The Supervisory Board of the Health Insurance Fund approved the financial results for the year 2014

At a meeting held on May 5, 2015, the Supervisory Board of the Health Insurance Board approved the annual report for the year 2014.

In the past year, the Health Insurance Fund financed health care services, medicines and a variety of benefits for a total of 908 million euro, which is 78 million more than the year before.

The budget for health care services is used to finance the areas of disease prevention, general medical care, specialized medical care, nursing care, dental care, and health promotion. In the year 2014, health care services were funded for a total of 664 million euro.

In 2014, family health care was funded for 82.2 million euro, which is 6.2 million euro more than the year before. Since the beginning of 2014, a separate operational fund has been used for family doctors, to motivate the actions of a family doctor. As a new service, first contact care was set up for visits outside normal working hours.

Funding for specialized medical care, in the past year, amounted to nearly 529 million euro, for which more than 3.2 million treatment cases were provided to persons covered by the insurance of the Health Insurance Fund. Compared to last year, funding for specialized medical care grew by 47 million euro, allowing to provide nearly 90 thousand medical appointments more than the previous year.

In the fourth quarter of 2014, 73% of the scheduled first contact outpatient specialist medical care appointments of the Hospital Network Development Plan took place, during which the maximum allowed length of a waiting list (up to 42 calendar days) was achieved. Compared to the same period last year the number of scheduled first contact appointments has increased by 11 thousand appointments, whereas the number of the appointments held within the maximum length of waiting time has increased by 4 thousand appointments. Waiting times for the specialist medical outpatient appointment are particularly long in hospitals in Tallinn and Tartu. The desire of the patients to gain access to medical treatment in central and regional hospitals is higher than the possibilities of hospitals to provide outpatient consultations.

In 2014, the Health Insurance Fund paid the medical institutions 24.5 million euro for 57 thousand cases of nursing care. In the year 2014, estimated financial volume of nursing care was 23.9 million euro, which was 16% higher than the funding of the nursing care services in the year 2013. The preferential growth of the budget compared to that of other types of health care services resulted from the wage agreement with health care professionals and the need to support the growing role of nursing activities.  

In 2014, the Health Insurance Fund financed the provision of dental care to 147 thousand children. The number of children whose dental care and preventive dental services were funded by the Health Insurance Fund has grown by 1100 the children in comparison with the year 2013.

In 2014, discount medicines in the total amount of 109.8 million euro were compensated for to the persons covered by health insurance. The funding of compensation of medicines grew by 6.2% compared to the year 2013. The number of discount recipes has increased by 3% compared to the previous year, this reflects an increase in drug use, which is especially pronounced in terms of expensive discounted medicines compensated for by 100%.  In 2014, 86% of the prescriptions were issued by doctors on the basis of the active ingredient. An active ingredient based prescription enables a person to choose in the pharmacy the medicine with the most suitable price from among the medicines with the same active ingredient.

Benefits for temporary incapacity for work in 2014 were 103.9 million euro, which is 9.8 million more than in the previous year. Compared to the year 2013, benefits for incapacity for work increased by 10%, exceeding the budget by 8%. The cause for exceeding the budget was a higher increase than projected of the average salary, the number of employed insured persons and the number of certificates for maternity leave.

Last year, the Health Insurance Fund financed cross-border health care for slightly more than 10 million euro, including the scheduled treatment abroad for 3.9 million euro, and for 6.1 million euro for the use of the facilities established for the Estonian residents covered by health insurance under the European Union legislation. In the case of scheduled treatment during the year 2014, the Health Insurance Fund has taken over the payment obligation of 248 cases. Of these, 58 decisions were made on the scheduled treatment abroad, 166 for conducting examinations abroad and in the case of 24 insured persons, a non-related bone marrow donor was searched for.  Reject decisions have been made only in 8 events, i.e., the proportion of accepted applications is 97%. In 2014, most patients went for treatment or examinations to Finland and Germany. Most of the gene research was performed in the Netherlands and Belgium.

The Health Insurance Fund will reimburse the insured persons with the necessary medical device, with the help of which is possible to treat illnesses and injuries, or the use of which prevents the progression of the disease. In 2014, the compensation for medical devices was almost 9 million euro, which compared to the year 2013 has grown by more than 5%. This is expected since at the beginning of 2014 the list was supplemented by a new group of medical devices, and a number of groups were supplemented with new products, and the conditions for compensation were changed. The number of users of medical devices reimbursed by the Health Insurance Fund has grown by over 24%.

The Annual Report of the Health Insurance Fund is available on the web page of the Fund in the statistics and financial reports section: https://www.haigekassa.ee/et/haigekassa/aruanded-eelarved-statistika