Archive:Healthcare statistics

Data from September 2008, most recent data: Further Eurostat information, Main tables and Database.

Table 1: Healthcare indicators (per 100 000 inhabitants)

Most Europeans agree that there is a basic need for universal access to healthcare, as the cost of many modern-day health treatments can often be prohibitive to the average person. The provision of healthcare systems varies considerably between the Member States of the European Union (EU), although widespread use is made of public provision (national or regional health services) and comprehensive healthcare insurance. Healthcare schemes generally cover their entire resident population; nevertheless, an increasing proportion of individuals choose to adhere to private insurance schemes (usually on top of the national provision for care).

Main statistical findings

Table 2: Hospital beds (per 100 000 inhabitants)

Table 3: Hospital discharges of in-patients by diagnosis (ISHMT - international shortlist for hospital morbidity tabulation), 2006 (per 100 000 inhabitants)

File:Hospital discharges of in-patients by diagnosis (ISHMT - international shortlist for hospital morbidity tabulation), average length of stay, 2006(days).PNG

Table 4: Hospital discharges of in-patients by diagnosis (ISHMT - international shortlist for hospital morbidity tabulation), average length of stay, 2006 (days)

The highest number of physicians per 100 000 inhabitants was recorded in Greece (almost 500 professionally active physicians in 2005), followed by Belgium (405 practising physicians in 2007) and Austria (376 practising physicians in 2007); note the methodological differences between the various types of physicians reported in each country.

In 2005 there was an average of 590 hospital beds per 100 000 inhabitants within the EU-27, compared with 695 beds in 1997 (an overall reduction of 15 %); Austria was the only Member State to report an increase in hospital bed numbers, rising by 24.6 beds per 100 000 inhabitants over the period 1996 to 2005. A more detailed breakdown shows that reductions in bed numbers were spread across different categories, with an average of 406.3 curative care beds available per 100 000 inhabitants in the EU-27 in 2005, while there were 60.4 psychiatric beds in hospitals per 100 000 inhabitants; compared with 1997 these latest figures represented overall reductions of 16.6 % and 22.6 % respectively.

The general reduction in hospital bed numbers may result from a more efficient use of resources, with an increasing number of operations being dealt with in out-patient treatment, and shorter periods being spent in hospital following an operation. Nevertheless, the output of each National Health Service, as measured by the number of in-patient discharges, will usually (at least to some degree), reflect the number of physicians and hospital beds available. The highest number of hospital discharges in 2006 was recorded in Austria (more than 27 000 per 100 000 inhabitants), which was almost 25 % more than the next highest figure, 21 866 discharges in Lithuania. At the other end of the range, the number of hospital discharges of in-patients was relatively low in both Malta (2004) and Cyprus (below 7 000 per 100 000 inhabitants).

Diseases of the circulatory system accounted for the highest number of hospital discharges in 2006 in the vast majority of countries for which data are available, often with upwards of 3 000 discharges per 100 000 inhabitants. In Bulgaria and Romania (both 2005), higher numbers of discharges were recorded for diseases of the respiratory system. In Ireland, Spain (2005) and Malta (2005) there were more discharges from pregnancies, while in Cyprus the highest number of discharges resulted from injury or poisoning. Ireland, Spain, Cyprus and Malta were characterised by relatively low levels of hospital discharges, which may, at least in some cases, be due to patients travelling abroad in order to receive specialist treatment.

The average length of stay in hospital was generally longest for those patients suffering from cancer or from circulatory system problems. The average time spent in hospital is a function of hospital efficiency, as well as the type of treatments that are on offer; France, Cyprus, Malta and Poland reported the shortest average stays in hospital. At the other end of the range, some of the longest average stays were registered in Finland, the Czech Republic, Germany and Lithuania, with lengthy average stays for diseases of the circulatory system a common feature.

Data sources and availability

Information on healthcare can be divided into two broad groups of data: resource-related healthcare data on human and technical resources; and output-related data that focuses on hospital patients and the treatment(s) they receive. Healthcare data are largely based on administrative data sources, and, to a large degree, they reflect country-specific ways of organising healthcare; as such, the information collected may not always be completely comparable.

Hospitals are defined according to the classification of healthcare providers of the System of Health Accounts (SHA); all public and private hospitals should be covered. Data on healthcare staff, in the form of human resources available for providing healthcare services, is provided irrespective of the sector of employment (i.e. whether the personnel are independent, employed by a hospital, or any other healthcare provider). These statistics cover healthcare professionals such as physicians, dentists, nurses, pharmacists and physiotherapists. In the context of comparing healthcare services across Member States, Eurostat gives preference to the concept of ’practising professionals’, as this best describes the availability of healthcare resources. By way of example, physicians may be counted as licensed, economically active or practising. Data for two or more concepts are available in the majority of Member States. The preference, however, is for practising physicians who are defined as those seeing patients either in a hospital, practice or elsewhere. Practising physicians’ tasks include: conducting medical examination and making diagnosis, prescribing medication and giving treatment for diagnosed illnesses, disorders or injuries, giving specialised medical or surgical treatment for particular types of illnesses, disorders or injuries, giving advice on and applying preventive medicine methods and treatments.

Hospital bed numbers provide information on healthcare capacities, i.e. on the maximum number of patients who can be treated by hospitals. Hospital beds are those which are regularly maintained and staffed and immediately available for the care of admitted patients. These include: beds in all hospitals, including general hospitals, mental health and substance abuse hospitals, and other specialty hospitals: occupied and unoccupied beds. The statistics exclude surgical tables, recovery trolleys, emergency stretchers, beds for same-day care, cots for healthy infants, beds in wards which were closed for any reason, provisional and temporary beds, or beds in nursing and residential care facilities. They cover beds accommodating patients who are formally admitted (or hospitalised) to an institution for treatment and/or care and who stay for a minimum of one night in the hospital or other institution providing in-patient care. Curative care (or acute care) beds in hospitals are beds that are available for curative care; these form a subgroup of total hospital beds.

Output-related indicators focus on hospital patients and covers the interaction between patients and healthcare systems, namely in the form of the treatment received. Data in this domain are available for a range of indicators including hospital discharges of in-patients and day cases by age, sex, and selected (groups of) diseases; the average length of stay of in-patients; or the medical procedures performed in hospitals; the number of hospital discharges is the most commonly used measure of the utilisation of hospital services. Discharges, rather than admissions, are used because hospital abstracts for in-patient care are based on information gathered at the time of discharge. A hospital discharge is defined as the formal release of a patient from a hospital after a procedure or course of treatment. A discharge occurs whenever a patient leaves because of finalisation of treatment, signs out against medical advice, transfers to another healthcare institution or on death; healthy newborn babies should be included; transfers to another department within the same institution are excluded.

Context

Public regulation of the healthcare sector is a complex task, as the healthcare market is characterised by numerous market imperfections. EU Member States generally aim to balance the efficient use of resources with ensuring that healthcare provisions are available to all. There is no simple answer to the question of how much a country should spend on healthcare, as each of the Member States faces a different burden of disease, while populations have different expectations of what services their national healthcare systems should offer. Indeed, the amount of money needed to fund a healthcare system is a function of a large number of variables, the most obvious being the burden of disease requiring treatment – although there is no simple linear relationship between the burden of disease and the need for resources, as some conditions can be treated simply and at low cost while others may require a complex and expensive care.

The main consumers of healthcare are older people – a section of the European population that is growing rapidly, partly as a result of the baby-boom cohort reaching older age, but also because of continued increases in life expectancy. The likely increase in numbers of elderly persons will probably drive demand for more healthcare provision in the future, while medical advances are also likely to result in more and better treatments being available. Demand for healthcare is also likely to rise in the coming years in relation to long-term care provision (nursing and convalescence homes).

In addition, more patients are travelling across borders to receive treatment, to avoid waiting lists or to seek specialist treatment that may only be available abroad. The EU works towards ensuring that people who move across borders have access to healthcare anywhere within the Union. Indeed, healthcare systems and health policies across the EU are becoming more interconnected. This is not only a result of the movement of patients and professionals between countries, but may also be attributed to a set of common public expectations of health services across Europe, as well as more rapid dissemination of new medical technologies and techniques. On 2 July 2008, as part of a Renewed Social Agenda, the European Commission adopted a draft Directive on the application of patients’ rights to cross-border healthcare.