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Strategy and policy
Reform Support

Health system performance assessment framework for Estonia

Supporting reforms to improve the quality and sustainability of our healthcare systems

Funding Programme
Year
  • 2021

Health system performance assessment framework for Estonia

The European Commission helped national authorities in Estonia to have a clear health information system governance and an agreement on a systematized list of health system performance monitoring indicators and objectives.

Context

In Estonia, a National Health Plan (NHP) describes the strategies and developments of the various health system stakeholders. Activities that monitor some aspects of the health system and its performance are in place, but they are fragmented and not systematically conducted. The last Health System Performance Assessment (HSPA) in Estonia was conducted in 2009, and while it resulted in a HSPA framework, it has not been consistently implemented since.

Estonian health data is collected and analysed by several different organisations which all follow separate strategy, methodology and procedure for the health statistics. The lack of a coherent and transparent governance structure hinders synchronisaton of data collection policies and processes towards an overall HSPA in Estonia. The roles and responsibilities are blurred, which results in fragmentation in the health information system, wastage of resources, duplication of efforts, and making it very complicated to make evidence-based policy decisions. Furthermore, a vast amount of health data are collected and occasionally collected data is overlapping, thus there is a clear need to incentivize the use of e-health information system data in a way that will boost the development of indicators based on e-health data. Therefore, there is a need for clear health information system governance and for agreement on a systematized list of health system monitoring indicators and objectives.

Support Delivered

In order to produce the aforementioned outputs, the OECD performed the following activities:

  • Organise and carry out workshops with key stakeholders in Estonia on the objectives of the new HSPA in Estonia, alignment with the NHP, HSPA governance, and the contents of the HSPA framework.
  • Organise in-depth, technical focus groups discussions on data availability for the HSPA and on the existing health data infrastructure.
  • Organise health data collection and data analysis based on the new agreed HSPA framework indicators.
  • Organise and carry out trainings to enhance capacity building during the duration of the project with the support of a local university. * Organise study visits or an exchanges with international experts on a HSPA, focused on local capacity building for HSPA. * Draft a HSPA framework including an action plan, including the HSPA results interpreting and dissemination for different target groups.

Results achieved

The project developed the following outputs:

  1. As-is situation analysis, to assess the current status quo of HSPA in Estonia and a comparison with other countries;
  2. The new HSPA framework, an assessment of the performance of the health system and tools for the dissemination of the assessment results. This included a description of the supporting governance structure, the supporting health data infrastructure, and the process of making evidence-based policy recommendations.

More about the project

You can read the documents related to the project here: