Strategic purchasing reform in Estonia

dc.contributor.authorHabicht, Triin
dc.contributor.authorHabicht, Jarno
dc.contributor.authorGinneken, Ewout van
dc.date.accessioned2018-05-07T11:01:05Z
dc.date.available2018-05-07T11:01:05Z
dc.date.issued2015
dc.description.abstractAs 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.en
dc.identifier.issn0168-8510
dc.identifier.urihttps://depositonce.tu-berlin.de/handle/11303/7758
dc.identifier.urihttp://dx.doi.org/10.14279/depositonce-6936
dc.language.isoenen
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/en
dc.subject.ddc610 Medizin und Gesundheitde
dc.subject.otherspecialist careen
dc.subject.otherselective contractingen
dc.subject.otherstrategic purchasingen
dc.subject.otherquality of careen
dc.subject.otherhospitalsen
dc.subject.otherEstoniaen
dc.subject.otherEstlandde
dc.titleStrategic purchasing reform in Estoniaen
dc.title.subtitleReducing inequalities in access while improving care concentration and qualityen
dc.typeArticleen
dc.type.versionpublishedVersionen
dcterms.bibliographicCitation.doi10.1016/j.healthpol.2015.06.002en
dcterms.bibliographicCitation.journaltitleHealth Policyen
dcterms.bibliographicCitation.originalpublishernameElsevieren
dcterms.bibliographicCitation.originalpublisherplaceAmsterdamen
dcterms.bibliographicCitation.pageend1016en
dcterms.bibliographicCitation.pagestart1011en
dcterms.bibliographicCitation.volume119en
tub.accessrights.dnbfreeen
tub.affiliationFak. 7 Wirtschaft und Management::Inst. Technologie und Management (ITM)::FG Management im Gesundheitswesende
tub.affiliation.facultyFak. 7 Wirtschaft und Managementde
tub.affiliation.groupFG Management im Gesundheitswesende
tub.affiliation.instituteInst. Technologie und Management (ITM)de
tub.publisher.universityorinstitutionTechnische Universität Berlinen

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