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Data set notes

European Health for All database

Indicators: 565

Updated: 18 October 2024

Contact: Data and Digital Health Unit (DDH)

The following abbreviations are used in the indicator titles:

• SDR: age-standardized death rates (see HFA-DB user manual/Technical notes, page 13, for details)

• FTE: full-time equivalent

• PP: physical persons

• PPP$: purchasing power parities expressed in US $, an internationally comparable scale reflecting the relative domestic purchasing powers of currencies.

More information: http://www.euro.who.int/en/data-and-evidence/databases/european-health-for-all-database-hfa-db

Indicator notes

Outpatient contacts per person per year
Indicator code: E992801.T

The total number of primary health care or ambulatory care contacts divided by the population. An outpatient contact is one episode of examination/consultation performed by a physician or by a nurse in the presence of a physician, in relation to one outpatient at one time and location, normally at the physician's office or the patient's home. The number of outpatient contacts includes: patient's visit to physician's office; physician's visit to patient's home or other place; call for ambulance; day-patient cases. The number of outpatient contacts excludes: telephone calls for consultation purposes; visits for prescribed laboratory tests; contacts to perform prescribed and scheduled treatment procedures, e.g. injections, physiotherapy etc.; visits to dentist. Definition of outpatient: A person attending a PHC (Primary Health Care) unit or outpatient department in an outpatient establishment or hospital and who makes use of the diagnostic or therapeutic service but does not occupy a regular hospital bed.

Definition of day patient: A patient who does not require inpatient care but who needs specialized observation or health care or treatment from hospital during a limited number of hours of the day and who returns to his home for the evening meal and the night. These patients can occupy specialized beds (e.g. recovery beds, beds for special purposes or belonging to special health devices). If a day patient occupies a regular hospital bed, then this case is not considered as a case of hospitalization and thus 'consumed' bed days are not included in the number of regular days of stay. Day-patient care is one of the forms of ambulatory care.

For countries participating in the Joint Eurostat / OECD / WHO Europe data collection on health care activities (for year 2012 those were: Austria, Belgium, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Israel, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Romania,, Slovak Republic, Slovenia, Spain, Sweden, Switzerland, The former Yugoslav Republic of Macedonia, Turkey and United Kingdom), following definition was used:

Doctor consultations (in all settings)

Average number of consultations/visits with a physician per person per year.

Inclusion

- consultations/visits at the physician’s office

- consultations/visits in the patient’s home

- consultations/visits in outpatient departments in hospital

Exclusion

- telephone contacts

- visits for prescribed laboratory tests

- visits to perform prescribed and scheduled treatment procedures, e.g. injections, physiotherapy etc.

- visits to dentists

- visits to nurses_

Country/Area notes

Albania

Ministry of Health.

Armenia

Source of data: National Health Information Analytic Center, Ministry of Health of the Republic of
Armenia http://moh.am/?section=static_pages/index&id=625&subID=824,29.
Data collected annually, reference period: 31 December.

Austria

Source: Main Association of Austrian Social Security Organisations Includes persons insured by
social security.

Belgium

Source: National Institute for Health Insurance. This number includes advice, patient's visit to
physician's office (general practitioners and specialists); physician's visit to patient's home and
medical assistance during urgent transfer to a hospital (in an ambulance).
1. Day patient cases are not included.
2. The number refers to the number of contacts with patients who are not self-employed / divided by
the population of people who are not self-employed.

Bosnia and Herzegovina

Public Health Institute - Annual report of outpatient departments. Available up to the war time on
yearly basis. PHI war period just for the part of FBIH. Number of examinations/consultations
performed by physicians at the physician's office in the primary health care.

Public Health Institute of Federation of B&H; Department for Health Statistics and Informatics
Public Health Institute of Republic of Srpska- Department for Social medicine, with Health
Organization and Health Economics. Law on health evidence and statistical research in health. Annual
report of primary health care services;
Department for Health of Brcko District;

Croatia

The 1995 figure does not include X-ray, ultrasound, EEG, ECG and epidemiology service examinations.

Cyprus

Attendances at general, rural and special hospitals and health centres of the public sector only.

Czechia

Source: Institute of Health Information and Statistics of CR (IHIS CR). Surveys on activity of
health establishments. Coverage: Until 1999 data covers only establishments of the Health Sector.
From 2000 data covers also health establishments of other central organs.
Included are: telephone calls for consultation purposes; visits for prescribed laboratory tests;
contacts to perform prescribed and scheduled treatment procedures, e.g. injections, physiotherapy,
etc.; visits to dentist and treatment in First medical aid.

Denmark

Data from 1995 onwards include telephone consultations.

Estonia

Source: annual reporting, National Institute for Health Development.

Finland

Source: Hospital Discharge Register, THL (National Institute for Health and Welfare). Since 2009,
visits in the private sector have been taken from Social Insurance Institution and not from regional
data sources, which remain incomplete due to restructuring of regional administrations.

Georgia

Source: National Centre for Disease Control and Public Health of Georgia (NCDC) (http://www.ncdc.ge)

Germany

Consultations with doctors represent only the number of cases of physicians? treatment according to
reimbursement regulations under the Social Health Insurance Scheme. These consultations with doctors
don?t include preventive medical check-ups and screening examinations. One case of treatment only
counts the first contact in three months even if the patient consults his doctor more often.
Therefore a substantial under-reporting has to be assumed.
Source: Federal Ministry for Health, KG-3 Statistics (statutory health insurance: accounts for
practitioner and dental treatment), KM-6 Statistics (statutory health insurance: insured persons).

Additional information:
In the BARMER GEK physician report 2010 (successor product of the GEK-report on ambulatory care)
data of a study on doctors? consultations were published. For the survey the Barmer GEK, a
compulsory German health insurance fund, has analyzed ambulatory data of 1.7 million insured persons
of the former Gmunder Ersatzkassen (GEK) for the years 2004 to 2008 and extrapolated them on the
total population. Information on calendar days on which physicians provided individual services to
individual patients form the basis for the analysis on doctors? consultations for the years 2004 to
2007. Doctor?s consultations per inhabitant:
2004: 16.4
2005: 16.9
2006: 17.1
2007: 17.7
With the newly established accounting allowances for the ambulatory medical care in 2008, a direct
counting is no longer possible. The procedure for the calculation of doctors? consultations,
selected so far, leads to incomplete results, which cannot be compared with the prior year results.
However, the study assumes, that the practising physicians invoiced on the average 7.5 cases of
treatment per insured person. If one takes into account that, in former years, 2.5 consultations per
case of treatment have been registered, you get a number of 18.1 doctors? consultations per
inhabitant for the year 2008. Corresponding analyses on dental and dentosurgical treatments are not
available.

Hungary

Physician consultations include contacts of family practice, outpatient care, CT and MRI. By
definition, we did not include the episodes of dental care and laboratory and pathology
examinations.

Iceland

Includes all contacts with physicians in public health centres and with self-employed general
practitioners, also with specialists in their private practices outside hospitals and ambulant
contacts in hospitals. Source: Directorate of Health.[S?2]

Israel

Source: Use of Health Services Surveys: 1-3/1993, 1996/97, 1999/2000, 2009, Central Bureau of
Statistics and Ministry of Health.

Italy

Source from 1991: Istat Helth Interview Survey \Healthconditions and use of health services\".
Day-patient cases are not included"

Latvia

The number of outpatient contacts excludes calls for ambulance as they form a separate group of
health care services in Latvia.

Lithuania

Source: Up to 2005: LHIC annual report data. From 2006: HI HIC data from annual reports and
Compulsory Health Insurance Database.

Malta

This includes primary health centre contacts, private hospitals, district dispensaries and renal
unit encounters and outpatient contacts in the public hospital service. Excludes visits to the A and
E Departments (emergency department).

Montenegro

Calculated for PHC services as total number of primary health care or ambulatory care contacts
divided by the population.

Netherlands

Statistics Netherlands: Health Interview Survey. Number of contacts with general practitioner and
specialist per person in the population. Due to change in the modes of interviewing, there is a
break in the trend from 2010 onwards.

Poland

Source: Ministry of Health.

Portugal

Source of data: National Statistical Institute Coverage: National

Romania

Includes treatments carried out by the physician (dressings, injections)

Serbia

Source: Institute of Public Health of Serbia. Data do not include consultations/visits in outpatient
departments in hospital.

Slovakia

Due to privatization in the health sector, not all units are included for 1993-1996.

Slovenia

Institute of Public Health of the Republic of Slovenia, Ljubljana 1996.

Spain

Measured using a standard questionnaire during a health interview of a representative sample of the
population not institutionalised. Question: Have you consulted a doctor for any problem, discomfort
or illness in the last two weeks? If answer is affirmative, how many times did you see the doctor?
Average number of consultations in one year per person in the population. Figures computed excluding
missing values.
Source: Ministry of Health and Consumer Affires. National Health Survey 1987, 1993, 1995, 1997,
2001 and 2003. (www.msc.es/)

Sweden

Visits at outpatient departments, health center units, both public and private. Source: Annual
statistics of County Councils.

Türkiye

The data does not include private outpatient clinics. These clinics offering outpatient health care
services are not classified as inpatient health care facilities as they do not have patient beds for
inpatient treatment. Source: General Directorate of Curative Services. Method: Covers visits to the
Ministry of Health-affiliated primary health care facilities and all inpatient treatment facilities.

Turkmenistan

Source of data: Administrative medical statistics, forms: ?Report of a health-care setting? and
039/y ?Statement of visits? records?.

Ukraine

In establishments under Ministry of Health only.
Source: Centre of Health Statistics, Ministry of Health.

United Kingdom

Source of Data: Calculated by the Information Centre for Health and Social Care (the IC:
http://www.ic.nhs.uk) using data from:
England, Scotland and Wales: Office for National Staistics (ONS) General Household Survey.
Northern Ireland: Continuous Household Survey (GP consulations) and Northern Ireland Statistics and

Research Agency (Outpatient visits).
- Pre 2003: data for Great Britain only. Data for the UK from 2003-2008. 2009: data for
Great-Britain only.
- Data not available for 1997 or 1999 as the General Household Survey was not carried out in those
years.
- An approximation of the number of National Health Service General Practice consultations per
person per year
over a 12-month period derived from the ONS General Household Survey in Great Britain and from the
Continuous
Household Survey in Northern Ireland for all ages in private households, giving average number of
consultations
with a National Health Service general practitioner per year. To this has been added the mean
number of NHS
hospital outpatient department consultations per person per year. Until 2008 this has been added to
the mean number
of NHS hospital outpatient department consultations per person per year. 2009 figures refer only to
GP
Consultations per person per year over a 12 month period.
- Figures do not include consultations of physicians in the independent sector and do not take into
account
consultations of specialists outside hospital outpatient departments.
- NHS GP consultations component (from the General Household Survey) of the figures comprises home
visits, GP
surgery consultations, consultations with a GP at a health centre, and telephone consultations.
- Caution should be exercised when comparing one year to another as variations caused by averaging
male/female
rates from the General Household Survey can exaggerate differences between one year and another
(this would
account for a large part of the 0.6 difference between 1996 and 1998, for example).
- Data from the surveys from 2003 are grossed and weighted. Data from Annual Abstracts are for
financial years.
- In 2005, the GHS changed from a financial year to a calendar year.

General notes

Understanding Outpatient Contacts Per Person Per Year

Outpatient contacts per person per year is a critical health indicator that reflects the average number of times a person in a specific population visits outpatient health services within a year. This metric is essential for assessing the accessibility and utilization of healthcare services among communities. It helps health policymakers and administrators understand healthcare demand and resource allocation needs, ensuring that medical facilities are adequately equipped to serve the population effectively. By monitoring this indicator, health systems can identify trends, plan interventions, and improve overall health service delivery to meet the community's needs.

Calculating Outpatient Contacts Per Person Per Year

To calculate the outpatient contacts per person per year, health statisticians divide the total number of outpatient visits recorded within a year by the mid-year population. This ratio provides a clear picture of healthcare service utilization on an individual level across a defined population. Accurate data collection from healthcare providers and robust population statistics are crucial for this calculation. This method helps in understanding not just the quantity but also the quality of healthcare services provided, influencing future healthcare policies and practices.

The Importance of Outpatient Contacts Per Person Per Year

The outpatient contacts per person per year indicator is vital for effective health system planning and management. It provides insights into the population's health-seeking behavior and the accessibility of medical services. High rates of outpatient contacts may indicate good accessibility or high disease prevalence, while low rates could signal barriers to healthcare access or low health service coverage. This data is crucial for governments and health organizations to allocate resources efficiently, ensuring that healthcare facilities are both accessible and capable of meeting the community's health demands.

Strengths and Limitations of the Outpatient Contacts Per Person Per Year Indicator

While the outpatient contacts per person per year indicator is a valuable tool for health system assessment, it comes with its own set of strengths and limitations.

Strengths

This indicator is instrumental in providing a standardized measure to compare healthcare service utilization across different regions and populations over time. It aids in longitudinal studies and benchmarking, helping to identify trends and outcomes of health interventions. The data derived from this indicator can also support resource allocation, health infrastructure development, and policy formulation, ensuring that healthcare systems evolve in response to the changing needs of the population.

Limitations

However, the reliability of this indicator heavily depends on the accuracy and completeness of healthcare visit records and population data. In regions with inadequate health record systems or where health services are underutilized, this indicator might not provide a true reflection of the population's health service access. Moreover, it does not account for the quality of services provided during the outpatient visits, which is crucial for evaluating the overall effectiveness of the health system. Seasonal variations and short-term spikes in healthcare demand, such as during epidemics or natural disasters, may also skew the data, leading to potential misinterpretations.

Understanding both the strengths and limitations is essential for using the outpatient contacts per person per year indicator effectively in health system planning and evaluation. By acknowledging these factors, health officials can better interpret the data, leading to more informed decision-making and ultimately, improved health outcomes for the population.