Ninety per cent of Estonian family physicians have joined the quality indicator system

Based on the results of 2010, the Health Insurance Fund has, since June, been paying a quality fee in the total amount of 808,357 euros to 281 family physicians. The best family physicians in Estonia work in the region of Pärnu, where 94 per cent of family physicians have joined the quality system and where 55 per cent of the participants achieved good results. As much as 90 per cent of all family physicians in Estonia have joined the quality indicator system. The family physicians’ quality indicator system comprises several indicators that measure the degree of quality of the most important activities performed by a family physician. Based on the results, the family physicians who achieve very good results are paid an additional fee.

The popularity of participating in the quality system has been growing over the years and 718 family physicians had joined the system by 2010. This year, 182 family physicians will receive an additional fee for their work in preventing diseases and monitoring chronic diseases with the coefficient 1.0 based on the assessed quality indicators. In addition, 99 family physicians will receive an additional fee calculated with the coefficient 0.8. Additional fees for advanced competence were received by 142 family physicians. The one-time quality fee will be paid out starting from July. This year, the total amount of the quality fee that a family physician could receive in addition to regular financing is 3719.66 euros.

At the early stages of the application of the quality indicator system, the number of family physicians who met the quality indicators grew year by year, but the results have stabilised over the past three years: 30 family physicians received an additional fee for their work done in preventing diseases and monitoring chronic diseases in 2006, 175 in 2007, 266 in 2008 and 355 in 2009.

“The quality system enables paying family physicians a differentiated fee depending on their performance. It is good to see that the number of participants is growing and that good results have been consistent,” said Mari Mathiesen, a member of the Management Board of the Health Insurance Fund. “Along with the Society of Estonian Family Physicians, we have decided that in the following years we will pay more attention to the family physicians who have joined the quality system but produce low scores. There is still room for improvement,” added Mathiesen.

The quality system for family physicians was developed by the Health Insurance Fund in cooperation with the Society of Estonian Family Physicians. It was initially launched in 2006 with the aim of improving the prevention of diseases and monitoring of patients with chronic conditions.

The quality system includes several measurable indicators that have been developed further over the years. Prevention activities include vaccinations as well as the prevention of chronic diseases in risk groups. The chronic diseases that family physicians deal with include high blood pressure, type II diabetes and thyroid malfunction, but also patients who have suffered a myocardial infarction. The activities are designed to prevent complications and keep diseases from becoming more acute. The disease groups were chosen based on their strongest impact on the health and mortality of the population and the indicators were selected according to internationally accepted evidence-based activities that have been identified as having an effect on people’s health. In addition, the quality system also assesses the additional competence of family physicians, e.g. gynaecological activities and monitoring pregnancies.


Evelin Koppel
Public Relations Manager
Estonian Health Insurance Fund
Phone 6 208 439; 534 789 49
evelin.koppel [at]