HealthDataNavigator Understand strengths and weaknesses of existing data bases and projects

Primary/Ambulatory Care

Primary care is the main point of contact of patients with healthcare systems. In the primary care setting, general practitionners and paramedics tend to endorse regulation functions, in particular by acting as gatekeepers and holding medical records. However, the role of primary care and its relationship to other healthcare settings differs from one country to another. Moreover, primary care is at the forefront of preventive medicine, a crucial element of public health. Providers of primary care represent between 20 and 30% of European countries' total expenditure on health.

Source: OECD Healthcare Financing Tables 2010

Health Status

Aggregate data

  • Estonia: The Health Statistics and Health Research Database collects and provides aggregate data on disease incidence and prevalence according to diagnosis, gender and age
  • Finland: The “Finnish Health Interview Survey 2000/2011” and the FINRISK survey administered by THL provide detailed information on self-perceived health, chronic diseases and mental conditions, life quality, health impairment in a periodically conducted survey. pfeil zu
  • France: Ecosanté IRDES, national longitudinal datasets from 1950 to 2010. There also exists a regional version of the same datasets which breaks down information local administrative units from 1968 onwards.
  • France: STATISS : demographics and healthcare provision at local level. Webpages hosted by the Ministry of Health offer a user-friendly mapping system.
  • Germany: Federal Health Reporting System- data on ambulatory procedures, operations, ect.
  • Israel: Central bureau of statistics, mortality and cause of death data – Aggregated data on adjusted and crude mortality rates by causes of death such as Diabetes, Tuberculosis, Cancer, etc. Causes of death derived from death certificates completed by the physician reporting the death and are coded according to ICD-10. Data is not separated by care provision.
  • Israel: Central bureau of statistics, 2009 Health survey data – Aggregated data on illnesses such as Hypertension, Diabetes etc. Data is not separated by care provision.
  • Israel: Weekly epidemiological reports by Epidemiology division in Israeli Ministry of health – Aggregated data on morbidity of disease that require notification to the authorities such as Smallpox, AIDS, and Hepatitis. Data collected from all care provisions hospitals and ambulatory care.  
  • Luxembourg: General Inspectorate of Social Security (IGSS)- the IGSS annual report has information on the human resources of the heath sector (doctors, health professionals, hospitals), and health spending.
  • United Kingdom: The NHS Information Centre provides data on health status aggregated by PCT.

Individual level data 

  • Austria: GAP-DRG (General Approach for Patient oriented Outpatient-based DRG) is a research data base with reimbursement data for outpatient services of sickness funds (social insurance) and Federal Ministry of Health (hospital data). pfeil zu
  • France: Baromètre santé surveys, by the National agency for health promotion and hazards prevention (INPES) since 1992. pfeil zu
  • France: ENTRED is the surveillance system on diabetes which surveyed 10000 people in two rounds (2001-2003 and 2007-2010). Health status of people with diabetes.
  • Israel: individual HMO administrative data. Person level data are collected by four HMOs and covers all Israeli citizens. Data elements are linked by unique identifier, and include information on member's health status, hospital services, pharmacy purchases, physician visits, laboratory tests and demographic data. pfeil zu
  • United Kingdom: The NHS Information Centre provides information for Patient Reported Outcome Measures from different pre and post-operative surveys.

Quality (valued outcomes)

Aggregate data

  • Finland: The Waiting list reporting system in THL provides region level statistics for waiting lists regarding primary care.
  • Finland: The SUHAT database in THL includes e.g. DMF indices in dental care.
  • France:  since 2009, quality indicators in general practice are measured for a pay for performance programme
  • Israel: The Israel national program for measuring care quality in the community [Hebrew] began as a cooperative effort between Ben Gurion University and the four Israeli HMOs, and was transferred to the Ministry of Health in 2004. To date, the program has developed 69 routinely measures of care quality in the clinical areas: diabetes, diseases of the heart and circulatory system, asthma, cancer screening, immunizations and podiatric medicine. The website is in Hebrew only.
  • United Kingdom: The Performance database of the Department of Health can provide aggregate information concerning waiting time statistics for: inpatient, outpatient, cancer waiting times and referral waiting times. Data is available at the aggregate level by PCT, SHA or NHS trusts. pfeil zu
  • United Kingdom: The Economic and Social Data Service collects survey data on patients’ experience in PCTs and in outpatient and accident and emergency departments in Acute Trusts. It also has survey data available on NHS staff views about working in their local NHS trust. Information is also available at the individual level.
  • United Kingdom: The NHS Information Centre collects and publishes yearly information on the Quality and Outcomes Framework. Additionally information is available also on general practice (including dental) complaints.
  • United Kingdom: The Quality of Outcomes Framework (QOF) database has very simple aggregate information of different quality indicators scores by practice. Very simple but allows evaluating practices. pfeil zu

Individual level data

  • Austria: GAP-DRG (General Approach for Patient oriented Outpatient-based DRG) is a research data base with reimbursement data for outpatient services of sickness funds (social insurance) and Federal Ministry of Health (hospital data). pfeil zu
  • Estonia: Individual administrative health service utilization data for any diagnosis are collected by the Health Insurance Fund since 2000 and it covers all population. Data elements are linked by unique identifier, and include information on hospital stays, physician visits, pharmacy purchases and all health care services provided as well as costs related to these services. Certain service quality indicators can be developed from the existing data.
  • France: Health, Healthcare and Insurance Survey (ESPS), contains a couple of questions on the experience of patients relative to the last visits to a GP/specialist (waiting time, responsiveness). pfeil zu
  • France: Baromètre santé surveys hosted by the national agency responsible for health promotion and hazards prevention (INPES) have a component addressed to general practitioners and pharmacists, in which prevention, health promotion, patient education and screening are assessed. pfeil zu
  • France: ENTRED survey directed at people with diabetes has several questions on perceived quality of care by the patients, and healthcare system responsiveness, while a questionnaire addressed to medical practitioners informs on their practice style.
  • Germany:Patient Satisfaction Survey is a representative study in the outpatient care in Germany conducted by WINEG (Wissenschaftliches Institut der TK). pfeil zu
  • Germany: Europe survey (Europabefragung) conducted by WINEG in 2009, 2010 and 2012 on patient satisfaction with quality of cross-border outpatient care for German population. pfeil zu
  • Israel: Individual HMO administrative data - Person level data are collected by four HMOs and covers all Israeli citizens. Data elements are linked by unique identifier, and include information on hospital services, pharmacy purchases, physician visits and laboratory tests and demographic data. Quality measurements can be derived from the linked files. pfeil zu   
  • Israel: 2009 Health survey – The health survey is one of seven health surveys that been conducted in 1977, 1981, 1993, 1996/97, 1999/2000 and 2003/04. The surveys based on a sample of Israeli households contain data on services from which quality measurements can be derived. In these surveys there is also data on HMOs membership, primary and secondary physician visits, referral to paramedical therapists or alternative medicine practitioners, absence of work because of illness or accident, waiting for surgical operation, health insurance, etc.

Efficiency / Economy

Physical Inputs (infrastructure)

Aggregate data

  • Austria: Krankenanstalten in Zahlen (hospitals in figures): data is available on staff at ambulatory hospital care services [in German]
  • Austria: ÖGIS provides detailed information on almost all subsectors of the health care system (e.g. acute care hospitals, rehabilitation centres, care homes and nursing homes, practice-based physicians, mobile care services or ambulance service centres). pfeil zu
  • Estonia: The Health Statistics and Health Research Database Collects and provides aggregate data on health care resources, providers, personnel and expenditure.
  • Finland: THL collects data on health care personnel (numbers per employee category and average wages) in Finnish municipalities.
  • France: The INSEE website has a variety of studies and statistics available on ambulatory healthcare professionals' demographics and equipment.
  • France: Eco Santé IRDES data on healthcare supply, available at the national and regional levels; health professionals, pharmaceutical industry, community pharmacies, etc.
  • Israel: Occupational characteristics of Israeli Physicians [Hebrew]– Number of physicians in the Israeli health system. Include aggregated data by work area (hospitals, ambulatory etc.) and other demographic data. 
  • United Kingdom: The Office for National Statistics (ONS) has general data on PCTs and health care facilities as well as health care personnel and finance.

Individual level data

  • Estonia: Individual administrative health service utilization data are collected by the Health Insurance Fund since 2000 and it covers all population. Data elements are linked by unique identifier, and include information on hospital stays, physician visits, pharmacy purchases and all health care services provided as well as costs related to these services.
  • Israel: Individual HMO administrative data - Includes information on health care professionals (physicians, nurses etc.), type of employment, education, income etc. pfeil zu

Activity/Utilization

Aggregate data

  • Austria: Statistics Austria issues data on the frequency of consultations of practice-based physicians by age, gender and type of physician for the years 1991 and 1999
  • Austria:Krankenanstalten in Zahlen (hospitals in figures): data is available on ambulatory hospital care by number and frequency of patients [in German]
  • Estonia: The Health Statistics and Health Research Database collects and provides aggregate data on use of health care services, including primary and hospital care
  • Finland: SOTKAnet provides data on the frequency of consultations of primary care physicians and other personnel, all by region pfeil zu
  • Finland: Hospital benchmarking database (THL) (hospitals in figures): hospital, hospital specialty unit and regional level data is available for various indicators for activity/utilization: DRGs and outpatient visits. pfeil zu
  • France: Eco Santé IRDES at the national and regional levels, detailed information on outpatient activity (e.g. procedures, doctor visits)
  • Israel: Individual HMO administrative data – Maintained by the four different HMOs and includes utilization data such as visits to physicians and specialists. The data is also in aggregated by region, age, gender etc. pfeil zu
  • Israel: Central bureau of statistics, 2009 Health survey data – Aggregated data on physician and family doctors visits. Data includes comparisons by gender, socio-economic status, districts, etc.   

Individual level data

  • Austria: Ärztekostenstatistik (statistics on physicians’ cost) provides at Länder level and for each type of practice-based physician information on number of patients per quarter
  • Austria: The “Austrian Health Interview Survey 2006/07” provides detailed information on outpatient treatment, preventative treatment, medication pfeil zu
  • Austria: BIG (Buisness Intelligence in the health care system), a health data pool hosted by the Main Association of Austrian Social Security institutions, contains data on costs and utilization of prescriptions, hospital services and ambulatory care as well as financial information from sickness funds. pfeil zu
  • Estonia: Individual administrative health service utilization data are collected by the Health Insurance Fund since 2000 and it covers all population. Data elements are linked by unique identifier, and include information on hospital stays, physician visits, pharmacy purchases and all health care services provided as well as costs related to these services.
  • Finland: The Finnish Health Interview Survey “TERVEYS 2000/2011” and the FinRISK survey administered by THL provide detailed information on self-perceived health, chronic diseases and mental conditions, life quality, health impairment. pfeil zu
  • Finland: AVOHILMO (THL) provides data for all patient encounters within the publicly provided primary care (primary health care centers) in Finland since 2011. pfeil zu
  • France: Health, Healthcare and Insurance Survey (ESPS), contains detailed questions on healthcare utilization, health insurance, forgone care, etc. by socio-economic status pfeil zu
  • France: SNIIR-AM reimbursement database of the National Health Insurance Fund. Exhaustive data on ambulatory care consumption (consultations, diagnostic tests, technical procedures, pharmaceuticals). pfeil zu
  • Germany:WIDO Monitoring ( Wissenschaftliches Institut der AOK) contains data from surveys on integrated health care, supplementary insurance, participation in screening procedures, etc. pfeil zu
  • Israel: Individual HMO administrative data - Person level data are collected by four HMOs and covers all Israeli citizens. Data elements are linked by unique identifier, and include information on pharmacy purchases, physician visits and laboratory tests and demographic data. pfeil zu
  • United Kingdom: HES database contains details of all admissions to NHS PCTin England. It contains aggregate and individual information on outpatient appointments, clinical information about diagnoses and operations with information about the patient such as time waited and date of admission, geographical information on where the patient was treated and the area in which they lived. pfeil zu
  • United Kingdom: The Office for National Statistics (ONS) has general information on outpatient health care utilization. Additionally information is available on general practice services, dentistry services, maternity services and pharmacy services.

Cost and Expenditure

Aggregate data

  • Austria: Krankenanstalten in Zahlen (hospitals in figures) provides data on social insurance funded hospitals by region since 1985. Data covers total costs, personnel cost, cost for medication, cost for ambulatory and stationary care, cost per bed, day and stay [in Germa
  • Austria: Statistics Austria provides a table compatible with SHA tables showing main aggregates of private and public health expenditure and investment since 1990 by type of provider (inpatient, outpatient, long-term care)
  • Austria: Ärztekostenstatistik (statistics on physicians’ cost) provides at Länder level and for each type of practice-based physician information on number of patients per quarter, revenue per patient per quarter. Information on diagnoses is not available.
  • Estonia: The Health Statistics and Health Research Database collects and provides aggregate data on health care resources, providers, personnel and expenditure
  • Finland: THL provides a table compatible with SHA tables showing main aggregates of private and public health expenditure and investment and publishes periodically the list of national reference (unit) prices of all important health and social services.
  • Finland:SOTKAnet provides data on costs by region. Data covers total costs and cocst for primary care, hospital outpatient care and social care per capita.pfeil zu
  • Finland: The hospital benchmarking database (THL) contains hospital and hospital specialty level total operating costs pfeil zu
  • France:National Health Accounts are published every year by the research and statistics branch of Ministry (DREES), macrolevel data on main sources of healthcare financing and expenditure areas
  • Germany:Federal Health Reporting System provides reports on German health expenditures in outpatient and inpatient treatment/rehabilitation, pharmaceuticals, nursing care, health research, specific diseases with the possibility to compare expenditures internationally.
  • Israel: Israeli Ministry of Health, supervisions of HMOs and complementary health services department financial reports [Hebrew] - Annually reports on HMOs expenditures.
  • Israel: Central Bureau of Statistics, National expenditure on health – aggregated data on health expenditure by type of services of different sectors such as hospitals, HMOs etc.
  • United Kingdom: Data concerning number of staff, staff earnings, staff turnover and vacancies are available at the NHS Information Centre.
  • United Kingdom: The PSSRU holds data on unit costs of health and social care. Based on administrative data and considers all NHS costs.
  • United Kingdom: PESA collects outturn data, estimated outturn for the latest year and budgetary plans over the whole range of UK public expenditure.
  • United Kingdom: The Department of Health provides data on recurrent and non-recurrent NHS PCT allocations. This is administrative data available for all PCTs in England.

Individual level data

  • Austria: BIG (Buisness Intelligence in the health care system), a health data pool hosted by the Main Association of Austrian Social Security institutions, contains data on costs and utilization of prescriptions, hospital services and ambulatory care as well as financial information from sickness funds. pfeil zu
  • Estonia: Individual administrative health service utilization data are collected by the Health Insurance Fund since 2000 and it covers all population. Data elements are linked by unique identifier, and include information on hospital stays, physician visits, pharmacy purchases and all health care services provided as well as costs related to these services.
  • Finland: The hospital benchmarking database (THL) contains patient level bottom-up based cost accounting data for ca. 30% all hospital inpatient and outpatient care in the country. National DRG cost weights are based on these data. pfeil zu
  • France: SNIIR-AM reimbursement database of the National Health Insurance Fund. Public expenditure in the ambulatory setting and in private hospitals (fee for service payments), excluding private out-of-pockets payments pfeil zu
  • Israel: Individual HMO administrative data - Person level data are collected by four HMOs and covers all Israeli citizens. Data elements are linked by unique identifier, and include data on cost of hospital services, pharmacy purchases, physician visits and laboratory tests and demographic data. pfeil zu
  • United Kingdom: The British Household Panel Survey (BHPS) collects comprehensive information about consumption and particularly general expenditure on primary care health. pfeil zu

Access/Equity

Aggregate data

Individual level data

  • Austria: The “Austrian Health Interview Survey 2006/07” provides detailed information on socio-economic factors, such as income, occupation, education, citizenship and country of birth and contains information on outpatient treatment. pfeil zu
  • Austria: FoKo datasets ("Folgekosten-Datenbank") maintained by individual sick funds provide socio-demographic data (age, gender, occupation, income) as well as information on diagnoses and treatment in in- and outpatient care, on medication and on sick days. FoKo datasets are available for three federal provinces only and differ in scope as well as depth of information contained.
  • France: Health, Healthcare and Insurance Survey (ESPS),contains information on the socio-economic background (education, occupation) and income. Allows assessing the distribution of health status and consumption. pfeil zu
  • France: Enquête décennale de santé provides information on socio-economic background and income. pfeil zu
  • France: ENTRED survey directed at people with diabetes has several questions on income levels and financial barriers to access to healthcare by the patients
  • Germany: Kompetenznetz Diabetes Mellitus: a study on Impact of social disparities on type 2 diabetes prevalence and quality of diabetes care in Germany (SP22) using survey data Data from two nationally representative health examination surveys of the adult population carried out by the Robert Koch Institute (GNHIES98, DEGS).
  • Israel: Individual HMO administrative data - Person level data are collected by four HMOs and covers all Israeli citizens. Data elements are linked by unique identifier and can be used to measure access and equity. pfeil zu
  • United Kingdom: The Health Survey for England contains information on the socio-economic background (education, occupation and income). This allows evaluating the distribution of health status. pfeil zu
  • United Kingdom: The British Household Panel Survey (BHPS) has comprehensive information on the socio-economic background and income of the individuals. Information about their households is also available. pfeil zu

Health System Design and Context

Austria | Estonia | Finland | France | Germany | Israel | Luxembourg | United Kingdom

International Projects  & Data

Projects

De-Plan | EUPrimeCare | QualiCopc | HealthBasket

Data

WHO Global Health Observatory pfeil zu | OECD pfeil zu | SHARE pfeil zu

Mental Health 

Mindful pfeil zu | EuroBarometer pfeil zu

Cancer

EUROCARE pfeil zu  | IARC pfeil zu

Diabetes

Diabetes Atlas pfeil zu