This article provides insufficient context for those unfamiliar with the subject.(March 2019) |
Healthcare in Estonia is supervised by the Ministry of Social Affairs and funded by general taxation through the National Health Service.
The service is administered by the Estonian Health Insurance Fund (EHIF). An insured person must be either a permanent resident or a legal resident who pays the social tax. All health care providers in Estonia are required to submit the health information of their patients to the digital health information system.
Estonia's health care system is based on compulsory insurance based on solidarity funding and on universal access to services provided by private service providers. All providers of health services are autonomous businesses governed by private law. The single buyer and payment method is the Estonian Health Insurance Fund (Eesti Haigekassa), which pays all contracted providers. The majority of general practitioners work for themselves, privately owned businesses, or local governments. In Estonia, the majority of hospitals are either foundations created by the government, municipalities, or other public organizations, or limited businesses owned by the local government. If the hospital has a contract with the Fund, the Estonian Health Insurance Fund will also pay for necessary treatments received in a private hospital. If no agreement is reached, private medical care is not reimbursed. [1]
The Estonian healthcare system is funded through mandatory contributions made through a payroll tax. It accounts for almost two-thirds of all healthcare expenditure in the country. The Estonian Health Insurance Fund (EHIF) is an independent body that acts as the sole purchaser of medical care. It operates through four regional branches, each covering two to six counties, which collect and disburse funds, contract service providers, and provide pharmaceuticals and other health programs. [2]
The health insurance system covers about 95% of the population. Contributions are proportional to employment and salaries, but non-contributing citizens represent almost half of the insured people. The Ministry of Social affairs covers uninsured persons and ambulance services.[ citation needed ]
Estonia is a pioneer in the use of electronic health records because when general practice was moved out of hospitals in 1998 the records were kept in the hospitals, so GPs had to start their own system. Madis Tiik established an electronic record system though it was officially illegal until 2002. He was a founding member of the eHealth Foundation and became its chief executive. There is now a central record system which is available to all healthcare professionals and can be viewed by the patient. Some tasks are automated, so that doctors do not have to certify that people are fit to drive. The application automatically checks their medical history. [3]
Estonia was the first country in the world that has implemented a nationwide EHR system, registering virtually all residents' medical history from birth to death. It was launched on 17 December 2008. [4]
Estonia used its existing digital public service software known as X-Road to create the EHR network. Estonia's system was overseen by the Ministry of Social Affairs until the creation of the Estonian e-Health Foundation. [5] Since its implementation, 95% of health data has been digitized. Citizens that participate in the program are given an individual card that is used to access their records, like a national identification. [6]
The cost of this system has been €7.50 per person at the time of creation. Costs can stay low due to Estonia's small population. [7] The system is still too small to create proper diagnosis and track national statistics according to the National Audit Office. [8]
Along with e-Health records, Estonia has also created an e-Prescription service. It allows doctors to create an electronic prescription that is then added to a patient's health card and accessed at a pharmacy to receive the medicine they may require. Now 97% of prescriptions are digital in Estonia. [9]
Upon giving birth, the Estonian government grants one of the parents 100% of their former salary for 18 months, plus 320 Euros of one-time support per child. After 18 months, the parent has the right to resume her/his former position. In addition, the parent and child receive free healthcare. Parents who did not work before giving birth (unemployed, students, etc.) receive 278 Euros a month; the top salary is capped at 2,157 Euros a month. [10] These measures, which have been in force from 2005, have not been proven to have had a major positive effect on the birth rate in Estonia, which has increased already since 2001. [11]
Those policy measures concentrate on the first 18 months of the child's life. After 18 months, the monthly state support to a child goes down to 60 Euros a month (for the first two children) and 100 euros (from third child on), plus free healthcare. There are many exceptions and added bonuses to the rule. For example, the child of a single parent receives additional sum of 19.18 Euros of child support. The child of an army member receives 300 Euros a month, and children in foster families receive 240 Euros a month. [12] Despite considerable variation and fluctuations in the support to the family with children, the majority of Estonian families do not face great hardships and the State of The World's Mothers 2011 report ranked Estonia as the 18th best country in the world to be a mother, ahead of countries like Canada and the United States. [13] The 2014 report ranked the neighboring Finland as the best country to be a mother in. According to the CIA World Factbook, Estonia has the 166th lowest maternal death rate in the world. [14]
Health care reform is for the most part governmental policy that affects health care delivery in a given place. Health care reform typically attempts to:
Health care, or healthcare, is the improvement of health via the prevention, diagnosis, treatment, amelioration or cure of disease, illness, injury, and other physical and mental impairments in people. Health care is delivered by health professionals and allied health fields. Medicine, dentistry, pharmacy, midwifery, nursing, optometry, audiology, psychology, occupational therapy, physical therapy, athletic training, and other health professions all constitute health care. The term includes work done in providing primary care, secondary care, tertiary care, and public health.
Health insurance or medical insurance is a type of insurance that covers the whole or a part of the risk of a person incurring medical expenses. As with other types of insurance, risk is shared among many individuals. By estimating the overall risk of health risk and health system expenses over the risk pool, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to provide the money to pay for the health care benefits specified in the insurance agreement. The benefit is administered by a central organization, such as a government agency, private business, or not-for-profit entity.
Healthcare in Canada is delivered through the provincial and territorial systems of publicly funded health care, informally called Medicare. It is guided by the provisions of the Canada Health Act of 1984, and is universal. The 2002 Royal Commission, known as the Romanow Report, revealed that Canadians consider universal access to publicly funded health services as a "fundamental value that ensures national health care insurance for everyone wherever they live in the country."
Two-tier healthcare is a situation in which a basic government-provided healthcare system provides basic care, and a secondary tier of care exists for those who can pay for additional, better quality or faster access. Most countries have both publicly and privately funded healthcare, but the degree to which it creates a quality differential depends on the way the two systems are managed, funded, and regulated.
Health care in Ireland is delivered through public and private healthcare. The public health care system is governed by the Health Act 2004, which established a new body to be responsible for providing health and personal social services to everyone living in Ireland – the Health Service Executive. The new national health service came into being officially on 1 January 2005; however the new structures are currently in the process of being established as the reform programme continues. In addition to the public-sector, there is also a large private healthcare market.
A public hospital, or government hospital, is a hospital which is government owned and is fully funded by the government and operates solely off the money that is collected from taxpayers to fund healthcare initiatives. In almost all the developed countries but the United States of America, and in most of the developing countries, this type of hospital provides medical care free of charge to patients, covering expenses and wages by government reimbursement.
Healthcare in the United Kingdom is a devolved matter, with England, Northern Ireland, Scotland and Wales each having their own systems of publicly funded healthcare, funded by and accountable to separate governments and parliaments, together with smaller private sector and voluntary provision. As a result of each country having different policies and priorities, a variety of differences have developed between these systems since devolution.
The Swedish health care system is mainly government-funded, universal for all citizens and decentralized, although private health care also exists. The health care system in Sweden is financed primarily through taxes levied by county councils and municipalities. A total of 21 councils are in charge with primary and hospital care within the country.
Healthcare in the Netherlands is differentiated along three dimensions (1) level (2) physical versus mental and (3) short term versus long term care.
Healthcare in Taiwan is administered by the Ministry of Health and Welfare of the Executive Yuan. As with other developed economies, Taiwanese people are well-nourished but face such health problems as chronic obesity and heart disease. In 2002 Taiwan had nearly 1.6 physicians and 5.9 hospital beds per 1,000 population. In 2002, there were 36 hospitals and 2,601 clinics in the country. Per capita health expenditures totaled US$752 in 2000. Health expenditures constituted 5.8 percent of the gross domestic product (GDP) in 2001 ; 64.9 percent of the expenditures were from public funds. Overall life expectancy in 2019 was averaged at 81 years.
Healthcare in Finland consists of a highly decentralized three-level publicly funded healthcare system and a much smaller private sector. Although the Ministry of Social Affairs and Health has the highest decision-making authority, specific healthcare precincts are responsible for providing healthcare to their residents as of 2023.
Electronic prescription is the computer-based electronic generation, transmission, and filling of a medical prescription, taking the place of paper and faxed prescriptions. E-prescribing allows a physician, physician assistant, pharmacist, or nurse practitioner to use digital prescription software to electronically transmit a new prescription or renewal authorization to a community or mail-order pharmacy. It outlines the ability to send error-free, accurate, and understandable prescriptions electronically from the healthcare provider to the pharmacy. E-prescribing is meant to reduce the risks associated with traditional prescription script writing. It is also one of the major reasons for the push for electronic medical records. By sharing medical prescription information, e-prescribing seeks to connect the patient's team of healthcare providers to facilitate knowledgeable decision making.
The French health care system is one of universal health care largely financed by government national health insurance. In its 2000 assessment of world health care systems, the World Health Organization found that France provided the "best overall health care" in the world. In 2017, France spent 11.3% of GDP on health care, or US$5,370 per capita, a figure higher than the average spent by rich countries, though similar to Germany (10.6%) and Canada (10%), but much less than in the US. Approximately 77% of health expenditures are covered by government funded agencies.
Healthcare in Denmark is largely provided by the local governments of the five regions, with coordination and regulation by central government, while nursing homes, home care, and school health services are the responsibility of the 98 municipalities. Some specialised hospital services are managed centrally.
The nation of Austria has a two-tier health care system in which virtually all individuals receive publicly funded care, but they also have the option to purchase supplementary private health insurance. Care involving private insurance plans can include more flexible visiting hours and private rooms and doctors. Some individuals choose to completely pay for their care privately.
Examples of health care systems of the world, sorted by continent, are as follows.
India has a multi-payer universal health care model that is paid for by a combination of public and government regulated private health insurances along with the element of almost entirely tax-funded public hospitals. The public hospital system is essentially free for all Indian residents except for small, often symbolic co-payments in some services.
Federal and state governments, insurance companies and other large medical institutions are heavily promoting the adoption of electronic health records. The US Congress included a formula of both incentives and penalties for EMR/EHR adoption versus continued use of paper records as part of the Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the, American Recovery and Reinvestment Act of 2009.
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