Evaluation of primary health care reform in Estonia

Soc Sci Med. 2003 Jun;56(12):2461-6. doi: 10.1016/s0277-9536(02)00280-0.


Estonia began to reform its health care system by reorganizing primary health care (PHC). Ten years ago, the health care system was inefficient, supply was biased towards institutional care, and PHC was almost non-existent in the western understanding: it was provided by different specialists in policlinics, and the financial basis of the system was in crisis. The reform had the following aims: to develop PHC by introducing family medicine, to guarantee the whole population access to family doctors' services, and to secure stable funding for these services. In 1998, a new phase in the reform was introduced through the creation of a new funding system for primary care services. The aim of this paper is to present a practically applicable set of indicators to evaluate PHC reform in terms of health economics criteria and then to apply these indicators in evaluation of the Estonian PHC reform.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Efficiency, Organizational / economics*
  • Efficiency, Organizational / standards
  • Estonia
  • Family Practice / economics
  • Family Practice / organization & administration*
  • Family Practice / standards
  • Family Practice / statistics & numerical data
  • Financial Audit
  • Health Care Reform*
  • Health Services Accessibility
  • Health Services Research
  • Humans
  • Management Audit
  • Office Visits / statistics & numerical data
  • Primary Health Care / economics
  • Primary Health Care / organization & administration*
  • Primary Health Care / standards
  • Primary Health Care / statistics & numerical data
  • Quality Indicators, Health Care