HealthDataNavigator Assess available data on different performance domains across various settings

Hospital/Inpatient Care

Secondary care essentially comprises of hospitals and medical specialists. Because this care setting is intensive in human and capital resources, it is the most costly for healthcare systems payers. Therefore, the issue of avoidable hospitalizations such as A&E is receiving increasing attention from regulators. Moreover, the current trend is to shift away as much hospital care towards other less expensive structures In most European healthcare systems, hospitals are currently financed on an activity-based diagnosis related group basis. However, new financing models are appearing  that introduce safety and quality incentives and aim at improving coordination between hospitals and other care-settings by bundling payments. Hospitals represent between 30% and 45 % of European countries' total expenditure on health.

Source : OECD Healthcare Financing Tables 2010

Health Status

Aggregate data

  • Austria: Statistisches Handbuch der österreichischen Sozialversicherung provides annual data on number and duration of hospital stays by type of sickness and type of insured person (active/inactive).
  • 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:SOTKAnet (THL) provides data on demographic variables and healthcare provision at regional level as well as epidemiological key themes (e.g. life expectancy, mortality, cancer incidence, self-reported health)
  • Germany: Federal Health Reporting System at the national and regional levels: detailed information on inpatient medical procedures, number of hospital admissions,average lengths of stay,patient movement, surgeries, fatal cases, etc.
  • 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:Visits to Emergency department report 2011 [Hebrew] – Provides aggregated data on death and diagnosis in the emergency department. 
  • 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 mortality rates aggregated by hospital.

Individual level data

  • Austria: DIAG-Extranet provides administrative as well as medical data on each hospital stay, i.e. main diagnosis and additional diagnoses (both based on ICD 10) pfeil zu
  • Austria: National Cancer Registry is a complete census of all cancer patients treated in hospitals pfeil zu
  • 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
  • Finland:Statistics Finland maintains records on the causes of death and mortality data pfeil zu
  • Finland: The national birth registry maintained by THL includes key information on all births
  • Finland:Finnish Cancer Registry is a complete census of all cancer patients. pfeil zu
  • Finland: THL hosts a database for a defined set of communicable diseases, reporting is mandatory for health care professionals
  • Finland: The “Finnish Health Interview Survey 2000/2011” and the FINRISK survey administered by THL provides detailed information on self-perceived health, chronic diseases and mental conditions, life quality, health impairment in a periodically conducted survey.pfeil zu
  • France: PMSI hospital database maintained by ATIH (Technical Agency for Hospital Information). Data on hospitals' activity by case mix, including patient level extended health status information. Data is available from 1996 for MCO database, covering medical, surgical and obstetrics wards —"médecine, chirurgie, obstétrique"; also provides data from 2006 for psychiatric wards and from 1999 for post-operative and rehabilitation wards. pfeil zu
  • Israel: National hospital services data: The Ministry of Health collects standard data elements, including dates of service, diagnoses and procedures for admissions, emergency room and outpatient clinic visits a aret Israeli hospitals. Patient and provider identity are masked, therefore these data are not available for linkage to other data sources, however, they provide important information on service utilization in Israel. pfeil zu
  • Israel: 2009 health survey data - The health survey is one of seven health surveys that has 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 hospitalization, waiting for surgical operation. In these surveys there are also data on influenza vaccination, absence from work because of illness or accident, primary and secondary physician visits, referral to paramedical therapists or alternative medicine practitioners, health insurance, HMOs membership etc.pfeil zu
  • Israel: Individual HMO's administrative data- Person level data are collected by four HMOs and coverall Israeli citizens. Data elements are linked by unique identifier, and include information on hospital services. In these databases there are also data on pharmacy purchases, physician visits and laboratory tests and demographic data.pfeil zu
  • Israel: The National Trauma Registry provides data on Israelis receiving hospital treatment for trauma, including demographic data, details on the nature of the injury, treatment received in the field, procedures, hospital course and condition at discharge since 1995. Collected and managed by Gertner Institute for Epidemiology and Health Policy Research. pfeil zu 

Quality (valued outcomes)

Aggregate data

  • Austria: Krankenanstalten in Zahlen (hospitals in figures) provides data on social insurance funded hospitals by region since 1985. Data on structural quality [in German]
  • Finland: The PERFECT reporting in THL  (hospitals in figures) provides data on regional and hospital level effectiveness (e.g. 1 year mortality) for a selection of patient/disease groups
  • Finland: The Waiting list reporting system in THL provides region level statistics for waiting lists regarding elective operations
  • Finland: SOTKAnet reports several indicators reflecting the quality/effectiveness of the health services e.g. cancer mortality and suicide rates, or the effectiveness of hospital services by different indicators developed in the PERFECT/EUROHOPE - projects pfeil zu
  • Israel:  Israel ministry of health, department of medical services research surveys - national surveys of the quality of care delivered in hospitals, with an emphasis on clinical outcomes such as nosocomial infections, postoperative complications, mortality and re-hospitalizations.
  • Israel:  Quality testing  [Hebrew] by Israel ministry of Health, Department of quality testing – aggregated data based on periodic planned quality testing in selected areas. Each year several areas are tested at the national level, in hospitals and in the community. Department publication includes aggregated data on quality test results in areas such as general surgery departments and hospitals preparation toward organ donation.
  • United Kingdom: The Care Quality Commission provides inpatient satisfaction measures for admission to hospital, hospital and ward, doctors, nurses, care and treatment, operations and procedures, leaving hospital and overall view of stay in hospital.
  • United Kingdom: The Economic and Social Data Service collects survey data on patients’ experience in accident and emergency departments in Acute Trusts.
  • United Kingdom: The NHS Information Centre collects and publishes yearly information on the Quality and Outcomes Framework by Hospital.

Individual level data

  • Austria: DIAG-Extranet provides data on patient information, diagnoses and treatments, date and type of discharge for social insurance funded hospitals: data on diagnoses available since 1989, on treatment since 1993, documentation of intensive care since 1998 pfeil zu
  • Austria: The “Patient Satisfaction Survey 2010/11” (carried out at Austrian hospitals) contains information on health status prior and after hospital stay, hospital admission, discharge and follow-up care as well as data on coordination between different health service providers pfeil zu
  • 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.
  • Finland: The Waiting list reporting system in THL contains information on observed waiting times and the persons waiting in elective operations
  • Finland: The national discharge register provides patient information including diagnoses and treatments for adverse effects, and deaths within a hospital or institution giving inpatient treatment.
  • Finland:Finnish Cancer Registry maintained by THL contains information on diagnoses and mortality pfeil zu
  • Finland:The Finnish Patient Insurance Centre handles the compensation procedures for patient injuries that occur in Finland and maintain a database which includes all these incidents.
  • France: PLATINES provides data, at hospital-level, on a set of safety and quality indicators (nosocomial infections, patient information, safety measures) and enables comparison between hospitals.
  • France:  ICALIN provides composite indicators at hospital-level on safety process and nosocomial infections.
  • Germany: German Endoprosthesis Register (EPRD) collects relevant patient data from AOK Statutory Health Insurance and medical records from some state Hospitals to Endoprosthetic surgical procedures in order to identify issues and improve quality of the procedure.
  • Germany:Quality assurance with routine data (QSR) measures quality of stationary care using anonymous administrative and hospital routine data of patients. QSR is a mutual project of AOK statutory health Insurance and HELIOS clinics, therefore only data of AOK insured patients are considered. pfeil zu
  • Germany: The Weisse Liste internet portal, a joint projectof the BertelsmannFoundation and theumbrella organizationof the largestpatient and consumerorganizations, represents outcomes of surveys on patient satisfaction with hospital services, nursing facilities and doctors. Survey is carried out in cooperation with AOK and BARMER GEK health insurance companies (in German only).
  • Israel: National hospital services data: The Ministry of Health collects standard data elements, including dates of service, diagnoses and procedures for admissions, emergency room and outpatient clinic visits to Israeli hospitals. Patient and provider identity are masked, therefore these data are not available for linkage to other data sources. Quality measures can be derived from data.pfeil zu 

Efficiency / Economy

Physical Inputs (infrastructure)

Aggregate data

  • Austria: Krankenanstalten in Zahlen (hospitals in figures) provides data on social insurance funded hospitals by region since 1985. Data is available on hospital beds, staff, number and types of hospitals
  • Austria: Statistics Austria provides data on health care staff in Austrian hospitals since 1980, number of hospitals and beds since 1985, by region
  • 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: Hospital benchmarking database (THL) collects the operating costs of all public hospitals divided into specialty unit level within a hospital. The operating costs can be divided into cost categories (e.g. capital and personnel costs)
  • Finland: THL collects data on health care personnel (numbers per employee category and average wages) in Finnish municipalities.
  • France: Statistique Annuelle des Etablissements, which is a complete census of public and private (for profit and not for profit) hospitals since 2004, provided by the Ministry of Health. The primary data source for hospital infrastructure and equipment. pfeil zu
  • France: STATISS presents regional and local level data on hospital and primary healthcare capacity, with preset tables enabling easy benchmarking between regions. Hosted by the Ministry of Health.
  • France: The INSEE website has a variety of studies and statistics available on hospitals and equipment
  • France: Eco Santé IRDES at the national and regional levels, information on hospital expensive technical equipment; private and public hospitals are covered.
  • Germany: The German Hospital Federation(DGK e.V.) website hosts statistics of hospital infrastructure including the number of private, not profit and for profit hospitals, hospital personnel, number of hospital cases, duration of hospital stay and etc.
  • Germany: The Federal Bureau of Statistics annually publishes a very detailed report to hospital statistics regarding hospital beds, patient movement, medical devices, hospital personnel and etc. Data is presented since 1991 and is available on regional level.
  • Israel:Registered hospital beds and stations publications [Hebrew] – Report by Israel ministry of health, information and computing department. Aggregated data on numbers of hospital beds, day hospitalizations, rehabilitation beds etc. updated December 2011.
  • 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 hospitals and health care facilities as well as health care personnel and finance.

Individual level data

  • Austria: DIAG-Extranet provides detailed information on staff and equipment in each Austrian hospital funded by the social insurance 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.
  • France: PLATINES ward-level information on hospitals, capacity and equipment with a few process quality indicators hosted by the Ministry of Health
  • Israel:Authorized Health professionals by Ministry of health [Hebrew] – Individual data on health professionals (physician, psychologist, dentist etc.) include data on city, licencing status, type etc.
  • United Kingdom: HES database contains details of all admissions and costs to NHS hospitals in England. It contains aggregate and individual information on inpatient admissions, outpatient appointments, clinical information about diagnoses and operations. pfeil zu

Activity/Utilization

Aggregate data

  • Austria: Statistics Austria issues data on hospital services and hospital discharges including average length of stay, all by region (data provided by Ministry of Health and Austrian Medical Association)
  • Austria: Krankenanstalten in Zahlen (hospitals in figures): data is available on type (hospital unit) and length of hospital stays
  • 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: Hospital benchmarking database (THL) (hospitals in figures): hospital, hospital specialty unit and regional level data is available for various indicators for activity/utilization: DRGs, bed-days, discharges,outpatient visits
  • Finland:SOTKAnet provides data on hospital discharges and bed-days, all by region pfeil zu
  • France: Eco Santé IRDES at the national and regional levels, detailed information on hospital activity (procedures, number of hospital admissions, average lengths of stay…); private and public hospitals are covered, long term and nursing care.
  • Germany:Federal Health Reporting System at the national and regional levels: detailed information on medical procedures, doctor visits, number of hospital admissions, hospital personnel, average lengths of stay, surgeries, etc.
  • Germany: Krankenhaus Barometer is an annual representative survey conducted in German hospitals since 2000 on current health policy and hospital policy issues. This survey is a project of a German Hospital Institute (DKI).
  • Israel:Inpatient Institutions and Day Care Units in Israel publications– by Israel ministry of health information and computing department. [Hebrew] . Annually aggregated data on hospitalization trends by type of hospitalization (general, mental health, extended illnesses and rehabilitation), and movement of patients by institutions and departments.
  • Israel: Central bureau of statistics, 2009 Health survey data – Aggregated data on hospitalization in general hospitals.
  • United Kingdom: The Performance database of the Department of Health provides information on hospital activity. Detailed information can be found for A&E admissions, Acute and Non acute delayed transfers of care, Bed utilisation, cancelled operations, diagnostics, referrals among others. pfeil zu
  • United Kingdom: The HES database contains details of all admissions to NHS hospitals in England. It contains aggregate and individual information on inpatient admissions, 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 inpatient and outpatient health care utilization. Additionally information is available on general practice services, dentistry services, maternity services and pharmacy services.

Individual level data

  • Austria: DIAG-Extranet provides treatment and epidemiological data for social insurance funded hospitals: administrative (length of stay, in which ward etc.), patient (age, gender etc.) and medical data (main and additional diagnoses, selected treatments) 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 national discharge register and the hospital benchmarking database (THL) contain key inpatient and outpatient data abstractions from the operative systems in hospitals (length of stay, in which ward etc.), patient (age, gender etc.) and medical data (main and additional diagnoses, selected treatments).
  • 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
  • France: PMSI hospital database maintained by ATIH (Technical Agency for Hospital Information). Data on hospitals' activity by case mix (DRG system). Data is available from 1996 for MCO database, covering medical, surgical and obstetrics wards —"médecine, chirurgie, obstétrique"; also provides data from 2006 for psychiatric wards . pfeil zu
  • Israel: Individual HMO administrative data – The following person-level data are maintained by the four different HMOs-membership/demographic data, as well as utilization data on hospitals services, pharmacy purchases, physician visits and laboratory tests. pfeil zu
  • Israel: National hospital services data - Includes reports of all hospital encounters, including admissions, emergency room and outpatient clinic visits, and day hospitalizations. Data fields include encrypted patient identity number, provider, dateof admission, date of discharge, diagnoses and procedures. pfeil zu
  • Israel: 2009 health survey data - The health survey is one of seven health surveys that has 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 hospitalization, waiting for surgical operation. In these surveys there are also data on influenza vaccination, absence from work because of illness or accident, primary and secondary physician visits, referral to paramedical therapists or alternative medicine practitioners, health insurance, HMOs membership etc. pfeil zu 
  • Israel: The National Trauma Registry provides data on Israelis receiving hospital treatment for trauma, including demographic data, details on the nature of the injury, treatment received in the field, procedures, hospital course and condition at discharge, since 1995. Collected and managed by Gertner Institute for Epidemiology and Health Policy Research. pfeil zu 
  • United Kingdom: HES database contains details of all admissions to NHS hospitals in England. It contains individual information on inpatient admissions, 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

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
  • Estonia: The Health Statistics and Health Research Database collects and provides aggregate data on health care resources, providers, personnel and expenditure
  • Finland: The hospital benchmarking database (THL) contains hospital and hospital specialty level total operating costs
  • 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 costs for primary care, hospital care and social care per capita. 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: The Institute for Hospital Remuneration System ( Institut für das Entgeltsystem im Krankenhaus) is responsible for the introduction, development and maintenance of the new DRG-Payment System in German hospitals. The website contains information about the implementation of DRG-System in Germany, including the most resent DRG Remuneration Catalog.
  • Germany: Federal Health Reporting System provides reports on German health expenditures in inpatient treatment/rehabilitation, nursing care with the possibility to compare expenditures internationally.
  • Germany:G-DRG-Report Browser is a free database with detailed calculation results per MDC (major diagnostic category) and DRG in 2010/2012 on number of cases, length of stay, costs, age and gender breakdown, etc. The database is provided by Institut für das Entgeltsystem im Krankenhaus (The Institute for Hospital Remuneration System). pfeil zu
  • Israel:Annual finance analysis of the government medical centers [Hebrew] by Israel Ministry of Health, accountancy department.  Aggregated data on income and expenditures of hospitals.
  • Israel:Central Bureau of Statistics, National expenditure on health.  Aggregated data on health expenditure by type of services and operating 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 Kinhgdom: 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.

Individual level data

  • Austria: DIAG-Extranet provides data for social insurance funded hospitals: total costs, personnel cost, cost for medication, cost for inpatient care including hospital outpatient care, cost per bed, day and stay 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 hospital benchmarking database (THL) contains patient level bottom-up based cost accounting data for c. 30% all hospital inpatient and outpatient care in the country. National DRG cost weights are based on these data.
  • France: Etude Nationale des Coûts (National Costs Study): patient level cost data from about 90 volunteer public and private hospitals. It is used to calculate DRG cost-weights. pfeil zu
  • France: SNIIR-AM reimbursement database of the National Health Insurance Fund. Includes information on public expenditure in private hospitals (fee for service payments), excluding private out-of-pockets payments pfeil zu
  • France: PMSI hospital database maintained by ATIH (Technical Agency for Hospital Information). Data on hospitals' activity by case mix (DRG system). Data is available from 1996 for MCO database, covering medical, surgical and obstetrics wards —"médecine, chirurgie, obstétrique"; also provides data from 2006 for psychiatric wards. pfeil zu
  • Israel: Individual HMO administrative data - The following person-level data are maintained by the four different HMOs- membership/demographic data as well as cost of  hospital services, pharmacy purchases, physician visits and laboratory tests. pfeil zu
  • United Kingdom: The British Household Panel Survey (BHPS) collects comprehensive information about consumption and particularly general expenditure on health. pfeil zu

Access/Equity

Individual level data

  • 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 all federal provinces but differ in scope as well as depth of information contained.
  • Finland: THL administers research datasets which combine socio-demographic data (age, gender, occupation, income) as well as information on diagnoses and treatment in in- and outpatient care
  • France: Enquête décennale de santé provides information on socio-economic background and income. pfeil zu
  • Israel:  Health survey data 2009 - The health survey is one of seven health surveys that have 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 hospitalization, waiting for surgical operation and demographic data. pfeil zu
  • Israel: Individual HMOs 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. In these databases there are also data on pharmacy purchases, physician visits and laboratory tests and demographic data.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

HealthBasket | EurHOBOP | DuQue | EuroDRG | euroHOPE

Data

Cancer

EUROCARE pfeil zu | IARC pfeil zu

Diabetes

Diabetes Atlas pfeil zu

Mental Health

Mindful pfeil zu | EuroBarometer pfeil zu | WHO pfeil zu

Various Diseases

EUROSTAT pfeil zu | WHO Global Health Expenditure Database pfeil zu | OECD pfeil zu | SHARE pfeil zu