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Estonia

Population (2011): 1,339,928
GDP per capita, US$ PPP at current prices (2011) 21,938.4
Health expenditure per capita, US$ PPP (2010): 1,293.8
Life expectancy at birth, years (2010) 75.6

The health care in Estonia is funded through mandatory health insurance and the use of acute care and primary care health services is practically free for the insured population. Health insurance covers 95% of the population, including children under 18 and anyone receiving social support (either retired or because of disabilities). Out-of-pocket payments comprise about one quarter of all health care expenditures in the form of co-payments for pharmaceuticals and nursing care and coverage of dental care and a small proportion of specialist outpatient care.

Primary health care is provided by private general practitioners and acute care is provided by not-for-profit hospitals. The general practitioners are paid according to capitation, the rest of services are paid fee-for-service and DRG-system is used to cover acute hospital care. The Estonian Health Insurance Fund administrative database collects detailed and person-level billing data on all health care services provided to all insured population from year 2000 onwards. pfeil zu

 

Health System Data in Estonia

All health related data, whether at aggregate or individual level is collected by the National Institute for Health Development, and the data is organised and presented in the Health Statistics and Health Research Database.pfeil zu

 

Health Status

Aggregate data

  • Official statistics is provided by Statistics Estonia, a government agency under the Ministry of Finance, in all aspects of economic, demographic, social and environmental situation and trends in Estonia, including aggregate data on mortality, causes of death, life expectancy, fertility and disease prevalence and incidence.

Individual level data

The National Institute for Health Development carries out three major national health surveys:

These surveys on nationally representative samples include detailed information on health status of respondents, health behaviour, use of health services as well as environmental and socio-economic determinants of health.

Quality (valued outcomes)

Aggregate data

  • The Estonian Health Insurance Fund started in 2011 to publish on its web site selected indicators on quality of care and use of resources in hospitals and by general practicioners. As well, it collects and publishes aggregate information on access and waiting times for in-patient and out-patient health care services.
  • Annual Patient Satisfaction Surveys are conducted by the Ministry of Social Affairs and the Estonian Health Insurance Fund and published via web. It contains information on patient experience, perceived quality and expectations as related to different types of care.

Individual level data

Efficiency/Economy

Aggregate data

  • The National Institute for Health Development provides data on physical infrastructure (hospitals, beds, equipment), human resources (health professionals) at national and regional level. The provision and utilization of health services (number of visits, hospital admissions, procedures and operations) are available as well as costs at macro-level.
  • The Estonian Health Insurance Fund provides data on the provision of health services and costs related in annual reports. Detailed aggregated data (in Estonian) is publicly available on the web site in the section of “statistics” and is organized according to the list of services and list of reimbursed medicines.

Individual level data

Access/Equity

Aggregate data

  • The Statistics Estonia provides aggregate information on social indicators from national perspective to undrestand the distribution of health status.

Individual level data

Non-health care determinants

Aggregate data

  • Official statistics on economic and environmental situation is provided by Statistics Estonia, and can be related to disease prevalence and incidence as well as causes of death and life expectancy.

Individual level data

The National Institute for Health Development carries out major national health surveys:

These surveys on nationally representative samples include detailed information on health status of respondents, health behaviour, use of health services as well as environmental and socio-economic determinants of health.

Health System Design and Context

Koppel A, Kahur K, Habicht T, Saar P, Habicht J and van Ginneken E. Estonia: Health system review. Health Systems in Transition. 2008; 10(1): 1-230.