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Specialized medical care costs are detailed and observable interactively

Software Technology and Applications Competence Centre (STACC), in cooperation with the Estonian Health Insurance Fund, has published an interactive chart, in which you can view the costs of the Estonian people with health insurance on specialized medical care by groups based on gender, age, and diseases.

The interactive graph is based on the 6.5 million medical invoices of the specialized medical care of the Health Insurance Fund from the years 2013- 2014 grouped by age, gender and main diagnosis. In the finding of the average number of cases and the costs, the distribution of the Estonian population by gender and age are taken into consideration. So that the individual cases would not be detectable in the graph, some invoices were removed from the database that does not however significantly change the overall amounts and proportions. In the near future, the data of the years 2015 and 2016 will be added to the chart.

“Disclosure of the data analysis of the healthcare provided to the insured persons increases the transparency of the health care system, which is one of our priorities. The created graph clearly shows that the greater part of the total cost of specialized care is already now made for the treatment of older patients. Given that the current financing of the Estonian health care depends mainly on employment-based financing, and looking at the trend that our population is aging, in the coming decades even more and people of working age are becoming scarcer, performance of such in-depth analyses is significant support in the discussions of health care funding and sustainability,” said Pille Banharn, the Head of the Financial Management Department of the Health Insurance Fund.

The interactive graph gives an overview of both the general picture of the specialized health care costs as well as allows for more detailed exploration of some more interesting diagnosis categories. In the specialized health care costs, which account for 80% of health care budget, as expected, dominated the expenditures of elderly care. For example, if the specialized medical expenses of all the 40-year-old Estonian people are less than 5 million euros, then in the case of 65-year-olds it is already more than two times higher. And when the average cost of a  45-year-old resident of Estonia for the Republic of Estonia is less than 300 euros a year, for the 50-year-old it is already 350 euros, and for the 60-year-old it is 550 euros.

The graph allows comparing the costs for men and women. So it appears, for example, that treatment of a 78-year-old Estonian takes an average of 1000 euros per year, the treatment of a man of the same age takes on average considerably more -  1,300 euros, while the treatment of one woman takes on average less than 900 euros per year. The average cost for one man is higher than the corresponding figure for women in many diagnosis categories, among others, there is an important difference in the cost of treatment of the circulatory system diseases and tumors. These two are the most costly diagnosis categories - in 2014 the Health Insurance Fund spent 93 million euros on the treatment of circulatory system diseases, and 61 million euros on the treatment of tumors.

"Such specific comparable numbers makes one think about their health at an early age because it is obvious that diseases and health-related costs do not only hit people at an old age. On the contrary, health costs will start growing year-by-year at a young age. This is proof of how important health promotion and prevention is, in order to develop a healthy lifestyle for people,” said Tormi Reinson, a researcher of STACC and the creator of the graph.

Professor Jaak Vilo, the leader of the direction of research of STACC added: “The frequency of the different diseases of Estonian residents and the cost of special medical care needed for these in case of people of different ages is important, in order to assess the impact of diseases and their costs in the context of an aging nation, and for the introduction of new therapies. Big data analysis is important in order to analyze the relationship between the diseases, treatment methods, and the course of treatment, as well as preventive actions."

While the general overview of health care costs has always been available, the detailed diagnosis, age and gender based view of the graph is innovative, and a novel interactive presentation solution has been used.