| Titre : | Estonia: health system review 2023 |
| Auteurs : | European observatory on Health Systems and Policies (Copenhagen, DNK) ; K. Kasekamp ; Triin Habicht ; Andres Võrk ; et al. |
| Type de document : | Ouvrage |
| Editeur : | Geneva [CHE] : World Health Organization - WHO, 2023/12 |
| Collection : | Health systems in transition , num. Vol. 25 n°5 |
| Description : | 236p. / tabl., graph., fig., carte |
| Langues: | Anglais |
| Mots-clés : | Système santé ; Organisation ; Financement ; Réforme ; Santé publique [généralité] ; Démographie ; Etat santé ; Population ; Evaluation ; Management ; Ressource humaine ; Service santé ; Estonie ; Rapport |
| Résumé : | Estonian health system has made remarkable progress in health status, but inequalities persist Life expectancy in Estonia is 77.2 years (2021) and has increased at one of the fastest rates in the EU, although it declined during the COVID-19 pandemic. Health inequalities and differences in health status are pronounced across socio-economic groups, highlighting the need to further improve public health integration and access to health care. Reducing inequalities is one of the objectives of the National Health Plan (NHP), the main strategic policy and budget planning document. Health care in Estonia is highly centralised and the functions of its purchasing agency are expanding Estonia has a centralised health care system with providers operating under private law. The Ministry of Social Affairs (MoSA) is responsible for health policy development, strategic planning, regulation and administration, while the Estonian Health Insurance Fund (EHIF) pools public funds and purchases health services on a contractual basis. The role of the EHIF has been gradually expanded to include service organisation and vaccine procurement. Local governments carry out public health activities and have a limited function in the organisation and financing of health services. Public spending on health in Estonia is increasing, with a growing role of government transfers. Per capita health expenditure has almost quadrupled since 2005, with public expenditure accounting for 76.4% in 2021, while the revenue base of the EHIF has been broadened by the inclusion of gradually increasing government transfers linked to the pension of non-working pensioners. In addition, out-of-pocket (OOP) expenditure remains above 21%, exceeding the target of 15% set in the NHP. To improve financial protection against high OOP payments for dental care and medicines, increased dental benefits have been introduced and general co-payment rates for prescription medicines have been elaborated. Nevertheless, gaps in coverage remain. Recent reforms focused on further strengthening PHC and prioritising mental health. Recent reforms in PHC encourage and incentivise the establishment of multidisciplinary teams to expand primary care services and improve efficiency, but providers still prefer to work in solo practices. Furthermore, in 2021, the government approved the long-awaited Green Paper on Mental Health, signaling a shift towards prioritising mental health at the individual, community and national levels. |
| En ligne : | https://eurohealthobservatory.who.int/publications/i/estonia-health-system-review-2023 |
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 Estonia: health system review 2023 URL |