All Indicators of the 1st wave of the euHS_I survey (N=361)

 
ID Indicator name Source Explanatory Information

Access to Care

1 Share of population covered by health insurance A,B,D,E Percentage of population covered by i) Government/ social health insurance, ii) private health insurance.
2 Self-reported unmet need for medical care (total by reason: cost, waiting time, distance) A,B,D,E Disaggregated by sex, by age group (total, 18-64, 65+), by education level (ISCED 0-1, 2, 3-4, 5-6) and by income quintile. Proportion of persons with self-declared unmet needs for medical care services due to either financial barriers, waiting times or traveling distances.
3 At-risk adults without a routine doctor visit in past two years D Percent of adults age 50 or older, or in fair or poor health, or ever told they have diabetes or pre-diabetes, acute myocardial infarction, heart disease, stroke, or asthma who did not visit a doctor for a routine checkup in the past two years.
4 Self-reported unmet need for dental care (total by reason: cost, waiting time, distance) A,B,E Disaggregated by sex, by age group (total, 18-64, 65+), by education level (ISCED 0-1, 2, 3-4, 5-6) and by income quintile. Proportion of persons with self-declared unmet needs for dental care services due to either financial barriers, waiting times or traveling distances.
5 Out-of-pocket medical spending as a share of final household consumption A,B,D,E Out-of-pocket payments are expenditures borne directly by a patient where neither public nor private insurance cover the full cost of the health good or service. They include cost-sharing and other expenditure paid directly by private households and should also include estimations of informal payments to health care providers. Only expenditure for medical spending (i.e. current health spending less expenditure for the health part of long-term care) is presented here, because the capacity of countries to estimate private long-term care expenditure varies widely. Household final consumption expenditure covers all purchases made by resident households to meet their everyday needs such as food, clothing, rent or health services.
6 Percentage of households experiencing high levels/catastrophic of out-of-pocket health expenditures D,E nA (Percentage of households experiencing high levels of/ catastrophic out-of-pocket health expenditures using different thresholds by age and income quintiles).
7 Shares of out-of-pocket medical spending by services and goods B Services and goods include curative care, Dental care, Pharmaceuticals, Therapeutic appliances and Other
8 Private household out-of-pocket expenditure as a proportion of total health expenditure C,E Out of pocket expenditure is any direct outlay by households, including gratuities and in-kind payments, to health practitioners and suppliers of pharmaceutical, therapeutic appliances and other goods and service whose primary intent is to contribute to the restoration or enhancement of the health status of individuals or population groups. It is a part of private expenditure’.
9 Out-of-pocket payments as percentage of GDP, per capita E Out of pocket expenditure is any direct outlay by households, including gratuities and in-kind payments, to health practitioners and suppliers of pharmaceutical, therapeutic appliances and other goods and service whose primary intent is to contribute to the restoration or enhancement of the health status of individuals or population groups. It is a part of private expenditure’, expressed in following units: i) as percentage of GDP, ii) in PPS per capita.
10 Household final consumption expenditure per capita C Household spending is the amount of final consumption expenditure made by resident households to meet their everyday needs, such as: food, clothing, housing (rent), energy, transport, durable goods (notably, cars), health costs, leisure, and miscellaneous services. Household spending, including government transfers, is the actual individual consumption that it is equal to households' consumption expenditure plus those (individual) expenditures of general government and non-profit institutions serving households (NPISHs) that directly benefit households, such as, health care and education.
11 Informal payments to doctors D Mean response to question: Would patients be expected to make unofficial payments?
12 Geographic distribution of doctors: Physicians density in predominantly urban and rural regions B Density per 1 000 population
13 Access to acute care E Percentage of people who can REACH primary, emergency and materinity care services within 15/30 minutes
14 Percentage of preterm births delivered in maternity units without an on-site neonatal intensive care unit E nA
15 Patient mobility: non-resident people among all people being discharged from hospital A,D Absolute number / Percentage
16 Ambulance response times E Percentage of emergency ambulance callouts that arrive on the scene within the 15-minute standard
17 Waiting times for emergency department care D Percentage of patients who were treated within national benchmarks for waiting times for each triage category in public hospital emergency departments. The national benchmarks are: _ Resuscitation: immediate (within seconds) _ Emergency: within 10 minutes _ Urgent: within 30 minutes _ Semi-urgent: within 60 minutes _ Non-urgent: within 120 minutes. This is presented as a percentage.
18 Reported waiting times for General Practitioners care D,E Disaggregated by sex, age, income level. Percentage of patients who were given an appointment with a general practitioner for i) acute care: the same day or ii) routine care: within seven days
19 Reported waiting times for dental care E Percentage of patients who were given an appointment with a dentist for i) acute care: the same day or ii) routine care: within x days. Exact day range to be defined.
20 Reported waiting times for access to specialist (care) A,D,E No attempt was made to provide a single definition; instead following definitions are considered as examples: Waiting time of more than two weeks to get an appointment with a specialist (% of population asking an appointment). Waited 2 months or longer for specialist appointment (base: needed to see specialist in past 2 years) (by two income categories). Waiting time longer than 1 month for first contact in ambulatory mental health centre (% of pop with contact in ambulatory mental health centre). Waiting time, referral to treatment: Doctors report patients often experience long wait times to receive treatment after diagnosis (e.g. cancer treatment delays). Percentage of patients treated within 18 weeks
21 Reported waiting times for imaging tests D,E Doctors report patients often experience difficulty getting specialized tests (e.g., CT, MRI).
22 Waiting times for elective surgeries A,B,D,E Average inpatient waiting time for elective (i.e. non-urgent) surgeries of Percutanerous Transluminal Coronary Angioplasty (PTCA), hip replacement and cataract operation, measured in number of days. Elective surgery is defined as when surgery is necessary, but the timing of the procedure can be scheduled and the patient can be sent home.
23 Rate of patients with colorectal tumour receiving chemotherapy whose treatment started within two months following surgery E .
24 Medical records/test results did not reach doctor’s office in time for appointment, in past 2 years D Survey question.
25 Numbers of people awaiting donor organs E nA
26 Waiting times for admission to public rehabilitation facility and to public long-term care facility E Waiting times for admission to public rehabilitation facility ‘The denominator is the total number of patients referred for rehabilitation in a year under review who are accepted for a period of rehabilitation at RHKG. The numerator is the total number of patients actually transferred for rehabilitation at RHKG during the year under review. The median waiting time is from date of referral to date of transfer. Exclusion criteria: deceased patients while waiting and discharged patients while waiting.’ Waiting times for admission to public long-term care facility ‘The denominator is the total number of patients applying for government long term care during the year under review. The numerator is the total number of patients admitted to government long term care within 18 months from the date of application. The median waiting time is from date of application of long term care to date of admission. Exclusion criteria: deceased patients while waiting and patients withdrawing their application’.
27 Waiting times for home/social care services E Percentages of clients receiving home help services within one month of approval
28 Percentages of informal carers of people with dementia who receive timely psychosocial and practical support for their own needs E Informal carers taking part in the Informal Care Monitoring Study reported needing psychosocial and practical support for themselves.
29 Waiting times for terminal palliative care E The number of people waiting for i) institutional and/or ii) mobile palliative care in excess of a defined national standard of (6) x weeks.
30 Percentage of dialysis done outside of hospital/centre D Percentage of all Dialysis patients on peritoneal dialysis (PD) and hemodialysis (HD) in the home of patient.

Health Care Resources: Labour

31 Employment in human health and social work activities A,D Disaggregated by age, by educational attainment level, by NUTS regions. Employment in health and social work, NACE rev 2 Q. Number of employees between age 15 and 64.
32 Practising physicians A,B,C,D,E Practising physicians per 100,000 population by category (MD, dentists, pharmacists, physiotherapists, psychiatrists) and partly by age and sex Physicians by specialty per 100 000 population (GP, general paediatricians, obstetricians and gynaecologists, psychiatrists, medical group of specialists, surgical group of specialists).
33 Share of GPs in all physicians A,B,E Share of generalist medical practitioners in all physicians.
34 Shortage of doctors (physicians and dentists): vacancy rate A A job vacancy is defined as a newly created, unoccupied, or about to become vacant, post. The job vacancy rate (JVR) measures the proportion of total posts that are vacant expressed as a percentage as follows: JVR = number of job vacancies * 100 / (number of occupied posts + number of job vacancies).
35 Shortage of doctors (physicians and dentists): percentage of care not covered A nA
36 Medical graduates A,B,C,E Medical graduates are defined as the number of students who have graduated from medical schools in a given year.
37 Remuneration of doctors (general practitioners and specialists), ratio to average wage B The remuneration of doctors refers to average gross annual income, including social security contributions and income taxes payable by the employee. It should normally exclude practice expenses for self-employed doctors.
38 Practising qualified nurses and midwives A,B,C,E Practising qualified nurses and midwives, per 100,000 population
39 Nursing graduates B,C,E Nursing graduates refer to the number of students who have obtained a recognised qualification required to become a licensed or registered nurse. They include graduates from both higher level and lower level nursing programmes. They exclude graduates from Masters or PhD degrees in nursing to avoid double-counting nurses acquiring further qualifications.
40 Remuneration of nurses B The remuneration of nurses refers to average gross annual income, including social security contribu- tions and income taxes payable by the employee. It should normally include all extra formal payments, such as bonuses and payments for night shifts and overtime.
41 Ratio of nurses and midwives to physicians A,B,E Ratio of practicing nursing and caring professionals including midwives (Eurostat: hlth_rs_prsns) to the total number of practicing physicians
42 Shortage of nurses: vacancy rate A,E A job vacancy is defined as a newly created, unoccupied, or about to become vacant, post. The job vacancy rate (JVR) measures the proportion of total posts that are vacant expressed as a percentage as follows: JVR = number of job vacancies * 100 / (number of occupied posts + number of job vacancies).
43 Shortage of nurses: Percentage of care not covered A nA
44 Share of foreign-trained doctors A,B The data relate to foreign-trained doctors working in OECD countries measured in terms of total stocks. The OECD health database also includes data on the annual flows for most of the countries shown here, as well as by country of origin.
45 International migration of nurses A,B The data relate to foreign-trained nurses working in OECD countries measured in terms of total stocks. The OECD health database also includes data on the annual flows for most of the countries shown here, as well as by country of origin. The data sources in most countries are professional registries or other adminis- trative sources.

Health Care Resources: Capital

46 Hospital beds A,B,D,E The total number of hospital beds per 100,000 inhabitants. (total number, acute care, psychiatric care, long-term care)
47 Long-term care beds in institutions and hospitals B,D Number of nursing home and elderly care beds per 100 000 population 65+
48 Numbers of palliative care facilities E nA
49 Number of high-care hospices with a quality accreditation E nA
50 Medical technologies (CT/MRI) A,B,E Number of CT/MRI per 100,000 by provider (hopsital, ambulatory health care)
51 MRI/CT exams B Number of diagnostic exams per 1 000 population

Health Care Activities

52 Hospital utilization A,B,C,D,E Total, disaggregated by selected diagnoses. Hospital in-patient discharges / Standardized rate of hospitalization / Volume of admissions, selected diagnoses: The number of hospital in-patient discharges from all hospitals during a given calendar year, expressed per 100,000 population, by age group (0-64, 65+), by sex for selected diagnoses (ISHMT code 0000 = ICD-10 codes A00-Z99 excluding V,W,X & Y codes and healthy newborns Z38). Calculated and presented by the following 25 categories of the International Shortlist for Hospital Morbidity Tabulation (ISHMT). (Total (All Causes), Infectious and Parasitic Diseases, Neoplasms, Malignant Neoplasm of Colon, Rectum & Anus; Trachea / Bronchus / Lung; Breast; Uterus; Prostate; Diabetes Mellitus, Mental & Behavioural Disorders, Dementia, Mental and Behavioural Disorders due to Alcohol, Mood [Affective] Disorders, Diseases of the Nervous System/Circulatory/Respiratory System; AMI, Cerebrovascular Disease, COPD and Bronchiectasis, Asthma, Diseases of the Digestive System, Alcoholic Liver Disease, Diseases of the Musculoskeletal System & Connective Tissue, Diseases of the Genitourinary System, Injury, Poisoning & Certain Other Consequences of External Causes).
53 Crude productivity by health care professional type E Inpatient admissions per hospital doctor/nurse
54 Hospital day-cases, total and selected diagnoses A,E Hospital day cases total and for selected diagnoses (ISHMT code 0000 = ICD-10 codes A00-Z99 excluding V,W,X & Y codes and healthy newborns Z38), per 100,000 inhabitants: total population, by age group (0-64, 65+), by sex
55 Average length of stay (ALOS), total and selected diagnoses A,B,C,D,E Total population, for selected diagnoses; by type of care (acute, mental and rehabilitation hospitals) disaggregated by age group (0-64, 65+), by sex. In-patient average length of stay (in days) , for selected diagnose (ISHMT code 0000 = ICD-10 codes A00-Z99 excluding V,W,X & Y codes and healthy newborns Z38, e.g. cancers, AMI, normal delivery, ). Average length of stay (ALOS) is computed by dividing the total number of in-patient hospital days , in all hospitals, counted from the date of admission to the date of discharge by the total number of discharges (including deaths) in all hospitals during a given year. A hospital day (or bed-day or in-patient day) is a day, during which a person admitted as an in-patient, is confined to a bed and stays overnight in a hospital. Day-cases (patients formally admitted for a medical procedure or surgery in the morning and discharged before the evening) are excluded. Patients admitted with the intention of discharge on the same day, but who subsequently stay in hospital overnight, are included.
56 Bed days per capita D,E Total number of bed-days in acute, mental and rehabilitation hospitals during the year.
57 Turnover rate B The number of cases per available acute care bed.
58 Occupancy rate A,B,D,E The occupancy rate is calculated as the number of beds effectively occupied (bed-days) for curative care divided by the number of beds available for curative care multiplied by 365 days, with the ratio multiplied by 100. Occupancy rate = Total number of bed-days during the year / (Number of beds available * 365 days) * 100
59 General practitioner (GP) utilisation: self-reported visits / Number of doctor consultations A,B,E Disaggregated by age group (15+, 15-64, 65+), by sex, by educational level (ISCED class 0-2, 3-4, 5-6) and income level. Mean number of self-reported visits to general practitioner per person per year. Derived from EHIS questions HC10 and HC11. HC10: When was the last time you consulted a GP (general practitioner) or family doctor on your own behalf? (1) Less than 12 months ago /2) 12 months ago or longer / 3) Never) If HC10 is 1) HC11: During the past four weeks ending yesterday, that is since (date), how many times did you consult a GP (general practitioner) or family doctor on your own behalf? (number of times). Total number of contacts reported under HC11 is extrapolated from 4 to 52 weeks, and divided by the total number of respondents in the sample
60 Estimated number of consultations per doctor B Annual consultations per doctor
61 Selected outpatient visits, self-reported A,C,D,E a) Mean number of self-reported visits to a (dentist or orthodontist / medical or surgical specialist) per person by age group (15+, 15-64, 65+) and by education level (ISCED class 0-2, 3-4, 5-6) per year. B) Proportion of population by age group (15+, 15-64, 65+) and by education level (ISCED class 0-2, 3-4, 5-6) reporting to have had a contact with a psychologist or psychotherapist during the past 12 months
62 Dentist utilization: No regular contacts with dentist D,E Disaggregated by age group (15+, 15-64, 65+), by sex, by educational level (ISCED class 0-2, 3-4, 5-6) and income level. Percentage of population aged 3+ reporting no regular contacts with dentist: i) at least at 2 contacts on 2 different years over a three year period; ii) without a dental visit in the past year.
63 Ratio of outpatient to inpatient contacts A,E Disaggregated by age and sex. Ratio of the number of outpatient contacts with a physician (in a physician's office or at patient's home) excluding dentists consultations to the number of all hospital discharges (including day cases and inpatient cases).
64 Rate of school health checks D The number of school health checks performed per 1000 pupils by age group.
65 Percentage of self-referrals to A&E E nA
66 Operations per specialist A The number of operations any one provider is performing
67 Ambulatory surgery: Share of selected surgeries carried out as ambulatory cases B,D,E Share of cataract surgery and tonsillectomies carried out as ambulatory cases
68 Number of surgical operations and procedures A,B,D,E The number of surgical operations and procedures performed in hospitals, inpatient surgery, per 100,000 population, by sex, For following categories: PTCA (Percutaneous transluminal coronary angioplasty); Hip Replacement, Cataract, Tonsillectomy, Coronary Artery Bypass Graft, Laparoscopic Cholecystectomy, Repair of Inguinal Hernia, Caesarean Section, Total Knee Replacement, Partial Excision of Mammary Gland, Total Mastectomy, non-conservative breast surgery, Hysterectomy in uterine cancer, Hysterectomy without uterus cancer diagnosis, Adenoidectomy and/or tonsillectomy, Prostatectomy with prostate cancer/benign prostatic hyperplasia, Kidney transplants.
69 Caesarean section rates A,B,D,E Disaggregated by age and regional level. The caesarean section rate is the number of caesarean deliveries (emergency, elected, nulliparous term singleton vertex (NTSV) or low-risk group, high risk) performed per 100 live births.
70 Mode of delivery in the so-called nulliparous term singleton vertex (NTSV) or low-risk group E Percentage of spontaneous/induced/instrumental deliveries in the nulliparous term singleton vertex group
71 Abortion rates D,E Percentage of induced abortions (prior to nine completed weeks of pregnancy) per 1000 live births
72 GPs using an electronic medical file D,E Percentage of GP practices using electronic patient records for diagnostic data
73 ePrescriptions transacted on line D,E Number of completed ePrescription transactions during a calendar year, divided by the total number of residents
74 Doctors report time spent on administrative issues related to insurance or claims is a major problem D Survey question.

Health Expenditure and Financing

75 Total health care expenditure by all financing agents (total, public and private sectors) A,B,C,D,E Total health expenditure for total, public, and private sectors expressed in following units: i) in Purchasing Power Standard (PPS) per capita, ii) as percentage of gross domestic product (GDP), iii) in millions of Purchasing Power Standard (PPS). ‘Total expenditure on health measures the final consumption of health goods and services (i.e. current health expenditure, CHE) plus capital investment in health care infrastructure. This includes spending by both public and private sources on medical services and goods, public health and prevention programmes and administration. To compare spending levels between countries, per capita health expenditures are converted to a common currency (US dollar) and adjusted to take account of the different purchasing power of the national currencies, in order to compare spending levels’.
76 Current health care expenditure (CHE) by all financing agents (total, public and private sectors) A,B,E Current health expenditure (CHE) for total, public, and private sectors, expressed in following units: i) in Purchasing Power Standard (PPS) per capita, ii) as percentage of gross domestic product (GDP), iii) in millions of Purchasing Power Standard (PPS). Current health expenditure measures the final consumption of health goods and services without capital investment in health care infrastructure. This includes spending by both public and private sources on medical services and goods, public health and prevention programmes and administration. To compare spending levels between countries, per capita health expenditures are converted to a common currency (US dollar) and adjusted to take account of the different purchasing power of the national currencies, in order to compare spending levels’.
77 Public (current) health expenditure as share of total government expenditure A,B,C,E Public (current) health expenditure (general government health expenditure) as a percentage of total government expenditure (according to COFOG http://ec.europa.eu/eurostat/statistics-explained/index.php/Government_expenditure_on_health). The size of the public budget allocated to health.
78 Public current health expenditure as share of total current health expenditure A,B,D,E General government and social security funds (HF.1) current expenditure (HC.1 - HC.9), including long-term nursing care (HC.3), but excluding social services of long-term care (HC.R.6.1) and capital investment in health (HC.R.1); where total is defined as public and private expenditure on health, where private comprises of the categories: private sector (HF.2), rest of the world (HF.3) and not elsewhere classified (HF.0).
79 Gross fixed capital formation in the healthcare sector as a share of GDP B Gross fixed capital formation in the health care system is measured by the total value of the fixed assets that health providers have acquired during the accounting period (less the value of the disposals of assets) and that are used repeatedly or continuously for more than one year in the production of health services. The breakdown by assets includes infrastructure (e.g. hospitals, clinics, etc.), machinery and equipment (including diagnostic and surgical machinery, ambulances, and ICT equipment), as well as soft- ware and databases.
80 Publicly funded health care expenditure per employed person E Public health expenditures in relation to the number of people in employment (per national labour force). Numbers of employed persons according to the OECD definition of total civilian employment (not adjusted for international variations in working hours)
81 Health expenditure per capita in PPP (purchasing power parities) in relation to life expectancy at birth E nA
82 Health expenditure per capita in PPP (purchasing power parities) in relation to avoidable mortality E nA
83 Expenditure on curative-rehabilitative care by all financing agents (total, public and private sectors) A,B,E Expenditure on curative-rehabilitative care by all financing agents expressed in following units: i) % of current expenditure on health care, ii) in PPS per capita. Curative care' means the health care services during which the principal intent is to relieve symptoms or to reduce the severity of an illness or injury, or to protect against its exacerbation or complication that could threaten life or normal function. Rehabilitative care means the services to stabilise, improve or restore impaired body functions and structures, compensate for the absence or loss of body functions and structures, improve activities and participation and prevent impairments, medical complications and risks.
84 Expenditure on long-term care by all financing agents (total, public and private sectors) A,B,E Expenditure on long-term care by all financing agents expressed in following units: i) % of current expenditure on health care, ii) % of GDP, iii) in PPS per capita. Long-term health care comprises ongoing health and nursing care given to i) in-patients and ii) patients at home who need assistance on a continuing basis.
85 Expenditure for palliative care E nA
86 Expenditures on pharmaceuticals by all financing agents (total, public and private sectors) A,B,D,E Expenditure on pharmaceuticals/medical goods by all financing agents expressed in following units: i) % of public current expenditure on health care, ii) public as % of GDP, iii) in PPS per capita. Pharmaceutical expenditure covers spending on prescription medicines and self-medication, often referred to as over-the-counter products. In some countries, other medical non-durable goods are also included. Pharmaceuticals consumed in hospitals and other health care settings are excluded. Final expendi- ture on pharmaceuticals includes wholesale and retail margins and value-added tax. It also includes pharmacists’ remuneration when the latter is separate from the price of medicines. Total pharmaceutical spending refers in most countries to “net” spending, i.e. adjusted for possible rebates payable by manufac- turers, wholesalers or pharmacies.
87 Expenditure on preventive care by all financing agents (total, public and private sectors) A,B,E Expenditure on preventive care by all financing agents expressed in following units: i) % of current expenditure on health care, ii) in PPS per capita. Preventive care' means any measure that aims to avoid or reduce the number or the severity of injuries and diseases, their sequelae and complications. It is based on a health promotion strategy that involves a process to enable people to improve their health through the control over some of its immediate determinants. Interventions (both individual and collective) are included when their primary purpose is health promotion and if they occur before the diagnosis has been made.
88 Expenditure on health administration and health insurance by all financing agents (total, public and private sectors) A,B,D,E Expenditure on health administration and health insurance by all financing agents expressed in following units: i) % of public current expenditure on health care, ii) % of GDP iii) in PPS per capita.
89 Total expenditure for midwifery E Primary obstetric care includes obstetric GP care and midwifery care. Reflect the costs of care covered by the basic health insurance package.
90 Total expenditure for maternity care E Reflect the costs of care covered by the basic health insurance package.
91 Public expenditure for hospitals A,E General government and social security funds (HF.1) expenditure on hospitals (HP.1), including general hospitals (HP.11), mental health and substance abuse hospitals (HP.12) and other specialty hospitals (HP.13) measured according to following units: as % of GDP, as % of public Current Health Expenditure, in PPS per capita.
92 Public expenditure for ambulatory services A,E General government and social security funds (HF.1) expenditure on providers of ambulatory health care (HP.3) including offices of physicians (HP.31), dentists (HP.32), other health practitioners (HP.33), out-patient care centres (HP.34), medical and diagnostic laboratories (HP.35), providers of home health care services (HP.36) and other providers of ambulatory health care (HP.39), measured according to following units: as % of GDP, as % of public Current Health Expenditure, in PPS per capita.
93 Share of hospital inpatient expenditures by main diagnostic category B,D,E Circulatory diseases; Cancer; Injury, poisoning and other consequences of external causes; Mental and behavioural disorders; Respiratory system; Diseases of musculoskeletal system; Digestive diseases and connective tissue; hospital obstetric care.
94 Expenditure per hospital discharge/case/ hospital stay A,B,D Expenditure per hospital discharge for two diagnostic categories (circulatory disease, cancer). This indicator measures the ratio of a hospital's total acute inpatient care expenses to the number of acute inpatient weighted cases related to the inpatients for which the hospital provided care.
95 Treatment costs: on five important disease groups: acute myocardial infarction (AMI), ischemic stroke, hip fracture, breast cancer and very low birth weight and preterm infants (VLBWI) A Episode care costs
96 Cost per DRG Point E Cost per DRG point – specialised medical care
97 Cost Per Contact with the Primary Care System E Cost per weighted primary care event in primary care, Home health care and drugs covered by the pharmaceutical benefits scheme are excluded.

Quality of Care: Effectiveness - Primary/secondary prevention

98 Vaccination coverage in children A,B,C,D,E Disaggregated by age. Percentage of infants who have been fully vaccinated against important infectious childhood diseases according to national vaccination schemes.
99 HPV vaccination rate in teenagers D Proportion of teenagers by sex who received HPV vaccination
100 Influenza vaccination rate in elderly A,B,D,E Proportion of elderly individuals by sex (65+) and education level (ISCED class 0-2, 3-4, 5-6) reporting to have received one shot of influenza vaccine during the last 12 months.
101 Screening rates for selected cancers (breast, cervical, colon) A,B,D,E Proportion of women (aged 50-69) by educational level (ISCED class 0-2, 3-4, 5-6) reporting to have undergone a breast cancer screening test within the past two years. Proportion of women (aged 20-69) by educational level (ISCED class 0-2, 3-4, 5-6) reporting to have undergone a cervical cancer screening test within the past three years. Proportion of persons by sex (aged 50-74) and by educational level (ISCED class 0-2, 3-4, 5-6) reporting to have undergone a colorectal cancer screening test in the past 2 years.
102 Timing of first antenatal visits among pregnant women A,D,E Percentage of women having their first antenatal visit in 1st, 2nd, and 3rd trimester or having no visits. Antenatal visit refers to a visit to a certified health care professional, e.g. general practitioner, obstetrician, midwife and public health nurse. Only visits to examinations and/or pregnancy-related advice are to be included. Mere prescription of a pregnancy test or booking in a maternity unit should be excluded.
103 Unintended pregnancy: Contraceptive use D nA
104 Unprotected sex - teenage abortions E Abortions among women under 19 years of age per 1 000 women 15–19 years old
105 Rate of preterm delivery where the mother has not received pregnancy care E nA
106 Percentages of newborn infants with rare serious disorders that are detected in the neonatal blood spot programme E Detection rates for rare disorders out of 18 screened. Failure to detect screenable serious disorders in newborn infants can have major consequences, because early treatment can be crucial to limiting or preventing serious impairment in their physical or mental development.
107 Caries free at 5 years D nA
108 Patients in primary care - discussing lifestyle and living habits D,E Patients who answered “Yes” to the question: Did the doctor or another member of staff discuss any of the following living habits with you: tobacco, alcohol, exercise or eating habits? Patients in primary care - discussing lifestyle and living habits
109 Cardiovascular risk management D Patients with hypertension who have had cholesterol checked in past year

Quality of Care: Effectiveness - Getting better

110 Hospital mortality E Number of in-hospital deaths by the expected number of in-hospital deaths
111 Hospital Standardized Mortality Ratio (HSMR) D This indicator examines the ratio of the actual number of in-hospital deaths in a region or hospital to the number that would have been expected based on the types of patients a region or hospital treats. The HSMR is calculated by dividing the actual number of in-hospital deaths by the expected number of in-hospital deaths, for conditions accounting for about 80% of inpatient mortality.
112 30-day in-hospital mortality A,B,D,E Percentage of people who die within 30 days following: i) admission to hospital for a specific acute condition (eg. MI, stroke, hip fracture, major surgery), ii) after arrival to an intensive care unit.
113 Thirty-day mortality rate of premature newborns under 1500 g E .
114 Waiting times for for actue surgery after arrival at hospital B,D,E The proportion of patients aged 65 years and older with a i) hip fracture, ii) tibia and fibula fracture who have surgery within two days of admission to hospital.
115 Survival after Cardiac Arrest outside of Hospital E Percentage of cardiac arrest patients outside hospital who had been administered CPR and were alive 30 days later
116 Survival rate by specific disease category, by surgical intervention A,B,D,E This indicator refers to survival rates by selected disease category (cancer, major trauma, AMI, etc. ), by surgical intervention (total knee, aortic aneurysm, bleeding ulcer, etc.) and by defined time period (e.g. 30 days, 90 days, 1 year, 5 years). Age-standardized x-year relative survival rate for specific disease category (...)/surgical intervention is the observed rate of persons diagnosed with selected disease/undergone selected surgical intervention surviving x years after diagnosis/surgical intervention, divided by expected survival rate in the general population.
117 Reoperation for cancer E Percentage of patients who were reoperated on within 30 days after primary cancer surgery
118 Patient reported outcome after an intevention/treatment D,E Percentage of patients who reported that they were satisfied or very satisfied with the results / reported improvement (one year) after selected surgery/treatment: hysterectomy, total hip arthroplasty, urinary incontinence, spinal stenosis, Biologic Drug Therapy, Tonsillectomy, etc
119 Inpatient suicide amongst patients with a psychiatric disorder B,E The inpatient suicide indicator is composed of a denominator of patients discharged with a principal diagnosis or first two listed secondary diagnosis code of mental health and behavioural disorders (ICD-10 codes F10-F69 and F90-99) and a numerator of the number of patients who committed “suicide” (ICD-10 codes: X60-X84). There are often fewer than ten inpatient suicides in a given year, meaning that reported rates can vary. The data have been age-sex standardised to the 2010 OECD population structure, to remove the effect of different population structures across countries.
120 Numbers of coercive measures per 1000 psychiatric admissions E The use of coercive measures (seclusion, physical and chemical restraint)
121 Admission of full-term babies to neonatal care E Number of full-term neonatal episodes, as a percentage of all full-term births. The number of full-term babies (gestation greater than 36 weeks) admitted within 28 days of birth to a neonatal unit, expressed as a percentage of all full-term births.

Quality of Care: Effectiveness - Living with illness or disability/chronic care

122 Ambulatory Care Sensitive Conditions (ACSC) Hospitalization Rate A,B,D,E Disaggregated by sex, age, condition. Avoidable hospitalization rate / Emergency admissions to hospital (indirectly standardised rate per 100,000 population) of persons with an ambulator care sensitive condition (ACSC). ACSCs are conditions for which effective management and treatment should prevent admission to hospital. They can be classified as: chronic conditions (e.g. asthma, COPD, Congestive heart failure, diabetes, etc.), where effective care can prevent flare-ups; acute conditions (ear/nose/throat infections, kidney/urinary tract infections, heart failure, among others), where early intervention can prevent more serious progression; and preventable conditions, where immunisation and other interventions can prevent illness (Ham et al 2010). Source: http://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/data-briefing-emergency-hospital-admissions-for-ambulatory-care-sensitive-conditions-apr-2012.pdf
123 Major lower extremity amputation in adults with diabetes B,E Number of first-time amputees above the ankle joint per 100 000 persons with diabetes. Patients receiving drug therapy
124 Complications of diabetes - annual incidence rates of stroke, myocardial infarction, dialysis and/or renal transplantation in patients with diabetes E .
125 Emergency Readmissions within 30 days of discharge from hospital A,D,E This indicator examines the risk-adjusted rate of urgent readmissions to acute care facilities within 30 days of discharge for: i) total, ii) by speciality (medical, surgical, obstetrics, pediatrics, psychiatry), iv) by selected disease (COPD, stroke, AMI, etc.)
126 Percent of short-stay nursing home residents readmitted within 30 days of hospital discharge to the nursing home D Percent of newly admitted nursing home residents (never been in a facility before) who are re-hospitalized within 30 days of being discharged to nursing home.
127 Percent of long-stay nursing home residents hospitalized within a six-month period D Percent of long-stay residents (residing in a nursing home for at least 90 consecutive days) who were ever hospitalized within six months of baseline assessment.
128 Unscheduled Readmission to an Intensive Care Unit E Percentage of patients with unscheduled readmission within 72 hours to the same intensive care unit
129 Readmission within 3 and 6 Months after Treatment for Schizophrenia and Bi-polar E Percentage of patients age 20–59 who were readmitted within 3 or 6 months after inpatient care for schizophrenia. Schizophrenia re-admissions to the same hospital, 2011 (Age-sex standardised rates per 100 patients). Bi-polar re-admissions to the same hospital, 2011 (Age-sex standardised rates per 100 patients).
130 Repeat Hospital Stays for Mental Illness D This indicator measures what’s known as the revolving door syndrome for mental health patients. It looks at how many patients have at least 3 repeat hospital stays for a mental illness in a single year. Frequent hospitalizations may reflect challenges in getting appropriate care, medication and support in the community.
131 Revision operations after selected procedures A,E Hip replacement revisions per 10,000 inhabitants aged 35 and older. Knee replacement revisions per 10,000 inhabitants aged 45 and older. Revision Operations after Anterior Cruciate Ligament Surgery (ACL).
132 Health-related quality of life for people with long-term conditions E The directly standardised average (mean) EQ-5D™ score for people self-reporting one or more long-term conditions. This indicator measures health-related quality of life for people who identify themselves as having one or more long-standing health conditions. Health-related quality of life refers to the extent to which people: i) have problems walking about; ii) have problems performing self-care activities (washing or dressing themselves); iii) have problems performing their usual activities (work, study etc.); iv) have pain or discomfort;
133 Health-related quality of life for carers E The directly standardised average (mean) EQ-5DTM score for individuals reporting that they are carers, measured based on responses to the GP Patient Survey.
134 Implant survival rate for selected surgical interventions E *) Estimated percentage of patients who were not reoperated on within one year after hemiarthroplasty for femur fracture. *) Percentage of knee arthroplasty procedures for which revision was not required within ten years. *) Percentage of total hip arthroplasty procedures that did not require revision within ten years.
135 Monitoring Patients after Bariatric Surgery E The percentage of patients who have been monitored at oneyear follow-up after bariatric surgery
136 Loss of Excess BMI One Year after Bariatric Surgery E Loss of excess BMI one year after bariatric surgery. This indicator is an internationally established outcome measure for bariatric surgery. The variable is the percentage of preoperative excess weight that the patient has lost one year after surgery. Preoperative excess weight is defined as the difference between the preoperative BMI value and 25. Weight loss (occasionally gain) is the difference between BMI one year after surgery and the preoperative level.
137 Recovery from hip fracture surgery E Following indicators are used: The proportion of patients, expressed as a percentage, with a hip fracture recovering to their previous levels of mobility at 30 days after admission. The proportion of patients, expressed as a percentage, with a hip fracture recovering to their previous levels of mobility at 120 days after admission. Percentage of patients, age 50 and older, who returned to their original residence within four months after hip fracture surgery. Proportion of older people (65 and over) who were still at home 91 days after discharge from hospital into reablement/rehabilitation service.
138 Proportion offered rehabilitation following discharge from acute or community hospital E The proportion, expressed as a percentage, of older people aged 65 and over offered reablement services following discharge from hospital. Reablement/rehabilitation services are focused on improving people’s health, well-being, confidence and independence after an acute episode of ill health, injury or a gradual decline in functioning in the community. They include all episodes of support provided that are intended to be time limited and aim at maximising the independence of the individual and reducing/eliminating their need for on-going support.
139 Improvement after Treatment for Macular Degeneration E Percentage of patients (eyes) who could read at least one more row on the ETDRS eye chart one year after treatment for macular degeneration
140 Personal Activities of Daily Living (ADL) three Months after Stroke E The percentage of patients who could handle their personal ADL by themselves prior to stroke, who survived and who were independent of others for these activities three months after the acute phase
141 Percentage of people treated successfully among laboratory confirmed pulmonary tuberculosis (TB) cases who completed treatment C Cure rate or treatment success (those cured plus those successfully completed tx without bacteriologic evidence) of sputum smear positive pulmonary TB cases is the most reliable indicator. TB cases registered under a national TB control programme in a given year that successfully completed treatment (without bacteriological evidence of success). At the end of treatment, each patient is assigned one of the following five mutually exclusive treatment outcomes: completed, died, failed, defaulted or transferred out with outcome unknown. The cases assigned to these outcomes, plus any additional cases registered for treatment but not assigned to an outcome, add up to 100% of cases registered.
142 Compliance of patients with prescribed medications E Percentage of patients age 18 and older with ongoing i) antihypertensive, ii) lithium therapy who continued treatment. Age-standardised.
143 Suicide following hospitalisation for a psychiatric disorder, within 30 days and one year of discharge B,E Suicide within 30 days and within one year of discharge is established by linking discharge following hospitalisation with a principal diagnosis or first two listed secondary diagnosis code of mental health and behavioural disorders (ICD-10 codes F10-F69 and F90-99), with suicides recorded in death registries (ICD-10 codes: X60-X84). In cases with several admis- sions during the reference year, the follow-up period starts from the last discharge. The data have been age-sex standardised to the 2010 OECD population structure, to remove the effect of different population structures across countries.
144 Self-reported pharmaceutical consumption by selected groups A Disaggregated by age group (15+, 15-64, 65+), by sex and by education level (ISCED 0-2, 3-4, 5-6) Proportion of people who report having used medication for asthma, COPD, high blood pressure, cardiovascular diseases, diabetes, tension/anxiety and depression prescribed by a physician during the past 2 weeks.
145 Pharmaceutical consumption by selected groups B,D,E DDD per 1 000 population by selected medication group (e.g. antibiotics, …)
146 Percentage of people consuming selected medication E *) Use of antibiotics at least once in the year (% of population) *) Use of antidepressants (% of adult population, at least once in the year) *) Rheumatoid arthritis – percentage of patients age 18 and older treated with biologic drugs. *) Number of people age 20–79 with regular and high consumption of soporifics or sedatives per 100 000 inhabitants. Age-standardised.
147 Patients Treated at a Special Stroke Unit E Percentage of patients treated at a special stroke unit
148 Specific disease care performance according to key indicators of quality of care A,D,E This includes all possible quality of care indicators as defined by evidence based medicine, i.e. stroke performace, diabetes control, asthma action plan, Good Viral Control for HIV, etc. No attempt was made to list all of them individually.
149 Proportion of people with mental illness with a GP care plan D The number of people aged 16–84 with a GP mental health treatment plan, as a percentage of the estimated number of people aged 16–84 with mental illness.
150 Percentage of short-term episodes of care in mental health services E nA
151 Percent of population with a usual source of care B,D,E Percent of adults ages 18 and older who have one (or more) person they think of as their personal healthcare provider.
152 GP encounter within 7 days after hospital discharge (% patients 65+) B,E nA
153 Percentages of patients perceiving problems with planning and coordination of health care E Percentagesa of persons aged 18 and older that reported experiencing problems with health care coordination (source: Faber et al., 2013).
154 Practice can electronically exchange patient clinical summaries and laboratory and diagnostic tests with doctors outside practice D Survey question.
155 Regular doctor or place always or often helps coordinate and arrange care from other doctors or places D Survey question.
156 Specialist did not have information about medical history D Survey question.
157 When primary care physicians refer a patient to a specialist, they always or often receive a report back with all relevant health information D Survey question.
158 When primary care physicians refer a patient to a specialist, they always or often receive information about changes to a patients medication or care plan D Survey question.
159 When primary care physicians refer a patient to a specialist, they always or often receive information that is timely and available when needed D Survey question.
160 Doctor receives alert or prompt to provide patients with test results D Survey question.
161 Know whom to contact for questions about condition or treatment (base: those hospitalized or having surgery within past 2 years) D Survey question.
162 Receive written plan for care after discharge (base: those hospitalized or having surgery within past 2 years) D Survey question.
163 Hospital made arrangements for follow-up visits with a doctor or other health care professional when leaving the hospital (base: those hospitalized or having surgery within past 2 years) D Survey question.
164 Primary care physician always or often receives notification that patient has been seen in emergency room D Survey question.
165 Primary care physician always or often receives notification that patient is being discharged from hospital D Survey question.
166 Primary care physicians receive the information needed to manage a patient's care within 2 days after they were discharged from the hospital D Survey question.

Quality of Care: Effectiveness - Coping with end-of-life

167 Patients with terminal cancer who received palliative care E Patients with terminal cancer who received palliative care at the end of their life. Numerator: Number of patients who received palliative care (in usual place of residence or in hospital). Denominator: Number of patients diagnosed with a cancer with poor prognosis and that died within the studied time period.
168 Start of palliative care very close to death E Proportion of patients who started receiving palliative care and died within one week. Numerator: Number of patients who started palliative care and died within the week. Denominator: Total number of patients who received palliative care services before their death.
169 Death at usual place of residence (home or in residential care) E Death at usual place of residence (home or in residential care) (% of terminal cancer patients who died in the year)
170 Palliative sedation E Numbers of patients with palliative sedation. Palliative sedation is the deliberate lowering of a patient’s level of consciousness in the last stages of life. Sedation may be administered either continuously or temporarily or intermittently and it may be superficial or deep. Requirements for continuous and deep sedation are that the patient is suffering unbearably from one or more untreatable diseases (refractory symptoms) and has a life expectancy of one to two weeks. Sedation can be continued until the moment of death. Percentage of patients and relatives engaged in decisions about palliative sedation.
171 Euthanasia and assisted suicide E Number of notifications of euthanasia and assisted suicide. Euthanasia is defined as deliberately ending a person’s life at that person’s explicit request by a doctor administering lethal medication. A request for euthanasia does not need to be made in writing, but can also be made verbally. Assisted suicide differs from euthanasia in that the person self-administers medication that is prescribed by a doctor.
172 Pain management at the end-of-life E Percentage of patients at the end of life who assessed pain intensity on the VAS/NRS scale. Percentage of patients who were prescribed opioids on an as-needed basis at end of life.
173 End-of-life Conversations E Percentage of patients for whom end-of-life conversations were held
174 Perceived quality of end-of-life care according to relatives E This indicator refers to following individual indicators: *) Degree to which relatives report being treated well by care providers. *) Degree to which relatives report care providers having discussed the end of life with patients and relatives and aftercare with relatives. *) Degree to which relatives report having the opportunity to be alone with the patients. *) Degree to which relatives report being supported by care providers after the death of the patients.
175 Percentage of deaths due to withholding life-sustaining treatment E When the quality of life of a patient is so poor and treatment is no longer effective or the side-effects of treatment are unacceptable, a doctor may decide not to start or discontinue life-sustaining treatment. Hastening the end of life may be the result.

Quality of Care: Effectiveness - Safety

176 Patient believed a medical mistake was made in treatment or care in past 2 years D,E nA
177 Complications during/following delivery A,B,D,E Including complications during/following delivers: *) Obstetric trauma, vaginal delivery with/without instrument: The two obstetric trauma indicators are defined as the proportion of instrument assisted/non-assisted vaginal deliveries with third- and fourth-degree obstetric trauma codes in any diagnosis and procedure field per 100 instrument-assisted/non-assisted vaginal delivers. Therefore, any differences in the definition of principal and secondary diagnoses have no influence on the calculated rates. *) Cesarean delivery: complications during the delivery and puerperium (admitting hospital).
178 Patient safety: Wrong-site surgery D nA
179 Complications during/following surgery A,B,D,E Including complications during/following surgery (e.g. hysterectomy, uterine prolapse surgery, hip arthroplasty): Surgical complications: Foreign body left in during procedure per 100.000 hospital discharges, Surgical complications: Postoperative pulmonary embolism (PE) or deep vein thrombosis (DVT) in hip and knee surgeries [Incidence of post-operative pulmonary embolism or deep vein thrombosis, after hip or knee replacement (/100 000 hip or knee surgery discharges)], Surgical complications: Postoperative sepsis [Postoperative sepsis cases (as secondary diagnosis) per 1,000 total or elective surgical discharges for patients aged 18 years and older. Excludes cases with a principal diagnosis of sepsis or infection, cases with an immunocompromised state, cases with cancer, obstetric discharges, and cases with stays of less than four (4) days],
180 Prevalence and incidence rate of hospital-acquired infections (% of patients hospitalised) D,E Incidence of hospital-acquired MRSA infections (/1000 hospital stays). Incidence of healthcare associated infection (HSAI) – C. difficile. An infection is considered an HAI if all elements of a CDC/NHSN (Centers for Disease Control and Prevention/National Healthcare Safety Networks) site-specific infection criterion were first present together on or after the 3rd hospital day (day of hospital admission is day 1). For an HAI, an element of the infection criterion may be present during the first 2 hospital days as long as it is also present on or after day 3. All elements used to meet the infection criterion must occur within a timeframe that does not exceed a gap of 1 calendar day between elements’
181 Mortality due to hospital acquired infection E Age-standardised mortality rates for deaths with MRSA (methicillin-resistant staphylococcus aureusis) mentioned on the death certificate (per 1 million population)
182 Prevalence of hospital-acquired pressure ulcers D,E (% of patients hospitalised)
183 Percentages of patients experiencing an adverse event during hospitalisation D,E The number of hospitalisations involving an adverse event (treatment-related harm). This is presented as a number per 100 hospitalisations. Most adverse events are probably attributable to actions, or failures to act, on the part of health care providers.
184 Percentages of patients experiencing medical, medication or diagnostic errors D,E Errors had been made during treatment or care they received in the previous two years. Incidents included medical errors, errors in the prescribing or dispensing of medicines, errors in the conduct of medical examinations or testing, communication of erroneous test results and belated communication of abnormal test results.
185 Unnecessary care A,D,E Breast cancer screening outside age target group (% women aged 40-49). Patients who received chemotherapy in the last 14 days of life (% of terminal cancer patients who died in the year). Sent for duplicate tests in past 2 years.
186 Potentially inappropriate medication prescribed to seniors D,E Percentage Rate of Beers Drug Use Among Seniors on Public Drug Programs
187 Admissions for drug reactions D Number of hospital admissions due to adverse drug reations
188 Doctor routinely receives a computerized alert or prompt about a potential problem with drug dose or interaction D Survey question.
189 Doctor routinely recieves reminders for guideline-based interventions and/or tests D Survey question.

Quality of Care: Patient-centeredness/Responsiveness

190 Patient experience with inpatient care D,E Patient experience with inpatient care [hospitalization (admission/discharge)] refers to: *) Caregiver Respect and Consideration during Admission to Hospital, *) Information during Admission to Hospital, *) Participation during Admission to Hospital, *) Satisfaction with Care at Hospital.
191 Patient experience with ambulatory care: Doctor always listens, explains, shows respect, and spends enough time B,D,E Patient experience with a regular doctor rather than any doctor.Rates are age-sex standardised to the 2010 OECD population, to remove the effect of different population structures across countries.CWF definition: Percent of Medicare fee-for-service patients who had a doctor’s office or clinic visit in the last 12 months whose health providers always listened carefully, explained things clearly, respected what they had to say, and spent enough time with them.
192 Patient experience with ambulatory care: Doctor providing easy-to-understand explanations B,D,E nA
193 Doctor or health care professional discussed patient's main goals or priorities in caring for condition (base: has chronic condition) D nA
194 Patient experience with ambulatory care: Doctor giving opportunity to ask questions or raise concerns, B,D,E nA
195 Patient experience with ambulatory care: Doctor involving patient in decisions about care and treatment B,D,E nA
196 Patient spent a lot of time on paperwork or disputes related to medical bills D Survey question.
197 Satisfaction with healthcare services (% good or very good) A,D,E Measuring the opinion of the population regarding their personal experience when using health services (hospital care, GP, outpatient care, maternity, mental health care, etc.)
198 Primary care practices that routinely provide written instructions to patients with chronic diseases D Survey question.
199 Physicians reporting it is easy to print out a list D Physicians reporting it is easy to print out a list of: i) patients by diagnosis, ii) all medications taken by individual patients, including those prescribed by other doctors, iii) patients who are due or overdue for tests or preventive care.
200 Pharmacist or doctor did not review and discuss all medications patient uses in the past year (base: taking 2 or more prescriptions regularly) D Survey question.
201 Patients receive reminders for preventive care D Survey question.
202 Percentages of patients receiving discharge information at hospital discharge E Survey question.
203 Meeting Rehabilitation Needs after Stroke E Percentage of stroke patients 12 months after the acute phase who reported that their rehabilitation needs had been met
204 With same doctor 5 years or more D Survey question.
205 Doctor routinely receives and reviews data on patient satisfaction and experiences with care D Survey question.
206 Regular doctor always or often knows important information about patient's medical history D Survey question.
207 Healthcare law based on Patients' Rights D Is national HC legislation explicitly expressed in terms of Patients' rights?
208 Patient organisation involvement D nA
209 No-fault malpractice insurance D Can patients get compensation without the assistance of the judicial system in proving that medical staff made mistakes?
210 Right to second opinion D nA
211 Registry of bona fide doctors D Indicator refers to register of legit doctors based on survey question: Can the public readily access the info: Is doctor X a bona fide specialist? To qualify, this has to be a web/telephone based service..
212 Provider catalogue with quality ranking D “NHS Choices” in the U.K. a typical qualification for a Green score.
213 On-line booking of appointments? D Can patients book doctor appointments on-line?
214 Proportion of population that accesses own health data on-line D,E Proportion of the population aged 14 and over that has successfully logged into online services that provide access to the person’s own health data
215 Web or 24/7 telephone HC info D Information which can help a patient take decisions of the nature: “After consulting the service, I will take a paracetamol and wait and see” or “I will hurry to the A&E department of the nearest hospital”

Quality of Care: Others

216 Percentages of professional care providers expressing satisfaction with the quality of care delivered by their organisation E Survey question.
217 Percentages of professional care providers rating the quality of care delivered within their own unit or team as inadequate E Survey question.
218 Percentages of professional care providers reporting that sufficient staff and qualified staff is available to ensure good-quality care E Survey question.

Pharmaceutical Sector

219 Community pharmacies B The number of community pharmacies reported are the number of premises where dispensing of medicines happened under the supervision of a pharmacist per 100 000 population
220 Share of generics in the total pharmaceutical market A,B,E Market shares in volume of generics in all pharmaceutical products consumed
221 Research and development in the pharmaceutical sector: Business expenditure on R&D (BERD) in pharmaceutical industry as a proportion of GDP and of total BERD B Business enterprise expenditure on R&D (BERD) cov- ers R&D activities carried out in the private sector by performing firms and institutes, regardless of the origin of funding. This includes all firms, organisations and institutions whose primary activity is the production of goods and services for sale to the general public at an economically significant price, and the private and not-for-profit institutions serving them. BERD will register in the country where the R&D activity took place, not the country of origin of the organisations funding the activity.
222 W.A.I.T indicator for innovative medicinesa (in days) D,E W.A.I.T indicator defined as average number of days between marketing authorisation and patient access
223 Availabiliity of layman-adapted pharmacopoeia D Survey question: Is there a layman-adapted pharmacopeia readily accessible by the public (www or widely avaliable)? A pharmacopei is a book containing directions for the identification of compound medicines, and published by the authority of a government or a medical or pharmaceutical society.
224 Novel cancer drugs deployment rate D ATC code L01XC (monoclonal antibodies) Use per capita, MUSD p.m.p. This group comprises preparations used in the treatment of malignant neoplastic diseases, and immunomodulating agents. Monoclonal antibodies indicated only for the treatment of cancer are classified in L01XC.

Ageing and Long-term Care

225 Numbers of multiple-bed rooms in residential and nursing homes E nA
226 Share of the population aged over 65 and 80 years A,B,C,D .
227 Old age dependency ratio A,E Population 65 and over to population 15 to 64 years.
228 Ratio of discharges from public acute hospital to community care to discharges to long-term care facilities in the elderly population E Number of patients over 75 years of age who are discharged to their residence as compared to the number of patients over 75 years who are discharged to a long term residential or nursing facility.
229 Proportion of population receiving long-term care A,B,D,E Percentage of total population; by sex, by disease group (dementia, congestive heart failure), by age (younger than 65 years, oder than 85 years)
230 Share of long-term care recipients aged 65 years and over receiving care at home B % of total LTC recipients aged 65 years and over
231 Physical Functioning in Long-Term Care D Percentage of Residents Whose Status Improved on Mid-Loss ADL Functioning (Transfer and Locomotion) or Remained Completely Independent in Mid-Loss ADLs. This indicator looks at how many long-term care residents improved or remained independent in transferring and locomotion. Being independent or showing an improvement in these 2 activities of daily living (ADLs) may indicate an improvement in overall health status and provide a sense of autonomy for the resident.Percentage of Residents Whose Mid-Loss ADL Functioning (Transfer and Locomotion) Worsened or Who Remained Completely Dependent in Mid-Loss ADLsThis indicator looks at how many long-term care residents worsened or remained completely dependent in transferring and locomotion. An increased level of dependence on others to assist with transferring and locomotion may indicate deterioration in the overall health status of a resident.
232 Worsened Depressive Mood in Long-Term Care D This indicator looks at the number of long-term care residents whose mood from symptoms of depression worsened. Depression affects quality of life and may also contribute to deteriorations in activities of daily living (ADLs) and an increased sensitivity to pain.
233 Experiencing Pain in Long-Term Care D This indicator looks at how many long-term care residents had pain. The consequences of pain include increased difficulty with activities of daily living (ADLs), depression and lower quality of life. The prevalence of persistent pain increases with age, and proper treatment of pain is necessary to improve the health status of residents.
234 Experiencing Worsened Pain in Long-Term Care D This indicator looks at how many long-term care residents had worsened pain. Worsening pain can be related to a number of issues, including medication complications and/or improper management of medication. Careful monitoring of changes in pain can help identify appropriate treatment. Worsened pain raises concerns about the resident's health status and the quality of care received.
235 Proportion of people feeling supported to manage their long-term condition E The directly standardised proportion of people with a long-term health condition who report having had enough support from local services or organisations to help manage their condition, in the last six months. Patients are asked to consider all services and organisations, not just health services. This is expressed as a percentage.
236 Avoidable problems in clients in care homes and home care: pressure ulcers, malnutrition, malnutrition risks, falls, restraint use D,E *) Prevalence of pressure ulcers (grade II-IV) in home for the elderly (% of residents), *) Falls in the Last 30 Days in Long-Term Care, *) Restraint Use in Long-Term Care: This indicator examines the percentage of residents in daily physical restraints. It is calculated by dividing the number of residents who were in daily physical restraints by the number of all residents with valid assessments within the applicable time period.
237 Polypharmacy and excessive polypharmacy among the elderlies B,D,E Proportion of the population aged 65 years and older reporting having taken respectively 5 or 9 or more different medicines during the last 24 hours, also disaggregated by specific groups of medicines (e.g. lipid modifying agents, antithrombotic agents, antidepressants, etc.)
238 Population reporting to be informal carers B,E Informal carers (% of pop) by age (15+, older than 50 years) by sex
239 Frequency of care provided by informal carers B daily, weekl (% of carers)
240 Percentages of informal carers reporting problems with their own social participation as a result of their care provision E Survey question.
241 Percentage of people aged 65 years and over living alone C,E This indicator measures the potential support needed for older – and in general more vulnerable – people in a community by measuring the percentage of people aged 65 and over living alone.
242 Long-term care workers per 100 people aged 65 and over B Workers per 100 people aged 65+

Health Status: Mortality

243 Crude death rate per 1000 population C The crude death rate is the number of deaths occurring among the population of a given geographical area during a given year, per 1,000 mid-year total population of the given geographical area during the same year.
244 Life expectancy A,B,C,D,E Total population, disaggregated by sex and by educational attainment. Life expectancy at birth, ages 1, 15, 45 and 65 years represents the average number of years of life remaining if a group of persons at that age were to experience the mortality rates for a particular year over the course of their remaining life.
245 Gap in life expectancy at age 30 by sex and educational level B The gap in the expected years of life remaining at age 30 between adults with the highest level (“tertiary education”) and the lowest level (“below upper secondary education”) of education.
246 Healthy Life Years (HLY) A,B,C,D,E Total population, at birth and at age 65 disaggregated by sex.The indicator of healthy life years (HLY) measures the number of remaining years that a person of specific age is expected to live without any severe or moderate health problems. The notion of health problem for Eurostat's HLY is reflecting a disability dimension and is based on a self-perceived question which aims to measure the extent of any limitations, for at least six months, because of a health problem that may have affected respondents as regards activities they usually do (the so-called GALI - Global Activity Limitation Instrument foreseen in the annual EU-SILC survey). The indicator is therefor also called disability-free life expectancy (DFLE). So, HLY is a composite indicator that combines mortality data with health status data.
247 Potential years of life lost (PYLL) A,B,C,D,E Total population, disaggregated by sex, age and socio-economic-status (SES). Current OECD definition: Potential Years of Life Lost (PYLL) is a summary measure of premature mortality which provides an explicit way of weighting deaths occurring at younger ages, which are, a priori, preventable. The calculation of PYLL involves summing up deaths occurring at each age multiplying this with the number of remaining years to live up to a selected age limit (70 years for OECD Health data calculation).
248 Disability-Adjusted Life Year (DALY) E Disaggregated by sex. One DALY can be thought of as one lost year of healthy life. The sum of these DALYs across the population, or the burden of disease, can be thought of as a measurement of the gap between current health status and an ideal health situation where the entire population lives to an advanced age, free of disease and disability. (http://www.who.int/healthinfo/global_burden_disease/metrics_daly/en/)
249 Percentage of live births with Apgar Score below 7 E Disaggregated by place of birth (home, hospital, ...). Percentage of newborns with Apgar score under 7 at five minutes. Age-standardised. The Apgar score is a system for standardised assessment of the vitality of neonates. The baby’s heart rate, breathing, skin colouration, activity and muscle tone, and reflex irritability are rated on a scale of 0–10 at one minute, five minutes and ten minutes after birth.
250 Infant mortality rate A,B,C,D,E The ratio of number of deaths of children under one year of age to the number of live births. The value is expressed per 1000 live births.
251 Perinatal mortality rate A,B,E The number of fetal deaths and deaths in the early neonatal period (up to 6 completed days after birth) after live birth, expressed per 1000 live and stillbirths in the same year.Eurostat: Perinatal mortality rate per 1000 births is calculated as the the number of stillbirths plus deaths at age day 0 to (and including) day 6 divided by the number of births. The value is expressed per 1000 births.-) Early neonatal mortality rate per 1000 live births is calculated as the ratio of the number of deaths at age day 0 to (and including) day 6 to the number of live births. The value is expressed per 1000 live births.-) Late foetal mortality rate per 1000 births is calculated as the ratio of the number of stillbirths to 1000 births. The value is expressed per 1000 births.
252 Neonatal mortality rate A,E The number of babies stillborn or dying before 28 days old for every 1,000 that were born alive or stillborn.Eurostat: The ratio of the number of deaths at age day 0 to (and including) day 27 to the number of live births. The value is expressed per 1000 live births.
253 Postneonatal mortality rate A,E The number of babies and children dying after 29 days to one year old for every 1,000 that were born alive.
254 Child mortality rate A,D,E Death rate per 100,000 population by age 1-14
255 Maternal mortality rate C,D,E The maternal mortality ratio is the annual number of female deaths from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes), during pregnancy and childbirth or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, per 100 000 live births, for a specified year.
256 Avoidable mortality rate: amenable and preventable deaths D,E Avoidable mortality: A death is considered avoidable if, in the light of medical knowledge and technology or in the light of understanding of the determinants of health at the time of death, all or most deaths from that cause (subject to age limits if appropriate) could be avoided through good quality healthcare (amenable mortality) or by public health interventions in the broadest sense (preventable mortality). More precisely: A death is amenable if, in the light of medical knowledge and technology at the time of death, all or most deaths from that cause could be avoided through good quality health care. A death is preventable if, in the light of understanding of the determinants of health at the time of death, all or most deaths from that cause could be avoided by public health interventions in the broadest sense.
257 Preventable mortality rate A,D,E Total number of deaths which can be attributed to preventable deaths (list of ICD codes defined by Eurostat's TS Satellite list). A death is preventable if, in the light of understanding of the determinants of health at the time of death, all or most deaths from that cause could be avoided by public health interventions in the broadest sense.
258 Amenable mortality rate A,B,D,E Total number of deaths which can be attributed to amenable deaths (list of ICD codes defined by Eurostat's TS Satellite list). A death is amenable if, in the light of medical knowledge and technology at the time of death, all or most deaths from that cause could be avoided through good quality health care.
259 Disease-specific mortality rate A,C,E Standardised death rate (per 100,000 inhabitants), all 65 causes/by disease (incl. all cancers, e.g.cervical, breast, colorectal; cardivascular diseases; external causes, e.g. accidents, falls, suicide, homicide), total population, by sex
260 Chronic diseases mortality rate A,B,D,E Disaggregated by sex. It is defined as the standardised death rate per 100 000 persons of certain chronic diseases for persons aged under 65 years, by gender.The following diseases have been considered:malignant neoplasms, diabetes mellitus, ischaemic heart diseases, cerebrovascular diseases, chronic lower respiratory diseases, and chronic liver diseases.
261 Excess mortality from psychiatric disorders B,E This indicator is a ratio of two mortality rates (Rate 1 and Rate 2 below) and aims to measure the excess mortality from all causes in people who have a diagnosis of schizophrenia.Rate 1: Directly age- and sex-standardised “all cause” mortality rate in the reference year (e.g. 2013) for all persons aged between 15 and 74 years old in the population with schizophrenia. Numerator: All deaths among the denominator population in the reference year. Denominator: All people aged 15-74 ever diagnosed with schizophrenia (see list of ICD codes) as obtained from a register or equivalent data source in the reference year.Rate 2: Directly age- and sex-standardised “all cause” mortality rate in the same reference year for all persons aged between 15 and 74 years old in the total population. Numerator: All deaths among the denominator population in the reference year. Denominator: All people aged 15-74 in the reference year.This indicator is a ratio of two mortality rates and aims to measure the excess mortality from all causes in people who have a diagnosis of bipolar disorder.Rate 1: Directly age- and sex-standardised “all cause” mortality rate in the reference year (eg 2013) for all persons aged between 15 and 74 years old in the prevalent population with bipolar disorder. Numerator: All deaths among the denominator population in the reference year. Denominator: All people aged 15-74 ever diagnosed with bipolar disorder (see list of ICD codes) as obtained from a register or equivalent data source in the reference year.Rate 2: Directly age- and sex-standardised “all cause” mortality rate in the same reference year for all persons aged between 15 and 74 years old in the total population.Numerator: All deaths among the denominator population in the reference year. Denominator: All people aged 15-74 in the reference year
262 Mortality rates from external causes A,B,C,D,E Total population, disaggregated by sex. External causes of mortality V01-Y89 as accidents and violence including environmental events, circumstances and conditions as the cause of injury, poisoning, and other adverse effects.
263 Mortality rate from work-related accidents A Incidence rates relate the number of accidents to the reference population of persons in employment (persons exposed to the risk of accident at work). A fatal accident is defined as an accident, which leads to the death of a victim within one year of the accident.
264 Suicide mortality rate A,B,C,D,E Total population, disaggregated by age and sex. The crude death rate from suicide and intentional self-harm per 100 000 people.
265 Addiction related mortality rate A,C,D Drug-related deaths per 100,000 inhabitants by sex, age-group (<25y). Death rates from combined, selected causes of death which are related to smoking in people, per 100,000 by age group (aged 35+, 35-64), 65+), by sex. Death rates from combined, selected causes of death which are related to smoking in people, per 100,000 by age group (aged 35+, 35-64), 65+), by sex.
266 Excess mortality by extreme temperatures (formerly 'by heat waves') A To be developed: Daily number of observed deaths and death rates (all cause) in a region during a heat wave or a period of extreme winter cold in relation to the expected number of deaths and death rate for the same calendar day.

Health Status: Morbidity & Well-being

267 Incidence rate of sexually transmitted infections and blood-borne viruses A,C,D,E Disaggregated by sex and age group (0-24, 25-64, 65+). The number of new cases per 100,000 population of syphilis, HIV, AIDS, hepatitis B, hepatitis C, chlamydia and gonococcal infections.
268 Incidence rate of tuberculosis (TB) C,E Disaggregated by sex and age. The number of new cases per 100,000 population of tuberculosis.
269 Incidence rate of measles E Disaggregated by sex and age. The number of new cases per 100,000 population of measles.
270 Incidence rate of bacterial meningitis E Yearly numbers of new bacterial meningitis cases
271 (Low) birth weight A,B,D,E Percentage of life births with weighing less than 2500 grams per 100 live births in a given year.
272 Self-reported/perceived general health A,B,D,E Disaggregated by by sex, age-group (15-64, 65+), educational level (ISCED 0-1, 2, 3-4, 5-6), by income quintile (gap q1/q5). Proportion of persons who assess their health to be very good or good.
273 Self-reported dental health E Disaggregated by sex and age. Individuals who stated that they consider their dental health to be fairly good or very good.
274 Percent of adults ages 18–64 who have lost 6 or more teeth due to tooth decay, infection, or gum disease D Survey question.
275 Long-term activity limitations A,B,D Disaggregated by sex, by age-group (15-64, 65+), by educational level (ISCED class 0-1, 2, 3-4, 5-6).Proportion of people reporting that they have long- term restrictions in daily activities.
276 Self-reported physical and sensory functional limitations A Disaggregated by sex, by age-group (15+, 15-64, 65+) and educational level (ISCED class 0-2, 3-4, 5-6). Proportion of people reporting to have physical and/or sensory functional limitations (concerning seeing, hearing, mobility, speaking, biting/chewing, and agility).
277 Self-reported general musculoskeletal pain A To be developed: Prevalence of general musculoskeletal pain, measured by means of health interview survey using representative population sample.
278 Self-reported chronic morbidity A Disaggregated by sex, by age-group (15-64, 64+) and by educational level (ISCED class 0-1, 2, 3-4, 5-6). Proportion of people reporting that they have any long-standing chronic illness or long-standing health problem.
279 Self-reported mutliple chronic morbidity D Proportion of people reporting that they have multiple long-standing chronic illnesses or long-standing health problems.
280 Standardised incidence rates of cancer (breast, colorectal, prostate, lung, cervical) A,B,C,D,E Total population, disaggregated by sex, age group (0-64, 65+) and SES. Total cancer incidence and incidence of the most important cancers, per 100,000 population, in a given year’.
281 Prevalence rate of Diabetes A,D,E Disaggregated by sex, by age-group (15+, 15-64, 65+) and by education level (ISCED class 0-2, 3-4, 5-6).Proportion of individuals reporting to have ever been diagnosed with diabetes and to have been affected by this condition during the past 12 months.Number of individuals that have ever been diagnosed with diabetes and that have been affected by this condition during the past 12 months, per 100,000 / % of population.
282 Incidence rate of Diabetes A,E Percentage of persons with diabetes diagnosed in the past 12 months.
283 Attack rate of acute myocardial infarction (AMI) (non-fatal and fatal) and coronary death A,D,E Disaggregated by sex and by age-group (35-74, 35-64).Attack rate of acute myocardial infarction (non-fatal and fatal) and coronary death per 100,000 population.
284 Attack rate of stroke (non-fatal and fatal) A Disaggregated by sex and by age-group (35-84, 35-64). Attack rate of stroke (non-fatal and fatal) per 100,000 population.
285 Incidence rate of Blood pressure, self-reported A,C,D Disaggregated by sex, age-group (25+, 25-64, 65+) and by educational level (ISCED class 0-2, 3-4, 5-6). Proportion of individuals reporting to have been diagnosed with high blood pressure which occurred during the past 12 months.
286 Prevalence rate of Asthma A,D Disaggregated by sex and by age-group (0-14, 15+). Proportion of individuals reporting to have been diagnosed with asthma and to have ever been affected by this condition during the past 12 months.Number of individuals per 100,000/% of population, that have ever been diagnosed with asthma and that have been affected by this condition during the past 12 months.
287 Prevalence rate of COPD A,D Disaggregated by sex, age-group (15+, 15-64, 65+) and educational level (ISCED class 0-2, 3-4, 5-6).Proportion of individuals reporting to have ever been diagnosed with chronic obstructive pulmonary disease (COPD) and to have been affected by this condition during the past 12 months. Number of individuals that have ever been diagnosed with chronic obstructive pulmonary disease (COPD) and that have been affected by this condition during the past 12 months, per 100,000 / % of population.
288 Incidence rate of end-stage kidney disease D Number of new cases of treated end-stage kidney disease (ESKD) plus number of individuals who died with an underlying cause of death of renal failure or an associated cause of death of chronic renal failure, end-stage, and did not receive dialysis or transplant treatment (untreated cases), per 100,000 population.
289 Incidence rate of accidents at home and/or during leisure activities resulting in injuries A,E Disaggregated by sex and age-group (0-14, 15-24, 25-64, 65+). Proportion of individuals reporting to have had an accident at home, during leisure activities, and/ or at school during the past 12 months, which a) resulted in injury; b) resulted in injury for which medical treatment was sought Number of accidents at home and/or during leisure activities during the past 12 months, resulting in an injury that required treatment in a hospital, expressed per 100,000.
290 Incidence rate of road traffic accidents resulting in injuries A Disaggregated by sex, age-group (15+, 15-24, 25-64, 65+) and educational level (ISCED class 0-2, 3-4, 5-6). Proportion of individuals reporting to have had a road traffic accident during the past 12 months, which resulted in a) injury
291 Incidence rate of accidents at work resulting in injuries A Disaggregated by sex and age-group (18-24, 25-64, 65+). Standardised incidence rate of accidents at work per 100,000 workers.
292 Incidence rate of occupational diseases E Incidence rates (new cases) of work-related/occupational diseases. WHO definition: An “occupational disease” is any disease contracted primarily as a result of an exposure to risk factors arising from work activity. “Work-related diseases” have multiple causes, where factors in the work environment may play a role, together with other risk factors, in the development of such diseases. (http://www.who.int/occupational_health/activities/occupational_work_diseases/en/)
293 Self-reported/perceived mental health A,D,E Disaggregated by sex, age, income quintile. Aspect of mental health (psychological distress and mental well-being, e.g. occurrence and extent of psychological distress/well-being during past month; Eurostat: EHIS 2014, available in 2017.
294 Prevalence rate of Depression A,D Disaggregated by sex, by age-group (15+, 15-64, 65+). Proportion of individuals reporting to have ever been diagnosed with depression and to have been affected by this condition during the past 12 months. Number of individuals that have ever been diagnosed with depression and that have been affected by this condition during the past 12 months, per 100,000 / % of population.
295 Incidence rate of Depression, self-reported A,D Proportion of people reporting diagnosed chronic depression in the past 12 months.
296 Suicide attempt A To be developed: Proportion of persons having ever attempted suicide.
297 Prevalence rate of dementia/alzheimer A,B,E Number of individuals by sex aged 65+ that have been diagnosed with dementia, per 100,000

Determinants of Health: Health behaviour / life course

298 Health literacy (at least sufficient level) D,E Percentage of people having a sufficient level of health literacy, defined as the ability to access, understand, appraise and apply relevant information to take decisions concerning health care, prevention and health promotion. The value of the indicator has been calculated as a score derived from a short version of the EU Health Literacy Survey (HLS-EU) project questionnaire; this short versions contains 16 questions. Values of the score are then grouped according to cut off scores into 3 groups: sufficient, problematic and insufficient health literacy.
299 Prevalence of different smoking status, self-reported A,B,C,D,E Diaggregated by sex, age-group (15+, 15-26, 25-64, 65+), educational level (ISCED class 0-2, 3-4, 5-6) and by income quintile gap q1/q5.Proportion of people reporting to i) smoke cigarettes daily, ii) be ex-smokers, iii) have never smoked.
300 Prevalence of smoking among pregnant women A,D,E Percentage of women who smoke during pregnancy
301 Total alcohol consumption A,B,C,D,E Disaggregated by sex and age. Total alcohol consumption is defined as the total (recorded + unrecorded) amount of alcohol consumed per adult (15+ years) over a calendar year, in litres of pure alcohol or total Adult Per Capita (Total APC). Recorded alcohol consumption refers to official statistics (production, import, export, and sales or taxation data), while the unrecorded alcohol consumption refers to alcohol which is not taxed and is outside the usual system of governmental control. In circumstances in which the number of tourists per year is at least the number of inhabitants, the tourist consumption is also taken into account and is deducted from the country s recorded APC.
302 Hazardous alcohol consumption, self-reported A,B,C,D,E Disaggregated by sex, age and educational level. Proportion of individuals reporting to have had an average rate of consumption of more than 20 grams pure alcohol daily for women and more than 40 grams daily for men.
303 Use of illicit drugs, self-reported A,D Disaggregated by by age group (15-34, 15-64). a) Percentage of people reporting to have ever used [drug category].b) Percentage of people reporting to have used [drug category] in the last year.
304 Fruit and vegetable consumption rate A,B,D,E Disaggregated by sex, by age group (15+, 15-24, 25-64, 65+) and by educational level (ISCED class 0-2, 3-4, 5-6). Proportion of people reporting to eat a) fruits (excluding juice) at least once a day.b) eat vegetables (excluding potatoes and juice) at least once a day.
305 Body Mass Index A,B,C,D,E Disaggregated by age-group, by sex and by educational level (ISCED class 0-2, 3-4, 5-6), by income quintile gap q1/q5. Proportion of persons who are underweight, normal weight, obese, i.e. whose body mass index (BMI) is <20 kg/m2 for underweight, <25 kg/m2 for normal weight, ≥25 kg/m2 for overweight and ≥30 kg/m2 for obesity.
306 Daily physical activity rate A,D,E Disaggregated by sex, age group and by education level (ISCED class 0-2, 3-4, 5-6). Percentage of the population practising at least 30 minutes of physical activity (moderate or intense) per day.
307 Sedentary leisure time E Individuals who stated that they have a sedentary leisure time when asked “How much have you moved about and exerted yourself physically in your leisure time during the past 12 months?”, 16–84 years old.
308 Participation in acitivites arranged by sports clubs E Individuals in the age group 13–20 who participate during a year in sports associations that qualify for municipal local activity support, divided by the number of inhabitants aged 13–20.
309 Breastfeeding rates A,D,E Percentage of infants reaching their first birthday in the given calendar year who were breastfed, at least partially, when they were 3 and 6 months of age.

Determinants of Health: Environment

310 Policies on ETS exposure (Environmental Tobacco Smoke) A,E Under development: Composite measure reflecting level of implementation by (health) authorities of regulations on smoking restrictions in specified (public) domains.
311 Cigarette sales per capita age 15+ D Smoking Prevention: Cigarette sales per capita age 15+
312 Policies on healthy nutrition A Under development: A composite index of laws, regulations and good practices on promoting healthier nutrition.]
313 Policies and practices on healthy lifestyles A Under development: A composite index of regulations and good practices on promoting healthier nutrition.]
314 Integrated programmes in settings, including workplace, schools, hospital A,D,E Under development: A composite index of integrated programmes for health promotion policy and practice in different settings, including workplace, schools, hospitals, communities, prisons and other key settings for health promotion interventions.]
315 Housing conditions A ‘share of total population living in a dwelling with a leaking roof, damp walls, floors or foundation, or rot in window frames or floor, overcrowding and its positive counterpart, share of people living in under occupied dwellings) lack of bath or shower and toilet’) and ‘satisfaction with accommodation’ (under development in SILC 2013)
316 Satisfaction with recreational and green areas A,E Measures related to satisfaction with recreational and green areas and with the immediate living environment are currently under development in SILC 2013. The variable refers to the respondent’s opinion/feeling about the degree of satisfaction with the recreational or green areas in the place where he/she lives. As in variable PW010 the respondent should make a broad, reflective appraisal of recreational or green areas in a particular point in time (these days).
317 Access to footpaths and cycle paths D,E Citizens' assessment of the availability of footpaths and cycle paths in the municipality, on a scale of 1–10.
318 Satisfaction with living environment A SILC 2013: The variable refers to the respondent’s opinion/feeling about the degree of satisfaction with the quality of his/her living environment. As in variable PW010 the respondent should make a broad, reflective appraisal of all areas related to living environment in a particular point in time (these days).
319 Safe in school E Pupils in grade 5 in compulsory school who answered “agree completely” or “mostly true” in response to the statement “I feel safe at school”, the municipal pupil survey.
320 Children exposed to tobacco smoke in the home D The percentage of households with dependent children (aged 0–14) where adults report smoking inside the home.
321 Urban population exposure to air pollution, by particulate matter A,D,E Annual urban population average exposure to outdoor air pollution by particulate matter (PM10).Fine and coarse particulates (PM10), i.e. particulates whose diameters are less than 10 micrometers, can be carried deep into the lungs where they can cause inflammation and a worsening of the condition of people with heart and lung diseases.
322 Urban population exposure to air pollution, by ozone A Annual urban population average exposure to outdoor air pollution by particulate matter (PM10).Fine and coarse particulates (PM10), i.e. particulates whose diameters are less than 10 micrometers, can be carried deep into the lungs where they can cause inflammation and a worsening of the condition of people with heart and lung diseases.
323 Index of production of toxic chemicals, by toxicity class A Presents the trend in aggregated production volumes of toxic chemicals, broken down into five toxicity classes. The toxicity classes, beginning with the most dangerous, are: carcinogenic, mutagenic and reprotoxic (CMR-chemicals); chronic toxic chemicals; very toxic chemicals; toxic chemicals; and harmful chemicals. The indicator is a Sustainable Development Indicator (SDI). It has been chosen for the assessment of the EU progress towards the targets of the Sustainable Development Strategy.
324 Proportion of population living in households considering that they suffer from noise A The percentage of the total population who declare that they are affected either by noise from neighbours or from outside.
325 Percentage of population with improved sanitation facilities C An improved sanitation facility is defined as one that hygienically separates human excreta from human contact. Improved sanitation facilities include: i) flush/pour flush to: *) piped sewer system, *) septic tank, *) pit latrine; ii) ventilated improved pit latrine; iii) pit latrine with slab; iv) composting toilet.
326 Percentage of population having access to clean drinking-water D,E nA
327 Physical and personal security A,E Physical and personal security covers the issues of crime (age-standardised homicide rate / 100 000 people); -the perception of crime, violence or vandalism in the area; and -the perception of physical safety (population feeling safe when walking alone in their area after dark - under development in SILC 2013).
328 Surveying and collaboration: Domestic violence E The first indicator studies the incidence of surveys concerning the extent of violence against adults in the municipalities, while the second measures the incidence of current agreements concerning collaboration between social services for youth and adolescent, preschools and schools in the municipalities.Domestic violence, the social service in the municipalities answered questions regarding mapping andcollaboration with external stakeholders:1. Domestic violence, the social service in the municipalities answered questions regarding mapping and collaboration with external stakeholders:2. The social service for children and youth have through agreements cooperated in individual cases together with preschool and schools(has followed up a written agreement adopted at management level and established on 1 November 2012 - 1 November 2013).
329 Education - Competences and skills: Level of educational attainment A,C,D,E Proportion of population aged 25-64 by completed educational level [ISCED class lower (0-2), upper (3-4), tertiary (5-6)], by sex
330 Opportunities for education: Participation in early childhood education A,E Enrolment rate in ISCED 0-1 for 4 years old pupils
331 Low wage earners as a proportion of all employees (excluding apprentices) A Disaggregated by age, sex, and educational attainment.
332 Work-related health risks, self-reported A a) Percentage of employees by sex, by age group (<30 y, 30-49, 50+), by skill level (ISCO 1+2, 3-5, 6-7, 8-10) who think that their health or safety is i) at risk because of their work, ii) negatively affected by their work. b) Percentage of employees by age group (<30 y, 30-49, 50+) and by by skill level (ISCO 1+2, 3-5, 6-7, 8-10) receiving regular support from manager and colleagues.
333 Number of sick leave cases per 100 000 workers A Number of sick leave cases per 100 000 workers
334 Average length of 1 episode sick leave in days A Average length of 1 episode sick leave in days
335 Work-life balance A average number of usual hours of work per week in main job or percentage of employees working more than the ILO/OECD threshold level of 49 hours, employees working unsocial hours, and satisfaction with commuting time
336 Temporary contracts A Share of temporary contracts and transitions from temporary to permanent. Employees with a contract of limited duration (annual average) % of total number of employees disaggregated by age-group.
337 Assessment of quality of employment A Measures on average job satisfaction and assessment of quality of employment is under development and will cover: satisfaction with current work (under development in SILC 2013, currently from the European quality of life survey – EQLS), how possible it is to influence the content and order of tasks (under development in LFS 2015), and assessment of the relationships with colleagues and supervisors.
338 Share of jobs at risk of automatisation (%) A nA
339 Expected impact of technology (thousands of jobs gained/lost) by 2020 A nA
340 Social interactions: activities with people A Activities with people (including feeling lonely) are measured in terms of the frequency of contacting, meeting socially/getting together with friends, relatives or colleagues (SILC 2006 Ad Hoc Module) and satisfaction with personal relationships (collected in SILC 2013, will be available in 2015).
341 Social interactions: activities for people A Activities for people concern involvement in voluntary and charitable activities, excluding paid work (SILC 2006 Ad Hoc Module, which will be repeated in 2015).
342 Social interactions: Supportive relationships A,C,D,E Proportion of individuals by age group (15+, 15-64, 65+) and by educational level (ISCED class 0-2, 3-4, 5-6) reporting that they have none or 1 person that they can count on if they have serious personal problems and the ability to discuss personal matters (collected in SILC 2013, will be available in 2015).
343 Overall experience of life: Life satisfaction A,C Disaggregated by sex, age, income quintile.
344 Overall experience of life: Affects, meaning and purpose of life A Disaggregated by sex, age, income quintile. Afects, or the presence of positive feelings and absence of negative feelings; and eudaimonics, the feeling that one’s life has a meaning, as recommended by the OECD Guidelines on Measuring Subjective Well-being.

Additional Information on demographic and economic context

345 Total population A,C,D Population on 1 January , total (absolute numbers) by sex, age group, by area (rural, urban), share of immigrant population
346 Birth rate, crude A Live births per 1000 population
347 Total fertility rate A,C The mean number of children that would be born alive to a woman during her lifetime if she were to pass through her childbearing years conforming to the fertility rates by age of a given year.
348 Mother’s age distribution A,D Percentage of live births in mothers by age group and education
349 GDP per capita A,B,C GDP per capita in PPS per inhabitant.
350 Employment rate A Proportion of population aged 25-64 whose current or last main occupation is/was (by ESeC class: 1-2, 3/6, 4-5, 8-9, 7) by sex.
351 Unemployment rate A,C,D,E Unemployment rate, % of labour force, annual average, total population (15-74 years), by sex
352 Population living in very low intensity (quasijobless) households A People aged 0-59, living in households, where working-age adults (18-59) work less than 20% of their total work potential during the past year.
353 Mean and median income A Disaggregated by age and sex. Disposable net income is the total gross disposable income (i.e. all income from work, private income from investment and property, transfers between households and all social transfers received in cash including old-age pensions) minus social security contributions and income taxes payable by employees (see the metadata here).
354 At risk of poverty or social exclusion rate A,D,E The sum of persons who are: a) at-risk-of- poverty (cut-off point: 60% of mean equivalised income) or b) severely materially deprived (population living in households lacking at least 4 items out of the following 9 items: i) to pay rent or utility bills, ii) keep home adequately warm, iii) face unexpected expenses, iv) eat meat, fish or a protein equivalent every second day, v) a week holiday away from home, or could not afford (even if wanted to) vi) a car, vii) a washing machine, viii) a colour TV, or ix) a telephone) or c) living in households with very low work intensity (work less than 20% of their total work potential) as a share of the total population.
355 GINI coefficient (income distribution) A,C,E Gini index measures the extent to which the distribution of income (or, in some cases, consumption expenditure) among individuals or households within an economy deviates from a perfectly equal distribution. A Lorenz curve plots the cumulative percentages of total income received against the cumulative number of recipients, starting with the poorest individual or household. The Gini index measures the area between the Lorenz curve and a hypothetical line of absolute equality, expressed as a percentage of the maximum area under the line. Thus a Gini index of 0 represents perfect equality, while an index of 100 implies perfect inequality.
356 Spending on social protection as % of GDP A Structure of social protection expenditure old age and survivors, sickness/health care, family/children, disability, unemployment, administration costs, housing, social exclusion, other expenditure as % of GDP
357 Trust in, and satisfaction with, institutions and public services A trust in, and satisfaction with, institutions (under development in SILC 2013) and public services (to be developed)
358 Social interactions: Social cohesion A,E Social cohesion (covering interpersonal trust, perceived tensions and inequalities) will be measured using an indicator for trust in others (collected in SILC 2013, will be available in 2015).

Others

359 National and/or subnational policy addressing the reduction of health inequities established and documented C Existence of policies and strategies to address health inequalities and social determinants of health: A specific aim of the indicator is to capture whether health inequities and social determinants of health are addressed in one form or another, in accordance with the strategic goals of Health 2020. Replies options: i) Yes, stand-alone, ii) Yes, included elsewhere, iii) No. Elements in national policies to address health inequities and social determinants of health: Since there are multiple approaches or measures to address health inequities or social determinants of health, another aspect in the assessment included the various elements existing in the national health policies and strategies to deal with them, i.e. Healthy workplace, Healthy start in life, Poverty, Environment, Disadvantaged groups, Universal health coverage, Human rights, Others.
360 Establishment of process for target-setting documented (mode of documenting to be decided by individual Member States) C Existence of national or subnational processes of target - setting for health and well-being.An aim of the Health 2020 regional monitoring is to determine how countries have progressed towards establishing national goals, targets and specific indicators to monitor their advance in achieving the Health 2020 vision. Response options to this questions are: i) Targets defined, ii) Indicators defined, iii) Not but planned for the future, iv) Not and not planned for the future.
361 Evidence documenting: (a) establishment of national policies aligned with Health 2020; (b) implementation plan; (c) accountability mechanism (mode of ‘documentation’ to be decided by individual Member States) C As Member States in the WHO European Region develop policies and strategies to improve health and well-being, it is important to know whether these national policies are aligned with the Health 2020 vision. The alignment means having a comprehensive national health policy or another strategy, including improving universal health coverage, reducing the major causes of the burden of disease, addressing major health determinants of health and well-being and strengthening health systems.