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For any question on data and metadata, please contact: Eurostat user support |
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1.1. Contact organisation | Central Statistical Bureau of Latvia |
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1.2. Contact organisation unit | Social Statistics Department, Social Statistics Data Compilation and Analysis Section |
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1.5. Contact mail address | 1, Lāčplēša Street Riga, LV-1301 Latvia |
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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. Accounting period: Health expenditure and financing data pertain to the calendar year (1 January to 31 December). The time coverage of this Quality report is 2014 to 2016 reference years. |
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2.2. Classification system | |||
Healthcare expenditure is recorded in relation to the international classification for health accounts (ICHA) defining:
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2.3. Coverage - sector | |||
1. Household individual consumption on health, including the collective consumption with two exceptions: |
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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:
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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". |
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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). |
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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. |
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2.8. Coverage - Time | |||
2013-2016. |
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2.9. Base period | |||
Not applicable. |
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3.1. Source data | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Several data sources are used: - Surveys/census: 4 - Public administrative records: 1 - Financial reports: 3
Surveys/censuses
Public administrative records
Financial reports
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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. Two institutions are involved in data compilation – National Health Service (NHS) and the Central Statistical Bureau (CSB). The responsibility of NHS is to maintain a unified system of settlements on health care services paid by the government budgetary funds, where each service provider that is in contractual relations with NHS, enters information on government budget funded services provided to each patient. NHS concludes agreements with medical institutions on the provision and payment of health care services. Exchange of information is done only electronically by using unified classifications and institutions enter information on health care services according to the accounting documents. In order to meet requirements of the Commission Regulation NHS in 2015 has worked out methodological guidelines how to process the entered data and other information and classify them according to the Classification of Medical Services (ICHA- HC). The CSB collects information on private health expenditure, as well as on all other health care expenditures for which information is not provided by the NHS. As a result, the information is combined in data tables. For estimation of expenditure for the national SHA the Central Statistical Bureau follows several main conditions: - to use residual value for estimation private out-of-pocket expenditure with a joint estimation scheme and variables: net turnover of enterprises (for budgetary institutions expenditure and income of budget institutions from paid services) minus direct budgetary allocations; |
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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:
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3.5. Data compilation | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Several methods are normally used for estimations:
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3.6. Adjustment | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Publication of data at national level is carried out using the same international standards, only data is not published as detailed as data aggregation tables. |
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Quality assurance requirements in Latvia are explained in the Guidelines for Implementation of European Statistics Code of Practice. 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. https://www.csb.gov.lv/sites/default/files/Dokumenti/revision_policy_csb.eng_.pdf |
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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. |
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4.2. Quality management - assessment | |||
The data for SHA tables are obtained from several data sources. At each data collection stage, the quality of the data is evaluated individually for each data source. Every year information is compared with previous years, risks, discrepancies or changes and their impact is being evaluated. Data quality gaps are fixed before data is placed in SHA tablesData quality gaps are fixed before data is placed in SHA tables. As the managing institution of the PSOS, CSB has researched conformity to the Code requirements in Latvian statistical institutions producing European statistics including the National Health Survey. The NHS is main partner for data collection for SHA. Latvian State Agency of Medicine data covers 97% from all registered pharmacies. |
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5.1. Relevance - User Needs | |||
Data users at the national level: Ministry of Health (private expenditure); Ministry of Finance (Long-term care – HC.3 and HCR.1; private expenditure); Diseases Prevention and Control Centre (for national indicator database); Data users – researchers working on public health and social care; dental care indicators; Data users: National Accounts Section (for data comparisons). Data users also use Eurostat database online and request to explain differences between total public expenditure by Government Finance Section of the CSB (according to the ESA 2010) and data collection according to the SHA approach. Unmet user needs mainly relate to the timeliness of publication of data - data users would appreciate to get information faster. |
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5.2. Relevance - User Satisfaction | |||
The CSB of Latvia does not carry the data user’s satisfaction surveys. Once a year, the CSB collects information on the number of views and number of downloads of the CSB database tables. In the near future, it is planned to include in the data base also the main financial indicators according to the SHA methodology. |
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5.3. Completeness | |||
See 5.3.1. |
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5.3.1. Data completeness - rate | |||
HCxHF Missing (data not available) HF.2.3 - there are cases when enterprises directly finance health services (for instance, occupational health care, reimbursement of glasses) but it is not possible to separate these expenditures. Enterprises accounting reports also do not allow to distinguish these costs as they are included in the total labour costs. HF.4 – data are not available Missing (category reported elsewhere): Disaster and emergency response programmes (HC.6.6) are included into HC.4.3. HC.3.1 - Deviation from SHA definition: HC.3 - A splitting between ADL, IADL and "outside of LTC-health". We have no data on level of activity limitations of persons. People living in LTC facilities are diverse. We must use another key for splitting HPxHF Deviation from SHA definition: Residential long-term care facilities (HP.2) - Missing (data not available): There are some electronic shopping and mail-order enterprises in Latvia. However, there is no key to calculating what part to take for medical goods. Households as providers of home health care (HP.8.1) When calculating this indicator, we encounter several obstacles. It is difficult to determine the status of each cell (not applicable, missing, elsewhere reporting or insignificant value) due to lack of practice to apply information or do not know where to look for information. It mainly concerns financial schemes (HF2.3 or HF.4). There are cases also when cells are not recommended to fill at all (atypical). Would not it be possible to pre-show in the tables where these cells are, so that they cannot be included in the calculations and this would increase coverage. HCxHF 63% (without “not applicable”) HPxHF 69% (without “not applicable”) HCxHP 70% (without “not applicable”) |
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6.1. Accuracy - overall | |||
After quality measures and verification the overall accuracy of Latvian data for SHA is good. |
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6.2. Sampling error | |||
Not applicable. |
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6.2.1. Sampling error - indicators | |||
Not applicable. |
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6.3. Non-sampling error | |||
See 6.3.1. |
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6.3.1. Coverage error | |||
Health care goods and services consumed by non-residents are included. In 2020 this problem will be solved. In 2019 the Diseases Prevention and Control Centre carried out survey asking health care providers to fill in questionnaire about services provided for non-residents. Some financial data also will be available. Latvia is not able to report informal health care goods and services in the data collection. Private expenditure will be improved, deducting from HF.3, the eligible expenses reimbursed by the state, that is, types of expenditures - planned operations and dentistry expenses, or other expenditure on health - are deducted from taxable incomes when the annual tax declaration is submitted. Accordingly, to the Law On Personal Income Tax, in a year a person receives 23 % of expenses for medical services. |
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6.3.1.1. Over-coverage - rate | |||
During the data compilation, estimates are made for the units that are included in the list of health service providers, but health is the 2nd or 3rd enterprise activity. In these cases, the proportion of health services is calculated as the contribution of medical staff. |
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6.3.1.2. Common units - proportion | |||
Not available. |
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6.3.2. Measurement error | |||
Not available. |
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6.3.3. Non response error | |||
Not available. |
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6.3.3.1. Unit non-response - rate | |||
The CSB obtains data on SHA using provider side approach and list of providers for HP.1, HP.3, HP.4, HP.6 and HP.7, drawn up by the Health Inspectorate that determines the right to provide healthcare services. For HP.2 the register of Ministry of Welfare is used. In this case, the problem is not in the unit level, but rather how to calculate functions (services) ADL and IADL if the data source is not available. For HP.5.2 there is a special list for collecting information on hearing aids and medical products (NACE4774 and NACE 4778). |
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6.3.3.2. Item non-response - rate | |||
Not available. |
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6.3.4. Processing error | |||
Not available. |
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6.3.4.1. Imputation - rate | |||
Not available. |
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6.3.5. Model assumption error | |||
Not relevant. |
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6.4. Seasonal adjustment | |||
Not applicable. |
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6.5. Data revision - policy | |||
Not applicable. |
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6.6. Data revision - practice | |||
The revision of SHA tables occurs when the methodology is being changed. |
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6.6.1. Data revision - average size | |||
The revision of SHA tables occurs when the methodology is being changed. |
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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. |
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7.1.1. Time lag - first result | |||
Not available. |
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7.1.2. Time lag - final result | |||
Not available. |
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7.2. Punctuality | |||
Latvia complies with the Commission Regulation 359/2015 transmission deadlines, which is 30 April t+2 for reference year t. |
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7.2.1. Punctuality - delivery and publication | |||
Not available. |
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8.1. Comparability - geographical | ||||||||||||||||||||||||||||||||||||
Not applicable at national level. |
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8.1.1. Asymmetry for mirror flow statistics - coefficient | ||||||||||||||||||||||||||||||||||||
Not applicable. |
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8.2. Comparability - over time | ||||||||||||||||||||||||||||||||||||
Data according to the SHA 2011 methodology is comparable over the time with no break in time for 2014 to 2016 data. |
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8.2.1. Length of comparable time series | ||||||||||||||||||||||||||||||||||||
4 years (2013 to 2016) for SHA 2011 data. |
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8.3. Coherence - cross domain | ||||||||||||||||||||||||||||||||||||
Comparison of SHA and ESSPROS data collection approaches was carried out in 2015 in the frame work of Grant project "Health Accounts (SHA 2011)". During the reference period, it was possible to calculate national SHA (SHA2011) for 2013 (new methodology). Unfortunately, for mapping SHA codes to ESSPROS codes we used template “Harmonization table” from the document “ESSPROS and SHA an investigation on the possibility of Harmonization” (2006) afterwards adapted this table with some re-codification of the SHA 1.0 version codes to SHA2011. If necessary, it is possible to make comparisons between data collection systems of ESSPROS and national SHA. The differences for the total figures reach 1.8% however if the results are analysed between the subgroups the differences are increased but could be interpreted. |
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8.4. Coherence - sub annual and annual statistics | ||||||||||||||||||||||||||||||||||||
Not applicable. |
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8.5. Coherence - National Accounts | ||||||||||||||||||||||||||||||||||||
Comparison of SHA and SNA data collection approaches was carried out in 2015 in the frame work of Grant project "Health Accounts (SHA 2011)". Results from SNA and SHA differ due to the scope of health care goods and services included and the estimation methods used. From provider side of health services SNA uses NACE classification of economic activities 4-digit levels recorded under category 86 – Human Health including 8610, 8621, 8622, 8623 and 8690. In contrast, SHA boundary is broader, including partly NACE 87, administration, optical and vision products, medical appliances and non-durables (NACE 4774), partly - laboratory services providers which code their economic activity not as NACE 8690 but, for instance, NACE 7120, NACE 3250 or NACE 8423. |
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8.6. Coherence - internal | ||||||||||||||||||||||||||||||||||||
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9.1. Dissemination format - News release | |||
No press releases at national level have been published. |
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9.2. Dissemination format - Publications | |||
Latvian Health and Health Indicator Database (in Latvian) https://www.spkc.gov.lv/lv/statistika-un-petijumi/datu-bazes
Health in the Baltic Countries https://www.spkc.gov.lv/lv/statistika-un-petijumi/statistika/health-in-the-baltic-countries |
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9.3. Dissemination format - online database | |||
SHA data are not disseminated in the CSB on-line database. |
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9.3.1. Data tables - consultations | |||
SHA data are not disseminated in the CSB on-line database. |
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9.4. Dissemination format - microdata access | |||
Not applicable. |
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9.5. Dissemination format - other | |||
Latvian Health and Health Indicator Database (in Latvian) https://www.spkc.gov.lv/lv/statistika-un-petijumi/datu-bazes CSB Statistical Year book 2018 |
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9.6. Documentation on methodology | |||
Not available. |
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9.7. Quality management - documentation | |||
Not available. |
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9.7.1. Metadata completeness - rate | |||
Not available. |
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9.7.2. Metadata - consultations | |||
Not available. |
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Restricted from publication |
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11.1. Confidentiality - policy | |||
The Regulation (EC) No 223/2009 on European statistics (recitals 23-27, 31-32 and Articles 20-26) applies. |
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11.2. Confidentiality - data treatment | |||
As data tables use aggregates from several data sources, the confidentiality of every data sources could be applied.
The primary confidentiality rules:
1. indicator of the aggregates is obtained from one, two or three statistical units;
2. proportion of a one statistical unit in the respective indicator accounts for 80% and more;
3. total proportion of two statistical units accounts for 90% or more.
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No further comments. |
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