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Main Title: Strategic purchasing reform in Estonia
Subtitle: Reducing inequalities in access while improving care concentration and quality
Author(s): Habicht, Triin
Habicht, Jarno
Ginneken, Ewout van
Type: Article
Language Code: en
Abstract: As of 2014, the Estonian Health Insurance Fund has adopted new purchasing procedures and criteria, which it now has started to implement in specialist care. Main changes include (1) redefined access criteria based on population need rather than historical supply, which aim to achieve more equal access of providers and specialties; (2) stricter definition and use of optimal workload criteria to increase the concentration of specialist care (3) better consideration of patient movement; and (4) an increased emphasis on quality to foster quality improvement. The new criteria were first used in the contract cycle that started in 2014 and resulted in fewer contracted providers for a similar volume of care compared to the previous contract cycle. This implies that provision of specialized care has become concentrated at fewer providers. It is too early to draw firm conclusions on the impact on care quality or on actors, but the process has sparked debate on the role of selective contracting and the role of public and private providers in Estonian health care. Lastly, the Estonian experience may hold important lessons for other countries looking to overcome inequalities in access while concentrating care and improving care quality.
Issue Date: 2015
Date Available: 7-May-2018
DDC Class: 610 Medizin und Gesundheit
Subject(s): specialist care
selective contracting
strategic purchasing
quality of care
Journal Title: Health Policy
Publisher: Elsevier
Publisher Place: Amsterdam
Volume: 119
Publisher DOI: 10.1016/j.healthpol.2015.06.002
Page Start: 1011
Page End: 1016
ISSN: 0168-8510
Appears in Collections:FG Management im Gesundheitswesen » Publications

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