Proportion of medication cost-sharing by patients has continued to decrease

The report covering the first half of 2011 of the Health Insurance Fund is now completed. In the first half of 2011, the income of the Health Insurance Fund exceeded its expenses. The revenue was 3.5 per cent higher than forecast and the amount of expenses was 2.4 per cent lower than planned. The finances spent by the Health Insurance Fund on health care and benefits for temporary incapacity for work have grown compared to 2010.

The portion of medication costs shared by patients is still decreasing. When in the first half of 2010, the patients paid an average of 8 euros for medication dispensed at a discount, then at the end of the first half of 2011, they paid 7 euros. However, 36,000 more people are using medication dispensed at a discount.

In the first half of 2011, the revenue of the Health Insurance Fund was a total of 364.8 million euros. The health insurance expenses of the same period were 362.8 million euros.

At the end of the first half-year, 1,254,245 people were insured. Of them, 45 per cent were employed, 48 per cent were persons equal to insured persons and 5.5 per cent were persons insured by the state.

In the first half of the year, the Health Insurance Fund paid 262 million euros for health care services, which is 4.8 per cent higher year-on-year. The main cause for the growth of expenditure was the increased number of ambulatory care cases in the first half of the year and the changed coefficient applied to the reference prices of health care services from 1 January 2011.

In the first half of 2011, 33.2 million euros were spent to finance general medical care. The expenses of general medical care increased 4 per cent compared to the same period of 2010. The largest share of expenses, 67 per cent, was made up by the capitation fee, the examinations fund accounted for 21 per cent of the total expenditure of general medical care and the base money 11 per cent. The expenses of examinations have increased 10 per cent compared to the previous year.

The expenses of specialised medical care in the first half of the year were a total of 209.4 million euros. The number of treatment cases has increased by more than 88,000 and the number of people who have used specialised medical care services has grown 3 per cent. For example, around 1.9 million ambulatory and day surgery and procedure consultations were carried out in the first half of the year, which is 5 per cent more than in the previous year. Consequently, the number of people who have been treated has grown compared to the first half of the previous year. The number of in-patient cases has remained the same.

The number of nursing care cases has grown by 11 per cent compared to the previous year. The number of both in-patient and out-patient nursing care cases has increased, the latter primarily including home nursing (20 per cent).

In the first half of 2011, the cost of medication was compensated for insured persons in the amount of 44.6 million euros. Of all the prescriptions issued, digital prescriptions accounted for 84 per cent. The widespread use of digital prescriptions has provided a good opportunity to prescribe discount medication to patients, which in turn has resulted in a reduction in the proportion of medication sold at a 50 per cent discount.

The proportion of medication cost-sharing is continuingly decreasing. Compared to the same period of 2010, the share paid by the insured has decreased by 1.4 per cent. Consequently, the cost shared by patients has decreased both in terms of percentage and absolute numbers.

In the first half of 2011, expenses connected with benefits for temporary incapacity for work were higher by 3 per cent than in the previous year. This was caused by the growth in the number of certificates for sick leave and care leave with 22 per cent and 28 per cent, respectively. The Health Insurance Fund spent 84.4 million euros on paying other monetary benefits in the first half of the year, which is 3.4 per cent less than at the same period in the previous year.

Further information:

Agnes Männiste
Estonian Health Insurance Fund
Communications specialist
Phone 620 8419