Professional Documents
Culture Documents
HOPE Study Tour No 4 for Senior
Hospital Professionals and Managers
21.10.2009. Tallinn, Estonia
Dr. Urmas Sule, CEO Estonian Hospital Association
and Foundation Pärnu Hospital
Dr. Teele Raiend, Certified quality manager, Foundation
Pärnu Hospital
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K Talk about the key actors in health
care
K Major changes that have taken
place over the last 20 years
K How we got here where we are ±
the reforms
K hat has been and is the hospitals
role
K uality management development
K And we expect for active discussion!
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K According to the Estonian Constitution, §10, social
justice in Estonia is a state-based right. This
means, that the state must provide the possibility to
receive certain vital services for its citizens, one of
which, according to the Constitution¶s §28, is
everyone¶s right to the protection of health.
K The right to the protection of health means the
state¶s obligation to engage in both health
promotion and disease prevention as well as to
provide health services and benefits for persons.
As the state¶s obligations are limited by its
economic situation, persons do not have the right of
claim, arising from the Constitution, against the
state in order to receive health services or benefits
to the extent not specified by other Acts.
Consequently, persons cannot demand the
provision of all health services. Neither can they
demand the provision of health services completely
free of charge and without a waiting period.
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K Financing ± Estonian Health
Insurance Fund
K overnment, Ministry of Social
affairs etc ± legal basis, principles
and supervision
K Health care providers:
± The workforce
± Hospitals (and others)
K egislative framework ± market-
orientation and obligations¶-
regulation
K Centralized and state-controlled
K Over-capacitated provider network
± Strategic military network
± 120 hospitals with 18 000 beds (113 per 10
000)
K Health care free for everyone, the actual
costs of health care were rarely
considered
K Polyclinics
K Health promotion and prevention ± non-
existent?!?
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