Healthcare resource statistics - technical resources and medical technology

Data extracted in August 2020.

Planned article update: February 2022.

Highlights

Relative to population size, France had the highest number of day care places in 2018 among the EU Member States, at 115 per 100 000 inhabitants.

In 2018, Hungary had the most intensive use of CT and MRI scanners among the EU Member States, with averages of 14 000 and 9 200 scans performed by each unit.

Relative to population size, in 2018 more PET (positron emission tomography) scans were performed in Denmark, Belgium and France than in any other EU Member State.

[[File:Technical resources and medical technology-interactive Health2020.xlsx]]

Use of imaging equipment — number of magnetic resonance imaging (MRI) scans, 2018

This article presents an overview of European Union (EU) statistics related to the availability of technical facilities as well as the availability and use of medical technology. The technical facilities presented include operating theatres and day care places, while the medical technology concerns a variety of equipment used for diagnostic imaging (for example, magnetic resonance imaging (MRI) units) and treatment (for example, radiation therapy equipment).

This article is one of a set of statistical articles concerning healthcare resources in the EU which forms part of an online publication on health statistics.

Full article

Availability of technical resources in hospitals

Table 1 provides information concerning the number of day care places in hospitals in 2018 for 18 of the 27 EU Member States. It should be noted that not all day care services are provided in hospitals and some may also be offered in other healthcare facilities, such as independent day care centres or ambulatory premises, but these are not covered by the data presented here. Among the Member States for which data are available, by far the highest number of day care places was recorded in France (77 300 places), followed by Germany (30 700; 2017 data), Spain (19 500) and Italy (13 700).

Table 1: Availability of technical resources in hospitals, 2018
Source: Eurostat (hlth_rs_tech)

Relative to population size, France had the highest number of day care places among the EU Member States

France also had the highest number of day care places in hospitals relative to population size, with 115 places per 100 000 inhabitants in 2018. Three other EU Member States reported more than 90 day care places per 100 000 inhabitants: Slovakia, Croatia and Latvia.

Table 1 provides further information on four specialisations for day care places in hospitals: note that the sum of the number of day care places for these four specialisations may not equal the total if the specialisation of all places cannot be determined. In 2018, day care places in hospitals in Germany (2017 data), Croatia and France were most likely to be for psychiatric care, while in Slovakia, Italy, Cyprus, Romania and Belgium day care in hospitals was mainly focused on surgical day care places (across the four specialisations for which data are shown). In Greece, more than three fifths of all day care places in hospitals were for oncology, in other words the treatment/care of cancer patients, while in Spain this share was nearly half.

Table 1 also provides information on the number of operating theatres in hospitals for 19 of the EU Member States. In 2018, relative to population size, the number of operating theatres in hospitals ranged from 5.5 per 100 000 inhabitants in Ireland to 12.4 per 100 000 inhabitants in Belgium and Greece, with Austria below this range (4.0 per 100 000 inhabitants) and France, Cyprus and Latvia above it (16.1, 16.6 and 16.6 per 100 000 inhabitants respectively).

Figure 1 shows the same ratio of the number of operating theatres in hospitals per 100 000 inhabitants, with a comparison between 2013 and 2018. The number of operating theatres relative to population size decreased in four of the EU Member States during this period (subject to data availability; see Figure 1): in Luxembourg and the Netherlands (2015-2018) the fall was relatively small, while in Czechia and France it was notably larger, both down 1.4 operating theatres per 100 000 inhabitants between 2013 and 2018. There was no change in the number of hospital operating theatres per 100 000 inhabitants in Portugal, while there was a relatively small increase in Italy (up 0.1 per 100 000 inhabitants). The availability of hospital operating theatres grew at a somewhat faster pace elsewhere. The most substantial increases were recorded in Latvia (where the number of operating theatres per 100 000 inhabitants rose from 12.9 to 16.6) and Cyprus (from 3.3 to 16.6 per 100 000 inhabitants; note that there is a change in coverage).

Figure 1: Technical resources — hospital operating theatres, 2013 and 2018
(per 100 000 inhabitants)
Source: Eurostat (hlth_rs_tech)

Availability of medical technology

Eurostat collects data concerning six types of medical technology, five of which are imaging equipment used for diagnosis (see Table 2), while one is for treatment (see Table 3).

Widespread increase in the availability of imaging equipment over several decades

The availability of equipment for diagnosis increased rapidly in most EU Member States over recent decades. For example, in Finland the number of computed tomography (CT) scanners in hospitals and providers of ambulatory health care was 135 in 2017, compared with just seven CT scanners some 37 years earlier (in 1980), while in Hungary the number of CT scanners increased from 3 to 92 between 1980 and 2018. In the 21 years between 1991 and 2018 the number of MRI units in hospitals and providers of ambulatory health care increased in Czechia from 2 to 110, while in the Netherlands it rose from 13 in 1990 to 225 in 2018. More recently, there has been a notable increase in the number of positron emission tomography (PET) scanner units; for example, their number increased in France from 9 in 1998 to 156 in 2018.

Relative to population size and subject to data availability (see Table 2 for data availability), Greece, Cyprus, Italy and Belgium (2017 data for gamma cameras and for mammography units) reported the most imaging equipment among the EU Member States in 2018; note that data are not available for one of the five types of imaging equipment in three of the Member States.

Table 2: Availability of medical technology — imaging equipment, 2018
Source: Eurostat (hlth_rs_equip)

Greece, Denmark, Bulgaria, Latvia, Germany (2017 data), Italy and Cyprus reported more than 3.0 CT scanners per 100 000 inhabitants in 2018 (see Figure 2 for data availability), while Hungary had the lowest number of scanners relative to its population (0.9 scanners per 100 000 inhabitants). Between 2013 and 2018, the availability of CT scanners increased by 0.7 units per 100 000 inhabitants in Greece and by 0.6 units per 100 000 inhabitants in Romania and Portugal (hospitals only). By contrast, there was a reduction in the number of CT scanners per 100 000 inhabitants in Estonia (note that there is a break in series), Malta, Austria, Sweden (hospitals only; 2015-2018), Finland (note that there is a break in series) and Luxembourg. Changes in this ratio reflect changes in the number of inhabitants as well as in the number of scanners.

Figure 2: Availability of imaging equipment — computer tomography (CT) scanners, 2013 and 2018
(per 100 000 inhabitants)
Source: Eurostat (hlth_rs_equip)

Germany, Greece, Italy, Finland, Austria and Cyprus each reported more than 2.0 MRI units per 100 000 inhabitants in 2018. By contrast, there were 0.5 MRI units per 100 000 inhabitants in Hungary (see Figure 3 for data availability). Between 2013 and 2018, the largest increases in the availability of MRI units were recorded in Greece and Germany (2013-2017), where the number of MRI units per 100 000 inhabitants rose by 0.6 units per 100 000 inhabitants. Luxembourg was the only EU Member State reporting a decrease for this ratio, although the reduction could be attributed to an increase in the size of the population rather than a reduction in the number of actual units.

Figure 3: Availability of imaging equipment — magnetic resonance imaging (MRI) units, 2013 and 2018
(per 100 000 inhabitants)
Source: Eurostat (hlth_rs_equip)

Among the EU Member States (see Figure 4 for data availability), the highest number of gamma cameras relative to population size was recorded in Belgium (hospitals only; 2017 data), at 2.6 units per 100 000 inhabitants. With the exceptions of Denmark and Greece, the availability of gamma cameras in Belgium was more than twice as high as in any of the other Member States. Between 2013 and 2018 there were marginal increases of 0.1 gamma cameras per 100 000 inhabitants in Latvia and France (note that there is a break in series) and an increase of 0.2 per 100 000 inhabitants in Belgium (hospitals only; 2013-2017). The vast majority of Member States for which data are available recorded almost no change in the availability of gamma cameras (changes of no more than +/-0.2 units per 100 000 inhabitants), although there was a larger reduction recorded in Luxembourg where the ratio in 2018 was 0.3 per 100 000 inhabitants lower than in 2013.

Figure 4: Availability of imaging equipment — gamma cameras, 2013 and 2018
(per 100 000 inhabitants)
Source: Eurostat (hlth_rs_equip)

Greece (6.6 mammography units per 100 000 inhabitants) and Cyprus (5.5 mammography units per 100 000 inhabitants) reported the highest number of mammography units relative to population size in 2018, while the number of mammography units was also relatively high — within the range of 3.1-3.7 units per 100 000 inhabitants — in Belgium (2017 data), Croatia, Italy, Malta and Bulgaria (see Figure 5 for data availability). By contrast, there were fewer than 1.0 mammography units per 100 000 inhabitants in Romania and France (hospitals only). The largest increases in the availability of mammography units between 2013 and 2018 were recorded in Greece and Cyprus, while the largest decrease was registered in Poland (note that there is a break in series).

Figure 5: Availability of imaging equipment — mammography units, 2013 and 2018
(per 100 000 inhabitants)
Source: Eurostat (hlth_rs_equip)

In 2018, PET scanners were generally the least widely available of the six types of imaging equipment presented in this article. In absolute terms (see Table 2 for data availability), Italy had the most PET scanners, some 210 units, followed by France (156) and Germany (126; hospitals only; 2017 data). In 2018, relative to population size (see Figure 6 for data availability), Denmark reported 0.8 PET scanners per 100 000 inhabitants, while all of the other EU Member States for which data are available reported ratios of 0.5 units per 100 000 inhabitants or less. Between 2013 and 2018, the availability of PET scanners remained relatively unchanged in most of the Member States: the biggest changes were increases of 0.2 scanners per 100 000 inhabitants in the Netherlands and Denmark.

Figure 6: Availability of imaging equipment — PET scanners, 2013 and 2018
(per 100 000 inhabitants)
Source: Eurostat (hlth_rs_equip)

The final piece of medical technology presented in this article concerns radiation therapy equipment, as shown in Table 3. This type of treatment equipment was generally less commonly available than the previously discussed types of imaging equipment.

Table 3: Availability of treatment equipment — radiation therapy equipment, 2018
Source: Eurostat (hlth_rs_equip)

Belgium (hospitals only; 2017 data), Denmark, France (hospitals only), Slovakia, Finland and Ireland were the only EU Member States (see Figure 7 for data availability) to report at least 1.00 radiation therapy units per 100 000 inhabitants in 2018, while the lowest rates for this type of equipment were recorded in Portugal (hospitals only) and Romania, both with 0.4 units per 100 000 inhabitants. A majority (18) of the 26 Member States for which data are available reported an increase in their number of radiation therapy units relative to population size between 2013 and 2018. The highest increases were recorded in Cyprus and Bulgaria (where the biggest increase was recorded, an additional 0.5 radiation therapy units per 100 000 inhabitants). Germany (hospitals only; 2013-2017) and Romania recorded no change in this ratio. Among the six Member States that reported a decline for this ratio between 2013 and 2018, the reductions were relatively small, peaking at 0.1 units per 100 000 inhabitants in Sweden (hospitals only; 2015-2018), Croatia (note that the definition differs in 2013), Denmark and Slovakia.

Figure 7: Availability of treatment equipment — radiation therapy equipment, 2013 and 2018
(per 100 000 inhabitants)
Source: Eurostat (hlth_rs_equip)

Use of medical technology

Table 4 presents data on the use of three types of imaging equipment. In 2018, the largest numbers of scans, in absolute terms, for two of the three types of equipment were performed in France. For CT scanners, there were 13.1 million scans in France, with the next highest numbers in Germany (12.7 million; 2017 data), Italy (5.7 million) and Spain (5.6 million). For PET scanners, there were 607 000 scans in France, with Italy recording the next highest number, 338 000 scans. For MRI units, there were 12.3 million scans in Germany (2017 data) compared with 8.0 million scans in France, 4.5 million in Italy, and 4.3 million in Spain.

Table 4: Use of imaging equipment, 2018
Source: Eurostat (hlth_co_exam) and (hlth_rs_equip)

The number of CT scans relative to population size increased for all EU Member States

Relative to the size of their respective populations, the EU Member States with the highest number of CT scans in 2018 included Greece (21 400 scans per 100 000 inhabitants), Portugal (20 500 scans per 100 000 inhabitants; hospitals only), Belgium (20 200 scans per 100 000 inhabitants), Luxembourg and France (both 19 600 scans per 100 000 inhabitants). For the remaining Member States (see Figure 8 for data availability) this ratio ranged from 7 500 scans per 100 000 inhabitants in Bulgaria to 18 500 scans per 100 000 inhabitants in Denmark, with Finland and Romania (2016 data) below this range. Between 2013 and 2018, all of the Member States for which data are available reported an increase in the number of CT scans they conducted relative to the size of their respective populations. The largest increases — between 4 300 and 7 300 more scans per 100 000 inhabitants — were recorded in Denmark (note that there is a break in series), Hungary, Portugal (hospitals only) and Greece. Five Member States recorded increases of less than 1 000 CT scans per 100 000 inhabitants: Austria (2015-2018), Italy, Estonia (2015-2018), Luxembourg and Romania (2013-2016).

Figure 8: Use of imaging equipment — number of computed tomography (CT) scans, 2013 and 2018
(per 100 000 inhabitants)
Source: Eurostat (hlth_co_exam)

In 2018, the most intensive uses of CT scanners (as measured by the average number of scans per machine) were recorded in Hungary, Luxembourg and France; in each of these, the average number of scans performed by each CT scanner was at least 11 100, with a peak of 14 000 in Hungary (see Table 4 for data availability). By contrast, the least intensive use of CT scanner units was recorded in Bulgaria, Romania and Italy, where the average use that was made of each CT scanner in 2018 unit was less than 3 000 scans.

In 2018, the highest numbers of MRI scans relative to the size of the population were recorded in Germany (2017 data) and Austria, where the number of scans per 100 000 inhabitants was higher than 14 000. In France, Belgium, Spain, Denmark and Greece, there were between 8 300 and 12 000 MRI scans per 100 000 inhabitants (see Figure 9 for data availability). At the other end of the range, the lowest ratios were recorded for Bulgaria, Romania (2016 data) and particularly Cyprus (570 MRI scans per 100 000 inhabitants). Of the 25 EU Member States for which data are available (no data for Ireland and Sweden), there was generally an increase between 2013 and 2018 in the number of MRI scans conducted relative to population size; the only exceptions to this pattern were Cyprus, Luxembourg and Italy. By contrast, there were several EU Member States where the number of MRI scans relative to population size increased by more than 2 000 scans during the period under consideration — Spain, Slovakia, Austria (2015-2018), Lithuania, Germany (2013-2017), Malta, Denmark (break in series) and Greece — while the largest increases were recorded in France (an additional 3 000 scans per 100 000 inhabitants), Latvia (an additional 3 300 scans per 100 000 inhabitants) and Slovenia (an additional 3 400 additional scans per 100 000 inhabitants).

Figure 9: Use of imaging equipment — number of magnetic resonance imaging (MRI) scans, 2013 and 2018
(per 100 000 inhabitants)
Source: Eurostat (hlth_co_exam)

Hungary had the most intensive use of MRI scanners

The most intensive use of MRI units was in Hungary, where an average of 9 200 scans were performed by each MRI unit in 2018 (see Table 4 for data availability). This was more than 1 000 scans per unit higher than in Belgium, which recorded the second highest level of intensity (an average of 8 200 scans per unit). At the other end of the range, Cyprus made the least intensive use of its MRI scanners in 2018, as each unit was used on average 276 times, considerably less often than in Bulgaria (1 200 scans per unit) which had the second lowest average.

Relative to population size the most PET scans were performed in Denmark, Belgium and France

In 2018, Denmark, Belgium and France recorded by far the highest numbers of PET scans per 100 000 inhabitants among the EU Member States (see Figure 10 for data availability), with averages of 1 024, 912 and 906 scans per 100 000 inhabitants respectively; the next highest ratio was 646 PET scans per 100 000 inhabitants in the Netherlands. The use of PET scans was particularly low in relative terms in Finland, Lithuania, Romania and Slovenia, where there were fewer than 100 scans per 100 000 inhabitants; note that Cyprus did not have any PET scans.

Figure 10: Use of imaging equipment — number of PET scans, 2013 and 2018
(per 100 000 inhabitants)
Source: Eurostat (hlth_co_exam)

As well as having some of the highest numbers of PET scans relative to their populations, France and Denmark were also among the EU Member States whose number of PET scans increased at the most rapid pace between 2013 and 2018. Data are available for 22 of the Member States (see Figure 10 for data availability) with the number of scans per 100 000 inhabitants increasing by 420 per 100 000 inhabitants in France and 397 per 100 000 inhabitants in Denmark. The number of scans relative to population size also increased for each of the remaining Member States for which data are available.

The most intensive use of PET scanners was in France, where an average of 3 900 scans were performed by each PET scanner in 2018 (see Table 4 for data availability); PET scanners were also used relatively intensely in Belgium, Czechia and Luxembourg (an average of 3 000 to 3 500 scans for each unit). In Estonia, Finland, Germany (hospitals only; 2017 data) and Slovenia, each PET scanner was used, on average, for less than 500 scans during the course of 2018. Cyprus had the lowest use of PET scanners as there were no scans, although one PET scanner was recorded in 2017 and 2018 (none having been recorded in earlier years).

Data sources

Key concepts

Operating theatres (also known as operating rooms or suites) are hospital facilities for conducting surgical procedures in a sterile environment.

Day care does not involve an overnight stay. By contrast to in-patient and out-patient care, day care comprises planned medical and paramedical services delivered to patients who have been formally admitted for diagnosis, treatment or other types of health care but with the intention to discharge the patient on the same day. While day care patients are formally admitted, out-patients are not formally admitted.

Day care places in hospitals include the number of day care beds and seats in hospitals. Four types of specialisation of day care places are presented: surgical day care places; oncological day care places; psychiatric day care places and geriatric day care places. The sum of the number of day care places for these four specialisations may not equal the total if the specialisation of all places cannot be determined.

Computed tomography scanners (CT or CAT units) are machines which combine many X-ray images with the aid of a computer to generate cross-sectional views and, if needed, three-dimensional images of the internal organs and structures of the body.

Magnetic resonance imaging units (MRI units) visualise internal structures of the body using magnetic and electromagnetic fields which induce a resonance effect of hydrogen atoms from which images of the body structures can be produced.

Positron emission tomography scanner units (PET scanners) use short-lived radioactive substances for highly specialised imaging. This produces three dimensional images which are used mainly for the assessment of cancer spread in a patient’s body.

Gamma cameras (including single photon emission computed tomography, SPECT) are used for a nuclear medicine procedure in which a camera rotates around the patient to register gamma ray emissions from an isotope injected to the patient’s body. The gathered data are processed to form a cross-sectional (tomographic) image.

Mammography units include only dedicated mammography machines, in other words those designed exclusively for taking mammograms.

Radiation therapy equipment includes machines providing medical treatment through the use of X-rays or radionuclides, for example linear accelerators, Cobalt-60 units, high dose and low dose rate brachytherapy units; these units often form part of the treatment for cancer patients.

Healthcare resources and activities

Statistics on healthcare resources (such as technical resources and medical technology) are documented in this background article which provides information on the scope of the data, its legal basis, the methodology employed, as well as related concepts and definitions.

The data on the availability of medical technology and of imaging equipment concern equipment in hospitals and in ambulatory health care facilities. For some EU Member States, notably Portugal and Sweden, the data only cover the availability of this equipment in hospitals; for particular types of equipment and/or their use this is also the case for Belgium, Germany and France as well as for the United Kingdom and Switzerland.

More detailed country specific notes on this data collection, please refer to these background information documents:

Symbols

Note on tables:

  • a colon ‘:’ is used to show where data are not available;
  • a dash ‘–‘ is used to show where data are not applicable/relevant.

Context

Developments in medical techniques and technologies impact on medical diagnosis and treatment. The data on medical technology presented in this article concern equipment for diagnosis or treatment. After the discovery of X-rays, there was a relatively rapid transition before they started to be used for medical diagnosis of internal organs and body structures. Technological advances have subsequently led to the introduction of various other diagnostic devices, such as gamma cameras (developed to detect tumours) or ultrasound images. These were followed, among others, by PET scanners, MRI equipment and CT scanners.

One issue associated with the X-rays (and gamma rays) used in several of these types of equipment is exposure to ionising radiation, as this carries a risk of developmental problems and cancer. By contrast, MRI scans use magnetic and electromagnetic fields, rather than X-rays, and so avoid these risks. The European core health indicators (ECHI) shortlist includes indicators on medical technologies for MRI and CT units in the chapter on health services.

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Health care (t_hlth_care)
Health care (hlth_care)
Health care resources (hlth_res)
Health care facilities (hlth_facil)
Technical resources in hospital (hlth_rs_tech)
Medical technology (hlth_rs_equip)