European Commission - Public Health: healthindicators.org

DOCUMENTATION SHEET FOR:

Indicator: 73. Selected surgeries

SHORTLIST sub-division: D) Health interventions: health services

Status: implementation section

Date last modification documentation sheet: 09-08-2010

PDF version of documentation sheet

Operational indicators (Excel-file)

Definition

The number of surgical operations and procedures performed in hospitals, including day-cases as well as in-patient surgery, per 100,000 population, for eleven categories:

Calculation

The number of surgical operations and procedures performed in hospitals in a given year as day-cases or in-patient surgery (by ICD-9-CM), expressed as rates per 100,000 population (end of year population), for each selected category.

Relevant dimensions and subgroups

• Calendar year
• Country
• Region (according to ISARE recommendations; see data availability)
• Age groups (see data availability)

Preferred data type and data source

Preferred data type

Registers (administrative data sources, national hospital discharge registers)

Preferred data source

Eurostat

Data availability

Data from the 2009 and 2010 data collection, which are based on a new shortlist of procedures, are not published by Eurostat yet. Data currently available in Eurostat are based on an old procedures shortlist which does not comply with the ICD-9-CM codes of the new procedures shortlist which is followed by ECHI for this indicator (see remarks). Eurostat does not collect data on surgeries by age. The ISARE poject on regional data has not collected data on surgical procedures.

Data periodicity

So far data have been collected by Eurostat in 2009 and 2010.

Rationale

The volume of certain surgeries is a function of the prevalence of the underlying diagnosis and the availability of appropriate medical resources. It serves as an indicator for aspects of accessibility, up-to-date quality of care, costs and use.

Remarks

• Data currently available in Eurostat are based on an old procedures shortlist that Eurostat was using up until 2008. This procedure shortlist is no longer being updated by Eurostat.
• For the 2009 and 2010 data collection, Eurostat adopted a new procedure shortlist that was developed by the Hospital Data Project 2 (HDP2). The surgical procedures used in this ECHIM indicator are based on this new shortlist.
• Data have been collected by Eurostat in 2009 and 2010, but as yet have not been published.
• ECHIM would prefer age-standardized data, but as data are not being collected by age, this is not possible.
• From 2010 data collection on health care non expenditure data is made jointly with the OECD and WHO-Europe for human and physical resources. This joint questionnaire might be extended to include procedures and hospital patients.
• The methodology for the surgical procedures data may change as of the data collection round of 2011, pending on the outcomes of discussions of Eurostat, WHO and OECD that will take place in 2010.
• The selection of procedures in this ECHIM indicator was based on a reasonable mix of clinical importance and volume. Furthermore, procedure classifications are not standard across the EU, and therefore practical consideration of available data currently reported to Eurostat is also an important selection criterion. In case of multiple surgeries, only the main procedure performed on a patient during a hospital stay or day case treatment should normally be reported.
• An in-patient is a patient who is formally admitted (or 'hospitalised') to an institution for treatment and/or care and stays for a minimum of one night or more than 24 hours in the hospital or other institution providing in-patient care (source Eurostat metadata).
• Day-case: day care comprises medical and paramedical services (episode of care) delivered to patients who are formally admitted for diagnosis, treatment or other types of health care with the intention of discharging the patient on the same day. An episode of care for a patient who is admitted as a day-care patient and subsequently stays overnight is classified as an overnight stay or other in-patient case (source Eurostat metadata).

References

• Health Indicators in the European Regions (ISARE) project
• Hospital Data Project 2 (HDP2)
• Eurostat database, data based on old procedures shortlist that Eurostat was using until 2008. This procedure shortlist is no longer being updated by Eurostat
• Eurostat. Health care: resources and patients (non-expenditure data)
• Reference Metadata in Euro SDMX Metadata Structure (ESMS)
• Eurostat metadata Main surgical operations and procedures performed in hospitals (by ICD-9-CM)

Work to do

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