Estonia

Healthcare System

Estonia’s healthcare system is the Health Insurance System, described as “solidarity-based health insurance” [1], and the Estonian Health Insurance Fund (EHIF) is the public law organization responsible for providing the organization of national healthcare services in accordance with the Health Insurance Act, the Health Services Organization Act, and other legislation.

The body responsible for healthcare and all social policies in Estonia is the Ministry of Social Affairs. The Health Board is its child agency. Estonia’s Public Information Act details the terms of compliance to request information not already publicly available. The request is exempt from covering expenses if the request is made for research work.

Administrative or Claims Data

Estonian Health Insurance Fund (EHIF) Database

[2]

Sponsor, manager or home institution: Estonian Health Insurance Fund (EHIF); The Ministry of Social Affairs

Type of information: Medical contacts (physician visit, hospital stay, etc.), including diagnostic tests, prescription medicine, medical devices, and treatment.

Source of Information: Based on claims data from all Estonian healthcare providers that have signed a contract with EHIF and deliver EHIF-financed healthcare.

Data level: Patient level.

Number of Records: 1.3 million people, i.e. 95% of Estonia's population.

Date Range: 2004 onwards.

Link/Contact for data request: Contact information.

Registries

Estonian Cancer Registry

Primary purpose: A complete and reliable registration of incident cancer cases in Estonia.

Sponsor, manager, or home institution: The National Institute for Health Development; Ministry of Social Affairs.

Available databases: The Health Statistics and Health Research Database and the Statistics Estonia Database

Available information: Datasets about the incidence of cancer in general and specific types of cancer, sortable by year, sex, site and age group, as well as causes of death and death rates.

Available data level: National level. Malignant neoplasms' statistics are submitted by 15 counties.

Collected information: patient name, identification number, gender, date of birth, place of birth, residence, marital status, nationality, primary site, date of diagnosis, confirmation methods of diagnosis, tumour morphology and grade, extent of disease, primary treatment (surgery, radiotherapy, cytostatic chemotherapy, hormone therapy, other treatment), follow-up data (date of death or emigration) and cause of death, source of information

Number of records: Every registered Estonian citizen.

Data source: “Reporting of cancer cases is compulsory to all physicians working in Estonia who diagnose or treat cancer. Data are submitted to the registry also by forensic pathologists-experts” [3].

Cancer areas of interest (ICD): All sites (C00–C97); All sites except other skin (C00–C97, except C44); Lip, oral cavity and pharynx (C00–C14); Digestive organs (C15–C26); Respiratory and intrathoracic organs (C30–C39); Female genital organs (C51–C58); Male genital organs (C60–C63); Urinary tract (C64–C68); Brain and central nervous system (C70–C72); Leukaemia (C91–C95); Lymphomas (C81–C85/C96); county-level lymphoma data include Hodgkin’s disease as well as non-Hodgkin lymphomas.

Link/contact: Contact information.

Electronic Health Records

Health Information System

Primary Purpose: Allowing healthcare service providers to see and share patient information and healthcare data across the country.

Sponsor, manager, or home institution: Ministry of Social Affairs (sponsor); Health and Welfare Information Systems Centre - TEHIK (manager)

Number of records: Any Estonian citizen who used a healthcare service since 2008.

Data source: Data inserted by healthcare providers.

Date range: 2008 onwards.

Link/contact: Contact information.

Clinical Practices Guidelines

Action Plan for Cancer Control

Primary purpose: Reducing the number of cancer cases and deaths, and improving the quality of life of cancer patients.

Sponsor, manager or home institution: Ministry of Social Affairs; National Institute of Health Development; Estonian Cancer Society.

Level: National level.

Cancer ares of interest: All.

Availability in English: No.

Good Practices Guidelines for Clinical Trials

Primary purpose: To ensure the rights, safety and well-being of the participant according to the principles of the Declaration of Helsinki.

Sponsor, manager or home institution: European Medicines Agency.

Level: National level.

Cancer Areas of Interest: All.

Availability in English: Yes.

Latest Policymaking Initiatives

Healthcare Costs 2019

Institution: National Institute for Health Development.

Primary purpose: Provide information about healthcare costs for anyone interested in healthcare.

Type of information: Total national health expenditure, comparisons to previous years, share of public sector and other details, household expenditures, and healthcare insurance fund expenditures, among others.

Level: National level.

Estonian Handbook for Guideline Development

Institution: Estonian Health Insurance Fund.

Primary purpose: To serve as an up-to-date practical resource for developing health guidelines.

Type of information: Guideline development process, topic proposals, evidence retrieving, report, dissemination of recommendations, among other topics.

Level: National level.