The State of Health Care Integration in Estonia

The report “The State of Health Care Integration in Estonia” summarizes an assessment of the state of health care integration in Estonia and its driving forces. In the absence of a widely accepted definition, this study defines health care integration as: i) the delivery of care in the appropriate care setting and ii) coordination and continuity of care across care settings. The study focuses on integration issues related to the prevention and treatment of chronic diseases, with particular attention to the role and functioning of primary care and equity issues. The findings of this analysis therefore do not provide a comprehensive assessment of quality within specific care settings (i.e., primary care, acute inpatient care, etc.), nor of overall health system performance. Yet, they constitute one of several inputs that may be relevant for future policy changes. These study findings are based on a quantitative analysis of health insurance claims data plus stakeholder interviews and focus group discussions as part of a joint research agenda between the Estonian Health Insurance Fund (the EHIF) and the World Bank Group (WBG).

The report was prepared by a team led by Christoph Kurowski. Team members were Amit Chandra, Elyssa Finkel, and Marvin Plötz.

Study materials:


Evaluation Report of the 2017 Enhanced Care Management Pilot in Estonia 

Toward greater integration of care and improved efficiency: A critical review of EHIF’s payment system


Summary Report & presentation

Quality assurance analysis 

Qualitative Research Results: Focus Groups Discussions & Key Informant Interviews

The State of Integration of Care in Estonia - Operations Manual for Performance Indicators

Conference presentations:

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