Estonian Healthcare System
Tanel Ross
Chairman of the Management Board
Estonian Health Insurance Fund
Estonian Health Insurance Fund (EHIF)
• EHIF is a legal person in public law
• Main functions and purposes of EHIF:
– to cover the costs of health services provided to insured
persons,
– prevent diseases,
– health promotion,
– finance the purchase of medicinal products and
medicinal technical aids,
– provide the benefits for temporary incapacity for work
and other benefits.
The strenghts of health financing policy in
Esotnia are internationally recognized
However, there is need to broaden revenue base
Estonian Health Insurance Fund revenues and expenses on health in 2012 -2060 ( % of GDP)
Otherwise, we will start entering the deep red
territory in 7-8 years time
Change of reserves of Estonian Health Insurance Fund, % of GDP
Strategical EHIF 4 years cost plan includes
many strategical components
Additional cost due to increase of CPI
2014
2015
2016
2017
3,4%
1,8%
1,8%
1,7%
7,0%
7,3%
7,6%
6,2%
6,2%
6,2%
6,0%
6,0%
6,0%
6,0%
6,0%
6,0%
2,9%
1,5%
1,0%
1,0%
2,0%
1,7%
1,0%
1,2%
4,8%
9,9%
1,9%
1,8%
1,0%
1,0%
1,0%
1,0%
2,3%
1,3%
2,0%
1,3%
Health care workers salary increase
Primary care
Specialty care
Nursing care
Access improvement and new services
Primary care
Specialty care
Nursing care
Change in medical practice
Primary care
Specialty care
EHIF budget is part of the state
budget (approved by MoF)
Strategical EHIF 4 years cost plan is approved each year by EHIF board (mln
euros)
Type of care
Prevention
Primary care
Specialised care
Nursig care
Dental care
Total
2014
8,0
85,0
515,4
23,2
21,2
652,8
2015
8,3
90,7
545,3
26,5
22,2
693,0
2016
8,7
98,7
581,8
28,1
23,2
740,5
2017
9,1
106,0
617,4
29,8
24,2
786,5
Health insurance statistics 2015
•
•
•
•
•
1,2 million insured (94% population)
EHIF paid over 900 million euros for health care services
800 326 people used specialist care
4,7 family doctors appointments per insured person
Average cost per case in specialist care:
– 63 euros per outpatient care
– 481 euros per day care
– 1289 euros per inpatient care
•
Ca 7,9 million drug prescriptions
– 850 206 users
Average expenses per insured person
cost per patient in
euros
cost of benefits in cash
in thousands of euros
99
140.000
80
120.000
112.801
109.753
91.465
90.737
71.617
61.790
40.000
41
55.716
60.000
49
81.902
56
80.000
88.411
64
100
90
73
103.391
100.000
72
98.967
69
84
89
80
70
60
50
40
30
20
20.000
10
0
0
2005
2006
2007
2008
Benefits, thousands of euros
2009
2010
2011
2012
2013
2014
2015
Average cost of EHIF per one insured person, euros
The most important indicators in 2011-2015
The
change
compare
d to the
year
2011
2012
2013
2014
2015
2014
The number of the insured at the end
1 232
1 237
of the year
1 245 469 1 237 104 1 231 203
819
336
0%
Revenue (in thousand euros)
Health insurance costs (in thousand
euros)
Health Insurance Fund operating
expenses (in thousand euros)
The percentage of health insurance
expenditure from GDP (%) *
The percentage of the total health
expenditure from GDP (%) **
735 112
783 131 836,892 900,209 964,353
7%
718 418
773,575 830 419 908 213 973,609
7%
7,080
7,331
7,937
8,502
9,284
9%
4.3
4.3
4.4
4.5
4.8
5%
5.8
5.7
5.9
6.2
-
-
EHIF budget execution in 2014 and 2015
Target-financed health insurance costs
Additional benefit for medicinal products
Health care services of a European Union insured
person
Various health insurance benefits
Total
2014
actual
2015
budget
2015
Budget
actual execution
1,446
1,681
1,491
89%
199
220
349
159%
1,258
1,450
1,249
35
0
5
-
2,938
3,351
3,094
92%
86%
Thank you for your interest!
Tanel Ross
Chairman of the Management
Board
16.09.2016