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Evaluation of primary health care reform in Estonia

Author

Listed:
  • Koppel, Agris
  • Meiesaar, Kersti
  • Valtonen, Hannu
  • Metsa, Andrus
  • Lember, Margus

Abstract

Estonia began to reform its health care system by reorganizing primary health care (PHC). Ten years ago, the health care system was inefficient, supply was biased towards institutional care, and PHC was almost non-existent in the western understanding: it was provided by different specialists in policlinics, and the financial basis of the system was in crisis. The reform had the following aims: to develop PHC by introducing family medicine, to guarantee the whole population access to family doctors' services, and to secure stable funding for these services. In 1998, a new phase in the reform was introduced through the creation of a new funding system for primary care services. The aim of this paper is to present a practically applicable set of indicators to evaluate PHC reform in terms of health economics criteria and then to apply these indicators in evaluation of the Estonian PHC reform.

Suggested Citation

  • Koppel, Agris & Meiesaar, Kersti & Valtonen, Hannu & Metsa, Andrus & Lember, Margus, 2003. "Evaluation of primary health care reform in Estonia," Social Science & Medicine, Elsevier, vol. 56(12), pages 2461-2466, June.
    • Handle: RePEc:eee:socmed:v:56:y:2003:i:12:p:2461-2466
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    Citations

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    Cited by:

    1. Groenewegen, Peter P. & Dourgnon, Paul & Greß, Stefan & Jurgutis, Arnoldas & Willems, Sara, 2013. "Strengthening weak primary care systems: Steps towards stronger primary care in selected Western and Eastern European countries," Health Policy, Elsevier, vol. 113(1), pages 170-179.
    2. Atun, Rifat Ali & Menabde, Nata & Saluvere, Katrin & Jesse, Maris & Habicht, Jarno, 2006. "Introducing a complex health innovation--Primary health care reforms in Estonia (multimethods evaluation)," Health Policy, Elsevier, vol. 79(1), pages 79-91, November.
    3. Samuel S. Lieberman & Adam Wagstaff, 2009. "Health Financing and Delivery in Vietnam : Looking Forward," World Bank Publications - Books, The World Bank Group, number 2594.
    4. Habicht, Triin & Kasekamp, Kaija & Webb, Erin, 2023. "30 years of primary health care reforms in Estonia: The role of financial incentives to achieve a multidisciplinary primary health care system," Health Policy, Elsevier, vol. 130(C).
    5. Domantas Jasilionis & France Meslé & Vladimir M. Shkolnikov & Jacques Vallin, 2011. "Recent Life Expectancy Divergence in Baltic Countries," European Journal of Population, Springer;European Association for Population Studies, vol. 27(4), pages 403-431, November.
    6. Akinci, Fevzi & Mollahaliloğlu, Salih & Gürsöz, Hakki & Öğücü, Fatma, 2012. "Assessment of the Turkish health care system reforms: A stakeholder analysis," Health Policy, Elsevier, vol. 107(1), pages 21-30.
    7. Habicht, Jarno & Kunst, Anton E., 2005. "Social inequalities in health care services utilisation after eight years of health care reforms: a cross-sectional study of Estonia, 1999," Social Science & Medicine, Elsevier, vol. 60(4), pages 777-787, February.
    8. Põlluste, Kaja & Kasiulevičius, Vytautas & Veide, Sarmite & Kringos, Dionne Sofia & Boerma, Wienke & Lember, Margus, 2013. "Primary care in Baltic countries: A comparison of progress and present systems," Health Policy, Elsevier, vol. 109(2), pages 122-130.
    9. Simic, Snezana & Milicevic, Milena Santric & Matejic, Bojana & Marinkovic, Jelena & Adams, Orvill, 2010. "Do we have primary health care reform? The story of the Republic of Serbia," Health Policy, Elsevier, vol. 96(2), pages 160-169, July.
    10. Daisy Volmer & Martin Mäesalu & J. Simon Bell, 2008. "Pharmacy Students' Attitudes Toward and Professional Interactions With People With Mental Disorders," International Journal of Social Psychiatry, , vol. 54(5), pages 402-413, September.

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