Primary health care in Estonia
Journal Title: Family Medicine & Primary Care Review - Year 2016, Vol 18, Issue 1
Abstract
This article represents an overview about the development and current status of primary health care (PHC) system in Estonia. Since the beginning of 1990s the Estonian health system has undergone comprehensive health reforms, but the introduction of a new health care system based on family medicine was recognised as a priority of health care policymakers. The reorganisation of existing PHC in Estonia started with re-training of practicing PHC doctors and introduction of the residency training family medicine. The legal basis for the organisation of PHC was established in 1997 to create a list system and to introduce of partial gate-keeping system as well as new financing principles. Today, most of family doctors are self-employed contractors with the national health insurance fund. The payment for family doctors includes age-weighted capitation fee per registered insured person, funding for lab tests and investigation, basic practice allowance and some additional components,e.g. payment for performance. The evaluations of the Estonian PHC system have demonstrated rather high patient satisfaction and acceptability of the system, first of all in patients living outside the capital, in older patients and in patients with multimorbidity.However, due to increasing number of the people with chronic diseases the continuous strengthening of the PHC and introduction of chronic disease management models based would be in the focus of future developments in Estonian PHC.
Authors and Affiliations
Kaja Polluste, Margus Lember
Keywords
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