Provision of integrated care services in Estonia

The Commission aim to contribute to a more integrated and person-centred provision of social, medical and vocational support services to people with disabilities and elderly with high support needs in Estonia.

Context

Against the background of then recently introduced new policy settings for local governments, the Estonian government aimed at achieving a more integrated and person-centred provision of social, medical and vocational support services to people with disabilities and elderly with high support needs. The different support systems tended to be based on different principles and financing systems, used separate application procedures, and lacked a comprehensive exchange of information. As a consequence, citizens were faced with a complicated system and did not always get access to all the services they would need.

Support delivered

Estonian authorities, together with the project provider, International Foundation for Integrated Care (IFIC), contributed in developing: (i) a clear delivery strategy with agreed principles, accountabilities, and indicators for achieving the effective integration of services is in place; (ii) a defined dataset is designed and tested that supports the planning, monitoring and funding of integrated service provision for the agreed client groups and corresponding pathways/models of care; (iii) a clear and consistent process for national and local services to support the processing of integrated care requests for the agreed target client groups is in place; (iv) an optimal financing method (or bundle of methods) to incentivise integration and quality care delivery is recommended, and, finally, that local-level capacity to implement a new approach to integrated care provision is strengthened.

Results achieved

The project developed a strategy to the Estonian government which promotes: (i) improvements in the interoperability of registries and administrative datasets to specific cohorts of individuals with integrated care needs and vocational support; (ii) the development of measures and indicators through which to support quality improvement and assess performance; (iii) the introduction of performance-based financing and payment elements to incentivise integrated service provision; and (iv) a closer cooperation between services administered at central and at local level, as well as between local stakeholders.