Healthcare resource statistics - technical resources and medical technology

Data extracted in July 2018.

Planned article update: August 2019.

Highlights

In 2016, Hungary had the most intensive use of MRI scanners among the EU Member States, with an average of 10 600 scans performed by each MRI unit.

Relative to population size, in 2016 more PET (positron emission tomography) scans were performed in Belgium and Denmark than in any other EU Member State.

Use of imaging equipment — number of magnetic resonance imaging (MRI) scans, 2016

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 for 17 of the 28 EU Member States in 2016. 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 those Member States for which data are available, by far the highest number of day care places was recorded in France (75 000 places), followed by Germany (29 000), Spain (18 000), Italy (16 000; 2015 data) and the United Kingdom (15 000).

Table 1: Availability of technical resources in hospitals, 2016
Source: Eurostat (hlth_rs_tech)

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

Relative to population size, the number of day care places in hospitals was highest in France, with 112 places per 100 000 inhabitants in 2016. Three other EU Member States reported more than 80 day care places per 100 000 inhabitants: Croatia, Slovakia 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 2016, most day care places in hospitals in Germany, France and Croatia were for psychiatric care, while in Belgium, Italy (2015 data), Romania and Slovakia day care in hospitals was mainly focused on surgery (across the four specialisations for which data are shown). In Spain, almost half of the total number of day care places in hospitals were for oncology, in other words the treatment/care of cancer patients.

Table 1 also provides information on the number of operating theatres in hospitals for 19 of the EU Member States. In 2016, relative to population size, the number of operating theatres in hospitals ranged from 5.1 per 100 000 inhabitants in Ireland to 12.2 per 100 000 inhabitants in Greece, with Austria below this range (3.5 per 100 000 inhabitants) and Latvia and Cyprus above it (16.0 and 16.4 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 2011 and 2016. The availability of operating theatres relative to population size decreased in two of the EU Member States during this period: Czechia and Luxembourg (which recorded the largest reduction, equivalent to a fall of 1.3 operating theatres per 100 000 inhabitants). There was no change in the number of hospital operating theatres per 100 000 inhabitants in the United Kingdom, while there were marginal increases in Austria (note that the 2011 definition differs) and Italy (2011-2015). The availability of hospital operating theatres grew at a somewhat faster pace elsewhere, while the most significant increases were recorded in Latvia, where the number of operating theatres per 100 000 inhabitants rose from 10.9 to 16.0 and from 2.8 to 16.4 per 100 000 inhabitants in Cyprus (2012-2016; note that there is a break in series); as a result, Latvia and Cyprus recorded the highest ratios among the EU Member States for this indicator.

Figure 1: Technical resources — hospital operating theatres, 2011 and 2016
(per 100 000 inhabitants)
Source: Eurostat (hlth_rs_tech)

Availability of medical technology

Eurostat collects data concerning eight types of medical technology, six of which are imaging equipment used for diagnosis (see Table 2), while two are 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 was 133 in 2016, compared with just seven CT scanners some 36 years earlier (in 1980), while in Hungary the number of CT scanners in hospitals and providers of ambulatory health care increased from 3 to 87 over the same period. In the 20 years between 1996 and 2016 the number of MRI units in hospitals and providers of ambulatory health care increased in Czechia from 11 to 90, while in the Netherlands it rose from 13 in 1990 to 218 in 2016. 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 139 in 2016.

Relative to population size and subject to data availability (see Table 2 for data availability), Greece (2013 data for angiography units), Cyprus, Italy (2015 data) and Finland (2015 data for gamma cameras) reported the most imaging equipment among the EU Member States in 2016; note that data are not available for all six types of imaging equipment in several of the Member States and data for angiography units refer to 2015 rather than 2016.

Table 2: Availability of medical technology — imaging equipment, 2015 or 2016
Source: Eurostat (hlth_rs_equip)

Denmark, Greece, Latvia, Germany, Bulgaria, Cyprus and Italy (2015 data) reported at least 3.0 CT scanners per 100 000 inhabitants in 2016 (see Figure 2 for data availability), with 1.0 or fewer scanners per 100 000 inhabitants in the United Kingdom (2014 data) and Hungary. Between 2011 and 2016, the availability of CT scanners increased by 1.0 units per 100 000 inhabitants in Denmark and Belgium (hospitals only; note there is a break in series); there was however a reduction in the number of CT scanners per 100 000 inhabitants in Luxembourg and Malta (note there is a break in series), in part due to increases in the population but also due to a reduction in the absolute number of scanners.

Figure 2: Availability of imaging equipment — computer tomography
(CT) scanners, 2011 and 2016
(per 100 000 inhabitants)
Source: Eurostat (hlth_rs_equip)

Germany, Italy (2015 data), Greece, Finland, Austria and Cyprus each reported at least 2.0 MRI units per 100 000 inhabitants in 2016. By contrast, there were 0.4 units per 100 000 inhabitants in Hungary (see Figure 3 for data availability). Between 2011 and 2016, the largest increases in the availability of MRI units were recorded in Lithuania, Germany, Malta and France (note there is a break in series), where the number of MRI units per 100 000 inhabitants rose by 0.6 units. The Netherlands and Luxembourg were the only EU Member States reporting slight decreases for this ratio; however, the reductions could be attributed to an increase in population numbers, rather than a reduction in the number of actual units.

Figure 3: Availability of imaging equipment — magnetic resonance imaging
(MRI) units, 2011 and 2016
(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 in 2016 was recorded in Belgium (hospitals only), 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 2011 and 2016 there were increases of 0.2 gamma cameras per 100 000 inhabitants in Croatia (2012-2016) and France (note there is a break in series). 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 +/-0.1 units per 100 000 inhabitants), although there were larger reductions recorded in the Netherlands (down 0.2 gamma cameras per 100 000 inhabitants), Italy (2015 data), Belgium (both down 0.3; 2011-2015 for Italy; hospitals only for Belgium), Malta and Luxembourg (both down 0.5; note there is a break in series for Malta).

Figure 4: Availability of imaging equipment — gamma cameras, 2011 and 2016
(per 100 000 inhabitants)
Source: Eurostat (hlth_rs_equip)

Luxembourg and Croatia recorded the highest number of angiography units relative to their population size in 2015, 1.6 units per 100 000 inhabitants, closely followed by Finland (1.5 units per 100 000 inhabitants) and Italy (1.4 units). The lowest ratios of angiography units to population were recorded in Estonia (0.5 units per 100 000 inhabitants) and Romania (0.4 units). Between 2010 and 2015, the availability of angiography units increased in most of the EU Member States, with reductions in 6 of the 21 for which data are available (see Figure 5 for data availability), most notably in Finland (down 0.8 units per 100 000 inhabitants).

Figure 5: Availability of imaging equipment — angiography units, 2010 and 2015
(per 100 000 inhabitants)
Source: Eurostat (hlth_rs_equip)

Greece (6.2 mammography units per 100 000 inhabitants) and Cyprus (5.1 mammography units per 100 000 inhabitants) reported the highest number of mammography units relative to population size in 2016, while the number of mammography units per 100 000 inhabitants was also relatively high — within the range of 3.0-3.5 units per 100 000 inhabitants — in Malta, Italy (2015 data), Croatia, Finland and Bulgaria (see Figure 6 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 2011 and 2016 were recorded in Bulgaria and Greece, while the largest decreases were registered in Poland, Malta and Luxembourg (note there are breaks in series for Poland and Malta).

Figure 6: Availability of imaging equipment — mammography units, 2011 and 2016
(per 100 000 inhabitants)
Source: Eurostat (hlth_rs_equip)

In 2016, 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 185 units (2015 data), followed by France (139) and Germany (125; hospitals only). In 2016, relative to population size (see Figure 7 for data availability), Denmark reported 0.7 PET scanners per 100 000 inhabitants, while all of the other EU Member States for which data are available reported ratios of 0.4 units per 100 000 inhabitants or less. Between 2011 and 2016, 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 Denmark and Malta.

Figure 7: Availability of imaging equipment — PET scanners, 2011 and 2016
(per 100 000 inhabitants)
Source: Eurostat (hlth_rs_equip)

The final two pieces of medical technology presented in this article concern lithotriptors and radiation therapy equipment, as shown in Table 3. These two types of treatment equipment were generally less commonly available than the previously discussed imaging equipment.

Table 3: Availability of medical technology — treatment equipment, 2015 or 2016
Source: Eurostat (hlth_rs_equip)

In absolute terms, the highest number of lithotriptors among the EU Member States for which data are available (see Table 3 for data availability) was registered in Germany (326 units; hospitals only), followed by Poland (192 units) and France (132 units; hospitals only). Bulgaria (1.0 units per 100 000 inhabitants) and Belgium (0.9 units; hospitals only) reported the highest number of lithotriptors relative to their population size in 2015, while the lowest ratios — both fewer than 0.1 units per 100 000 inhabitants — were recorded in Finland (2016 data) and Latvia.

Between 2010 and 2015, the availability of lithotriptors (see Figure 8 for data availability) increased by 0.4 units per 100 000 inhabitants in Belgium (hospitals only) and by 0.2 units per 100 000 inhabitants in Cyprus and Malta. Finland (2010-2016), Luxembourg, France (hospitals only; note there is a break in series) and Portugal (hospitals only) recorded modest decreases in their number of lithotriptors per 100 000 inhabitants between 2010 and 2015, while Slovenia and Bulgaria (both down 0.2 units per 100 000 inhabitants; 2009-2015 for Slovenia; 2011-2015 for Bulgaria) recorded the biggest declines for this ratio.

Figure 8: Availability of treatment equipment — lithotriptors, 2010 and 2015
(per 100 000 inhabitants)
Source: Eurostat (hlth_rs_equip)

Belgium (hospitals only), Denmark, Slovakia, France (hospitals only) and Finland were the only EU Member States (see Figure 9 for data availability) to report more than 1.00 radiation therapy units per 100 000 inhabitants in 2016, while the lowest rates for this type of equipment were recorded in Portugal (hospitals only), Poland and Romania, all with 0.4 units per 100 000 inhabitants. A majority (20) of the 26 Member States for which data are available reported an increase in their respective number of radiation therapy units relative to population size between 2011 and 2016. The highest increases were recorded in Estonia, Belgium (hospitals only), Luxembourg, Bulgaria, the United Kingdom (note that there is a break in series) and Croatia (where the biggest increase was recorded, an additional 0.5 radiation therapy units per 100 000 inhabitants). Among the five Member States that reported a decline for this ratio between 2011 and 2016, the reductions were mostly relatively small, with losses at most 0.04 units per 100 000 inhabitants except in Malta where the loss was 0.3 units per 100 000 inhabitants, (note that there is a break in series).

Figure 9: Availability of treatment equipment — radiation therapy equipment, 2011 and 2016
(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 2016, the largest numbers of scans, in absolute terms, were performed in France for two of the three types of equipment. For CT scanners, there were 13.7 million scans in France), with the next highest numbers in Germany (11.7 million; 2015 data), the United Kingdom (5.6 million; hospitals only), Spain (5.1 million) and Italy (4.9 million). For PET scanners, there were 352 000 scans (hospitals only) in France, with Italy recording the next highest number, 301 000 scans. For MRI units, there were 11.1 million scans in Germany (2015 data), compared with 7.6 million scans in France, 4.1 million in Italy, 3.8 million in Spain and 3.7 million in the United Kingdom (hospitals only).

Table 4: Use of imaging equipment, 2016
Source: Eurostat (hlth_co_exam) and (hlth_rs_equip)

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

Relative to the size of their respective populations, the EU Member States with the highest number of CT scans in 2016 included Luxembourg (21 100 scans per 100 000 inhabitants), France (20 400 scans per 100 000 inhabitants and Belgium (20 000 scans per 100 000 inhabitants). For the remaining Member States (see Figure 10 for data availability) this ratio ranged from 6 000 scans per 100 000 inhabitants in Bulgaria to 17 900 scans per 100 000 inhabitants in Portugal (hospitals only), with Finland (2015 data) and Romania below this range. Between 2011 and 2016, nearly 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 highest increases — between 5 000 and 6 300 more scans per 100 000 inhabitants — were recorded in Slovakia, Portugal (hospitals only) and France. The largest decrease in the number of scans per 100 000 inhabitants was recorded in Greece (down 3 000 scans per 100 000 inhabitants between 2012 and 2016), with Italy (2013-2016) being the only other Member State to report a fall.

Figure 10: Use of imaging equipment — number of computed tomography
(CT) scans, 2011 and 2016
(per 100 000 inhabitants)
Source: Eurostat (hlth_co_exam)

In 2016, the most intensive uses of CT scanners (as measured by the average number of scans per machine) were recorded in Hungary, France and Luxembourg; in each of these, there were more than 11 000 scans performed by each CT scanner (see Table 4 for data availability). The least intensive use of CT scanner units was recorded in Bulgaria, Finland and Romania, each with an average of 2 200 scans per CT scanner or fewer.

In 2016, the highest numbers of MRI scans relative to population numbers were recorded in Germany (2015 data) and France, where the number of scans per 100 000 inhabitants was higher than 10 000. In Belgium, Luxembourg, Spain and Denmark, there were 8  000 - 9 000 MRI scans per 100 000 inhabitants (see Figure 11 for data availability). At the other end of the range, the lowest ratios were recorded for Bulgaria and Cyprus, below 1 000 scans per 100 000 inhabitants. Of the 25 Member States for which data are available, there was generally an increase between 2011 and 2016 in the number of MRI scans conducted relative to population size; the only exceptions to this pattern were Cyprus, the Netherlands, Greece (2012-2016) and Italy (2013-2016). By contrast, there were a few EU Member States where the number of MRI scans relative to population size increased by 2 000 - 2 800 scans — Slovenia, Lithuania, Slovakia (note that the 2011 definition differs) and Germany (2011-2015) — while the largest increases were recorded in Malta (and additional 3 146 scans per 100 000 inhabitants between 2012 and 2016 and in France (4 637 additional scans per 100 000 inhabitants).

Figure 11: Use of imaging equipment — number of magnetic resonance imaging
(MRI) scans, 2011 and 2016
(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 10 600 scans were performed by each MRI unit in 2016 (see Table 4 for data availability). This was considerably higher than in France, which recorded the second highest level of intensity (8 400 scans per unit). At the other end of the range, Cyprus made the least intensive use of its MRI scanners, as each unit was used on average 348 times during the course of 2016, considerably less often than in Bulgaria (1 068 scans per unit) which had the second lowest average.

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

In 2016, Belgium and Denmark recorded by far the highest numbers of PET scans per 100 000 inhabitants among the EU Member States (see Figure 12 for data availability), with averages of 910 and 764 scans per 100 000 inhabitants respectively; the next highest ratio was 526 PET scans per 100 000 inhabitants in France (hospitals only). The use of PET scans was particularly low in Lithuania, Romania, Slovenia and Cyprus, where there were fewer than 50 scans per 100 000 inhabitants; note that Cyprus did not have any PET scanning equipment.

Figure 12: Use of imaging equipment — number of PET scans, 2011 and 2016
(per 100 000 inhabitants)
Source: Eurostat (hlth_co_exam)

Between 2011 and 2016, Denmark and Belgium also recorded the largest increases in their number of PET scans relative to population size, up by 302 and 292 scans per 100 000 inhabitants respectively. The next highest increases in the use of PET scans during the period under consideration were registered in France (hospitals only) and Malta (2012-2016), while the number of scans relative to population size increased for each of the remaining Member States for which data are available (excluding Cyprus, where there was no change as a result of there being no PET scanning equipment).

The most intensive uses of PET scanners were in Hungary and France (hospitals only), where an average of 3 700 and 3 300 scans were performed by each PET scanner in 2016 (see Table 4 for data availability); PET scanners were also used relatively intensely in Czechia and Luxembourg where an average of 2 400 scans were made by each unit. In Estonia, Germany (hospitals only), Finland and Slovenia each PET scanner was used, on average, for less than 400 scans during the course of 2016.


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.

Digital subtraction angiography units (DSA units) combine pictures obtained before and after a contrast injection to create an accurate image of the cardiovascular system.

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

Lithotriptors (or shock-wave lithotripsy units; LSI units) are units that provide an extracorporeal shock wave to shatter kidney stones and gallstones.

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 concern equipment in hospitals and in ambulatory health care facilities. For some EU Member States, notably Belgium, Germany and Portugal, the data only cover the availability of this equipment in hospitals; for particular types of equipment this is also the case for France and Switzerland.

Data on the use of imaging equipment also concern units available in hospitals and in ambulatory health care facilities. Again, for some EU Member States (Germany, Ireland, Austria, Portugal and the United Kingdom) the data only cover hospitals, as is also the case for France for the use of PET scanners.

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

Note on tables: the symbol ':' is used to show where data are not available.

Note on tables: the symbol '–' is used to show where data are not applicable.

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