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PRESS RELEASE: Financial results of Estonian Health Insurance for nine months of the year 2016

In the first half of this year the Health Insurance Fund financed health care services for 564 million euros, which is approximately 33 million euros more than the same period last year. Medicines were compensated at 99 million euros and the temporary disability benefits were paid at 100 million euros.

During the 9 months, specialized medical care was used by 710 thousand insured patients, who had the total of three million physician appointments and were hospitalized for 954,000 days, whereas every patient spent in the hospital an average of 5.9 days. Physicians performed 115,000 surgeries. The number of people for whom the Health Insurance Fund financed services during the nine-month period, has remained at the same level compared to the same period last year.

Medicines were purchased in pharmacies on the basis of a total of 6 million prescriptions, and the Health Insurance Fund paid for each discounted prescription as a bonus on an average of about 16 euros. Compared to the same period last year, funding for medicinal products has increased by approximately 19% or by 16 million euros.  The hepatitis C medications affected the growth of financing of the medicines the most.  Temporary incapacity for work was compensated for 100 million euros, which is nearly 10 million more than in the same period last year.  The total compensation amounted to over 4 million days of incapacity for work, paying for one day for an average of 22.5 euros.

Compared to the same 9 months of last year, the funding of health care has grown most in primary medical care, whose budget has increased by 12%, or nearly eight million euros. Also, the funding of nursing care (6%), specialist medical care (5%) and dental care (4%) has increased.

During the 9 months, primary medical care was financed for the total of 77 million euros, which is 8 million euros more than the year before. The growth is due to increases in the Therapy and the Fee for Services Funds. The volume of the Fee for Services Fund grew by nearly 16%, which has created significantly expanded opportunities for family physicians to refer their patients for tests. About half of the family physicians use the possibilities of the Fee for Service Fund to the full extent. In addition to an increase in funding for services, the content of the Therapy Fund changed this year namely, in addition to the services of a clinical psychologist and speech therapist, physiotherapy services were added to its range. As of the beginning of the year, the e-Consultation service that allows family physicians to electronically and quickly consult with medical specialists can be used in 13 specialties. In the first half of the year, the Health Insurance Fund paid for 3051 cases of e-Consultations. E-Consultation is mostly sought after in the specialties of neurology, endocrinology, urology, and ear-nose-throat physicians. In 9 months, 177 thousand calls were made to the family physician’s helpline 1220, which is working around the clock.

During the period of 9 months, the Health Insurance Fund paid to medical institutions 440 million euros for about 2.4 million treatment cases of specialized medical care. In doing so, the Health Insurance Fund paid for a single outpatient appointment, an average of 74 euros, for a day treatment case, 549 euros, and for hospitalization, 1,453 euros, which in the three types of treatment is a total of 5% more than the year before. 70% of the people had a medical specialist’s appointment during the maximum waiting period provided for the scheduled treatment.

During the 9 months, nursing care was financed for a total of 23 million euros, which is 6 6% more than the year before. Inpatient nursing care was rendered to 9388 patients and home nursing services to 6804 patients.

The Health Insurance Fund paid nearly 17 million euros for dental services during the first 9 months of 2016. The total number of children, aged 3-19 in Estonia, is a little more than 236 thousand, and out of these, during the 9 months, 126 thousand have been to the dentist for treatment or for preventive check-ups. The number of children who received dental care has increased by 2% compared to the same period last year. Orthodontics services were rendered to 17 thousand children, which, compared to the same period of the previous year has increased by almost 822 children.

During the 9 months, the Health Insurance Fund financed medical devices for about 60 thousand patients who were insured for 7 million euros, which is 5.2% more than at the same period last year. The biggest share of the compensations for medical devices is formed of the means supporting the coping of people with diabetes, compared to the previous year, the number of users of blood glucose test strips, has increased by nearly 5%.

Tests and treatment abroad were funded by the Health Insurance Fund during the 9 months period for 5 million euros, and 165 patients were referred to a foreign country for scheduled treatment on the basis of the recommendation of a physician’s council. The Health Insurance Fund paid to foreign medical institutions for the medical care acquired on the basis of the European Health Insurance Card a total of 2.7 million euros, whereas repayments were made to the extent of 44 thousand euros directly to the insured people who, while staying abroad, did not have the European Health Insurance Card with them, which is why they had to initially pay for the medical care by themselves on the spot.

Read more:

·         The full report is available  here.

·         The set of slides summarizing the results of the 9-month report.

 Additional Information:

Liis Hinsberg
Head of the Division of Health Promotion and Communication
Estonian Health Insurance Fund
Tel 6208459
liis.hinsberg [at] haigekassa.ee