Methodological Notes – Health Facilities Module

Updated: January 2019

Concepts and Definitions

Health services are delivered in a variety of facilities, the most important (and costly) of which are hospitals. CircHOB collects data only on hospitals in circumpolar regions, which are broadly comparable internationally.

A variety of hospitals exist in circumpolar regions, from highly specialized ones such as the Alaska Native Medical Center in Anchorage, and university hospitals in Tromsø, Umeå, and Oulu, to small ones in remote towns of Greenland.

There are different categories of hospital beds, serving acute care, psychiatric care, rehabilitation, long-term care and palliative care, which may be located in general hospitals or specialized institutions. Acute care beds are further allocated to different medical and surgical specialties. In the Nordic countries, the term “specialized health services” is used to refer to hospital-based care, in distinction from primary care. In Finland, Iceland and Greenland, a number of beds are attached to health centres, some of which are used for the care of elderly people. In Finland such beds account for over half of all beds in the country.

According to OECD, “curative (acute) care beds” include beds in general and specialty hospitals, but exclude beds for other functions (such as psychiatry, rehabilitation, long-term and palliative care) in such hospitals and all beds in mental health/substance abuse institutions. Within the Nordic countries, the term “somatic” care or beds is used, which corresponds to general acute care hospitals elsewhere, and excludes psychiatric and long-term care beds. When accessing national databases, the type of hospital bed closest to the OECD definition is selected where possible.

Data Sources and Limitations

United States

Data for hospital beds are produced by the American Hospital Association from its annual survey of hospitals. They are available from the Area Resource File (AHRF) of the Health Resources and Services Administration of the Department of Health and Human Services. Beds refer to medical and surgical beds in short-term general hospitals.

Canada

Hospital beds data are available from the Canadian Institute of Health Information’s Canadian Management Information System Database (CMDB). Access Data and Reports > Search BSIO (Beds-staffed and in operations). Current year’s data are available from the spreadsheet; archived tables from earlier years can be obtained by special request to CIHI. Data are for all beds in “general hospitals”.

Denmark, Greenland, and Faroe Islands

Data on the total number of medicine and surgery beds, excluding psychiatry and long-term care, are obtained from NOMESCO’s Social and health indicators database, supplemented by the annual report Health Statistics in the Nordic Countries.

Iceland

Data from 2007 onward are available from OECD Health > Health care resources > Hospital beds

Norway

Hospital care (i.e. specialized health services), is delivered by health regions through health enterprises (helseforetak) and private institutions. The Northern Health Region (Helseregion Nord) comprises the three counties of Nordland, Troms and Finnmark. Hospital care data are available only for the health region and not the three counties individually. Data are available from Statistics Norway’s StatBank Health > Health services > Specialist health services > Table 4434. Hospital beds refer to those in “somatic institutions” (somatiske institusjoner), equivalent to general hospitals. Private hospital beds are included.

Sweden

In Sweden hospitals are operated by county and municipal governments, with a small number of private hospitals. Data on specialized somatic care beds are available from the Statistical Yearbook published by Statistics Sweden. The yearbook was discontinued after 2014. Most recent 3 years’ data are available from the statistical database of the Swedish Association of Local Authorities and Regions (Sveriges Kommuner och Landsting) > search by region and year.

Finland

Hospital beds data from both public and private sectors are from SOTKAnet of the National Institute for Health and Welfare, Services and resources > Inpatient health care > Specialised somatic health care > Care days > Indicator #1259. Excluded are psychiatric beds and nursing-home type beds operated by municipal health centres. The hospital beds number reported to both OECD and NOMESCO is actually calculated by dividing the total number of bed-days by 365.

Data are reported in the Rosstat publication Health Care in Russia (Zdravookhranenie v Rossii). The number of beds in psychiatric and “narcological” hospitals are subtracted from the total number of beds.