
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6.3. Non-sampling error | |||
We use census not samples. Estimation for underground health goods and services are not included in the data. Data on shadow economy are not included (for example data related to the shadow economy of home nursing care). Accuracy of the data that are related to administrative sources is checked by themselves. Regarding the data that derive from ELSTAT’s Household Budget Survey (HBS), their accuracy is checked within the evaluation framework of the survey itself. Health care goods and services by non-residents are excluded from domestic providers. So far we were not able to report the informal /illegal health care goods and services within the data collection. |
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6.3.1. Coverage error | |||
Not applicable. |
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6.3.1.1. Over-coverage - rate | |||
Not applicable. |
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6.3.1.2. Common units - proportion | |||
Not applicable. |
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6.3.2. Measurement error | |||
Not applicable. |
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6.3.3. Non response error | |||
Not applicable. |
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6.3.3.1. Unit non-response - rate | |||
Not applicable. |
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6.3.3.2. Item non-response - rate | |||
Not applicable. |
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6.3.4. Processing error | |||
No processing error occurs. |
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6.3.4.1. Imputation - rate | |||
Not applicable. |
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6.3.5. Model assumption error | |||
Not applicable. |
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6.4. Seasonal adjustment | |||
Not applicable. |
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6.5. Data revision - policy | |||
Data are considered provisional and are subject to revision. The Revision policy implemented by ELSTAT is presented on ELSTAT’s website at: http://www.statistics.gr/documents/20181/a49dca9a-dacf-4b52-b5df-b156216cb354
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6.6. Data revision - practice | |||
Usually, data are revised every March following the reference year. ELSTAT’s Revision Policy is being implemented as presented on ELSTAT’s website at: http://www.statistics.gr/documents/20181/a49dca9a-dacf-4b52-b5df-b156216cb354 Data for the years 2009 to 2011 were not revised for any of the sub sectors. Data for the years 2012 to 2015 were revised for the sub sector of Social Security Funds (HF.1.2) .The present revised data follow the accruals principles of National Accounts in a more consistent way, while at the same time, trying to adhere to the primary cash based data received directly from the SSFs (in cases where this is feasible). Data for the years 2012 and 2015 were revised for the sub sector of central government (HF.1.1) (in the case of the year 2015 the revision is substantial, around 260 mio euro, and is due to revised estimations of the salaries of personel employed in public hospitals as reported in the respective National Accounts data. |
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6.6.1. Data revision - average size | |||
For the year 2017 SHA notification data revision is of a small scale. |
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7.1. Timeliness | |||
Member States are required to transmit their data to Eurostat in compliance with the Commission Regulation 359/2015 transmission deadlines. Eurostat, OECD and WHO request data transmission for the reference year: N in time N+15 months. |
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7.1.1. Time lag - first result | |||
N+15 months. |
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7.1.2. Time lag - final result | |||
N+15 months. |
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7.2. Punctuality | |||
No delays in the publication and transmission of data have been recorded. |
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7.2.1. Punctuality - delivery and publication | |||
No delays in the publication and transmission of data have been recorded. |
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8.1. Comparability - geographical | |||||||||
Data are compatible with the respective data of the rest of the countries where SHA2011 Methodology is in force. |
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8.1.1. Asymmetry for mirror flow statistics - coefficient | |||||||||
Not applicable. |
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8.2. Comparability - over time | |||||||||
Breaks in time series resulting from methodological changes
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8.2.1. Length of comparable time series | |||||||||
The time series for the years 2009-2017 is annually revised and data are considered fully comparable with the previous notification for the same time period. |
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8.3. Coherence - cross domain | |||||||||
Coherence checks are carried out regarding the Social Security Funds survey of the Division of Social Statistics as well as with relevant data of the National Accounts Division and the ESSPROS data format. In particular scheme 18 of the ESSPROS data are based (on the uses side) on SHA2011 data (after the exclusion of non ESSPROS related data recorded in SHA2011). |
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8.4. Coherence - sub annual and annual statistics | |||||||||
Not applicable, the survey is annual. |
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8.5. Coherence - National Accounts | |||||||||
SHA2011 is consistent with the National Accounts data (at least for the sector of general government). Every year accruals based data from national accounts are processed and classified according to SHA2011 codification. Additionally, data related to general government which is recorded in the SHA 2011 system is cross checked with the respective data of the national accounts. |
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8.6. Coherence - internal | |||||||||
The System of Health Accounts is compatible according to the three (3) tables compiled as they appear at ELSTAT’s website at: http://www.statistics.gr/el/statistics/-/publication/SHE35/- Data are checked against their internal consistency if two different data sources are used. However consistency among data does not seem to be a problem since both SHA2011 and national accounts data receive their primary data from the same data sources. |
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9.1. Dissemination format - News release | |||
News release available on ELSTAT’s website at: |
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9.2. Dissemination format - Publications | |||
Data on the System of Health Accounts for the years 2009-2017 are available on ELSTAT’s website at: http://www.statistics.gr/en/statistics/-/publication/SHE35/- and on Eurostat’s website: https://ec.europa.eu/eurostat/statistics-explained/index.php?title=Healthcare_expenditure_statistics |
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9.3. Dissemination format - online database | |||
Data are available in ELSTAT’s data base: http://www.statistics.gr/en/statistics/-/publication/SHE35/- |
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9.3.1. Data tables - consultations | |||
The total access to the networking page regarding the specific survey for the year 2018 is 5,746 page views (total hits). |
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9.4. Dissemination format - microdata access | |||
Not applicable. The microdata are available upon request at: Division of Statistical Information and Publications 46, Peiraeus & Eponiton str., 185 10 Peiraeus Tel. (+30) 213-1352173, FAX : (+30) 213-1352022 e-mail : data.dissem@statistics.gr
Confidentiality of data is always ensured. |
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9.5. Dissemination format - other | |||
Please visit: |
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9.6. Documentation on methodology | |||
Categorization of health expenditures is based and is analytically described at: the System of Health Accounts http://www.who.int/health-accounts/methodology/sha2011.pdf as presented by the OECD in 2011. |
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9.7. Quality management - documentation | |||
The quality assurance system is presented on ELSTAT’s website at: As well as within the European Statistics Code of Practice, which was established by the Statistical Programme Committee in February 24, 2005 and published as Commission Recommendation in May 25, 2005, regarding the independence, integrity and responsibility of national and community statistical Authorities after its revision which was adopted in September 28, 2011 by the Commission of the European Statistical System. The basic advantages of the overall quality of the System of Health Accounts compilation refer to the availability of primary data sources from the official national administrative sources (Ministry of Health, Social Security Funds, ELSTAT, Church of Greece etc.). |
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9.7.1. Metadata completeness - rate | |||
The metadata are entirely covered. |
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9.7.2. Metadata - consultations | |||
Information not available. |
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Not estimated. |
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11.1. Confidentiality - policy | |||
The issues concerning the observance of statistical confidentiality by the Hellenic Statistical Authority (ELSTAT) are arranged by articles 7, 8 and 9 of the Law 3832/2010 as in force, by Articles 8, 10 and 11(2) of the Regulation on Statistical Obligations of the agencies of the Hellenic Statistical System and by Articles 10 and 15 of the Regulation on the Operation and Administration of ELSTAT. ELSTAT disseminates the statistics in compliance with the statistical principles of the European Statistics Code of Practice and in particular with the principle of statistical confidentiality. http://www.statistics.gr/en/statistical-confidentiality?inheritRedirect=true |
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11.2. Confidentiality - data treatment | |||
ELSTAT protects and does not disseminate data it has obtained or it has access to, which enable the direct or indirect identification of the statistical units that have provided them by the disclosure of individual information directly received for statistical purposes or indirectly supplied from administrative or other sources. ELSTAT takes all appropriate preventive measures so as to render impossible the identification of individual statistical units by technical or other means that might reasonably be used by a third party. Statistical data that could potentially enable the identification of the statistical unit are disseminated by ELSTAT if and only if:
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No additional comments. |
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