Health personnel accounts

Health personnel accounts of the Federal Statistical Office are an accounting system of secondary statistics. The data sources available in the health sector are combined in order to determine the number of employees by the variables of institution, occupation, type of employment, sex and age, as well as the full-time equivalents.

This includes, for example, the statistics of employees subject to social insurance contributions of the Federal Employment Agency, the microcensus, and the hospital statistics of the Federation and the Länder as well as the statistics of physicians of the German Medical Association. Results from health personnel accounts are available for the years from 1997 to 2007.

The numbers of employees are based on the principle of the reference day at the end of the year. They cover all persons working in the health sector, irrespective of the occupation they pursue. The term of employees refers to jobs, which means that persons with several jobs in different institutions are counted several times. This approach differs from the concept of persons in employment, which is used in official statistics.

Health personnel

The employees include self-employed, family workers, public officials, salaried employees, wage earners, apprentices, persons doing alternative civilian service as well as trainees. Other persons classified under employees are: Sick persons, persons on vacation and persons doing military exercises as well as any other persons temporarily absent, strikers and persons affected by lockout as long as the employment contract has not been dissolved. Employees in the health sector do not include persons doing voluntary work and employees assigned from other sectors to work in health sector institutions. This may refer, for example, to craftsmen doing repairs in hospitals whose employer is a craft enterprise.

Health sector

The methodical starting point for defining the health sector is the health expenditure accounts of the Federal Statistical Office. According to that delimitation, the health sector also includes nursing care, health protection in enterprises and health measures to reintegrate persons into working life. Activities of the health, social and environment sectors are included where they primarily serve the purposes of protection, prevention or recovery of health. So, employees excluded are those supporting health in the broader sense. Those are, for instance, employees in homes for the elderly where the treating or relieving of health problems is not the primary purpose of the job. The same applies to the veterinary branch. The delimitation is in line with the recommendations of the Organisation for Economic Co-operation and Development (OECD) and of the Statistical Office of the European Communities (EUROSTAT) on setting up a system of health expenditure accounts in industrialised countries.

Health occupations

Based on the national classification of occupations of 1992 of the Federal Statistical Office, health occupations can be divided into four occupational groups: Health service occupations, social occupations, health craftspersons and other special occupations in health care.

The health service occupations include all employees working in direct care of patients. Those are, first, physicians, dentists and pharmacists and, second, doctor’s assistants, dental assistants, assistant dieticians, non-medical practitioners, nurses, (man) midwives, associate nurses, physiotherapists, masseurs, medical bath attendants, medical laboratory and pharmaceutic-technical assistants as well as employees in therapeutical professions n.e.c.--not elsewhere classified. They are grouped under the term “other health service occupations”. Social occupations comprise geriatric nurses, medical pedagogues as well as remedial therapists. Health craftspersons cover opticians, orthopaedic mechanics, dental technicians as well as other health craftspersons such as hearing aid audiologists and orthopaedic shoemakers. The other special occupations in health care comprise health engineers, health technicians, pharmaceutical technicians, pharmaceutic-commercial employees and health-protecting professions, e. g. disinfectors and health inspectors. A fifth group, the so-called other occupations in health care, comprises all the occupations in the health sector which cannot be allocated to one of the above occupational groups. Examples are social workers, cleaning and kitchen staff in hospitals, courier services of pharmacies and craftspersons whose employers are institutions of the health sector.

Health institutions

Institutions are broken down according to the health expenditure accounts of the Federal Statistical Office. Institutions of health protection comprise municipal institutions such as public health offices, institutions of the Länder dealing with things like water protection, food control, municipal hygiene and environmental medicine, Land health authorities and Land ministries as well as federal institutions such as the Federal Institute for Occupational Safety and Health or the Federal Centre for Health Education. Ministries (e.g. Federal Ministry of Health) and the medical service of the statutory health insurance institutions are included. Out-patient institutions include practices of physicians, dentists and other medical occupations, the local units of health crafts, pharmacies and retail trade, institutions of domestic care and other out-patient health care facilities. In-patient and part-time in-patient health care facilities cover hospitals, prevention and rehabilitation facilities as well as facilities of institutional and part-time institutional care. Ambulance services include the services of transport of sick persons and emergency rescue. They may be public or private. The task of an ambulance service is to take on-the-spot life-saving measures for persons with potentially lethal injuries or sickness, to restore their transportability and to take professional care of them using special rescue equipment to transport them to an institution suitable for further treatment. Administrative institutions include institutions of statutory and private health insurance, of pension, accident and nursing care insurance as well as institutions of organisations providing benefits (e.g. regional associations of statutory health insurance physicians and dentists, medical and dental associations, pharmacists’ associations, professional organisations). Other institutions include mainly institutions of occupational safety, self-help institutions and non-profit institutions as well as research and training institutions. Intermediate consumption industries cover the pharmaceutic, the medico-technical and the ophthalmic industries as well as the medical laboratories and wholesale trade. The produce intermediate goods only for the health sector.