European Commission - Public Health: healthindicators.org

Physicians employed

Definition of indicator

Number of physicians per 100.000 population. Divided into sub-categories of:

i) practising, ii) professionally active, iii) economically active and iv) licensed to practice.

Calculation (numerator, denominator)

The indicator is calculated as the ratio of physicians (practising, professionally active, economically active, licensed to practice) per 100.000 population.

EU Member States use different concepts for reporting the number of health care professionals - both for national purposes and for international comparison. In the context of comparing health care services across Member States, Eurostat gives preference to the concept "immediately serving patients", as it best describes the availability of health care resources. Not all Member States are currently able to provide data based on this definition. Detailed information on which specific definitions are used in MS is provided in the NewCronos database.

The data for physicians presented here refers to: “Definitions and data collection specifications on health care statistics (non-expenditure data) Version 31 July 2007” (http://circa.europa.eu/Public/irc/dsis/health/library?l=/methodologiessandsdatasc/health_care/estat-oecd-definitions-c/_EN_1.0_&a=i )

PHYSICIANS

Physicians (medical doctors) as defined by ISCO 88 (code 2221) apply preventive and curative measures, improve or develop concepts, theories and operational methods and conduct research in the area of medicine and health care.

Practising physicians provide services directly to patients. Practising physicians' tasks include: conducting medical examination and making diagnosis, prescribing medication and giving treatment for diagnosed illnesses, disorders or injuries, giving specialized medical or surgical treatment for particular types of illnesses, disorders or injuries, giving advice on and applying preventive medicine methods and treatments.

Inclusion

• Persons who have completed studies in medicine at university level (granted by adequate diploma) and who are licensed to practise.
• Interns and resident physicians (with adequate diploma and providing services under supervision of other medical doctors during their postgraduate internship in a health care facility).
• Salaried and self-employed physicians delivering services irrespectively of the place of service provision.
• Foreign physicians licensed to practise and actively practising in the country.

Exclusion

• Students who have not yet graduated.
• Dentists and stomatologists / dental surgeons.
• Physicians working in administration, research and in other posts that exclude direct contact with the patients.
• Unemployed physicians and retired physicians.
• Physicians working abroad.

Professionally active physicians are practising physicians plus other physicians for whom their medical education is a prerequisite for the execution of the job.

Please note: OECD does not collect this item.

Inclusion

• Physicians who provide services directly to patients.
• Physicians conducting research into human disorders and illness and preventive and curative methods.
• Physicians participating in the development and implementation of public health laws and regulations for safeguarding and promoting health of a community.
• Physicians preparing scientific papers and reports.
• Other jobs that require a medical education (administration and management).

Exclusion

• Physicians who hold a post / job under which medical education is not required.
• Unemployed physicians and retired physicians.
• Physician working abroad.

Economically active physicians are practising physicians, professionally active physicians as well as physicians who do not use their medical education for the purpose of their actual job.

Please note: OECD does not collect this item.

Eurostat currently does not collect data for this definition; the definition is rather provided for completeness.

Inclusion

• Physicians who provide services directly to patients.
• Physicians for whom their medical education is a prerequisite for the execution of the job.
• Physicians for whom their medical education is NOT a prerequisite for the execution of the job (e.g. taxi driver).

Exclusion

• Unemployed physicians and retired physicians.
• Physicians working abroad.

Physicians licensed to practise are practising physicians, professionally active and economically active physicians as well as all physicians being registered and entitled to practise as health care professionals.

Please note: OECD does not collect this item.

Inclusion

• Physicians who provide services directly to patients.
• Physicians for whom their medical education is a prerequisite for the execution of the job.
• Physicians for whom their medical education is NOT a prerequisite for the execution of the job (e.g. taxi driver).
• Physicians registered as health care professionals and licensed to practise but who due to various reasons are not economically active in the country (e.g. unemployed or on retirement).
• Physicians working abroad.

General practitioner (GP) is a physician (medical doctor) who does not limit his/her practice to certain disease categories and assumes the responsibility for the provision of continuing and comprehensive medical care or referring to another health care professional. In some countries, GP is treated as a specialisation.

Additional underlying concepts

Absolute number of posts (PP) versus number of full time equivalent (FTE) posts. The number of working hours per week varies between countries, but normally should not be less than 35 hours. The number of FTE should be calculated by adding the full and appropriate proportion of part-time occupied posts.

Relevant dimensions (subgroups)

Country, region, calendar year

Preferred data sources

As of 2005 Eurostat, OECD and WHO collect data on resources for health care services with a common questionnaire. The data collection is performed under a “gentlemen’s agreement” as there is no legal framework for the delivery of health care data to European institutions.

Rationale

Indicator widely used in assessments of accessibility and/or efficiency of health care services. It describes staff needs for the whole country and the distribution of staff across the country. Time trends may help to identify eg. staff shortages due to migration.

Data availability, quality and periodicity

Eurostat, OECD and WHO annually collect data on health care statistics (non-expenditure data). However, the timing, variables and indicators as well as countries covered by the different data collections vary. The aim is to provide common definitions for a set of nonexpenditure data regularly collected by Eurostat, OECD and WHO. Definitions specified in the section “Calculation of the indicator” relate to the data collection on: health employment ('manpower').

OECD reports figures per 1000 (head counts).

References

- Definitions and data collection specifications on health care statistics (non-expenditure data)

Work to do

• The WP Indicators should decide, which of the above listed grouping is relevant for the ECHI shortlist. The ECHIM group recommends practising physicians. Is it so?
• Head count or FTE? WHO also has data for: Physicians, full-time equivalent (FTE). FTE if possible. But seldom available?
• Check Manpower project?