Estonia's hospital network needs reform — experts

Põlva Hospital.
Põlva Hospital. Source: ERR

Patients should be treated at bigger hospitals rather than in smaller county facilities and capacity should be expanded, experts have suggested after analyzing the medical network.

Authors of a new development plan believe emergency treatment should be reduced at smaller hospitals and patients redirected to larger facilities. The ambulance service should also be improved to transport patients quickly.

These changes would benefit Estonia's hospital system which sees a a shortage of both medical staff and patients to fill them.

This trend is most noticeable in areas outside of the country's main cities, such as in Jõgeva, Valga, Põlva, Lääne and Järva county hospitals which treat fewer than 20,000 people.

In these facilities, several members of staff must be kept on call in case of emergencies but in reality, few people are treated there.

"It's barely 10, 15, 20 people. If we have to keep four specialists on call plus the whole team there then it seems that this is not very practical," Jaanus Pikani, author of the plan, told Tuesday's "Aktuaalne kaamera".

Rural hospitals face two problems, lack of funds as the Health Insurance Fund pays for treatments carried out but additionally is also hard to attract staff to these jobs in the first place.

Additionally, Pikani said labor costs are increased as wages need to be higher to attract staff to hospitals outside of big cities.

The report also suggests the creation of a network of community hospitals that would treat patients with chronic illnesses who do not need to be in hospital.

However, Pikani said this will take at least a decade to develop as family doctors would not currently be able to carry this out.

"Not only in Haapsalu or Põlva, but also in Tallinn, because there is also a similar problem, where there are quite a lot of sick people in hospitals who should not be there," said Pikani.

Staff shortages need to be addressed

Lääne County hospital manager Edvard Garder said staff shortages affect all hospitals not just those outside of cities. Short-term problems, as well as long-term issues, need to be addressed, he said.

"The problems that we have to solve are the ones that are going to happen in the next five years. It's completely possible that in the next two to three years, five years at the most, some small hospitals will have to start closing their doors," Garder said.

One solution is hiring staff from abroad, but Garder said the Estonian medical system is not ready for this. He said this is already a popular idea in Ida-Viru County.

"Another other option is to grit your teeth and work as much overtime with the existing staff as necessary while a new generation grows up," Garder said.


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Editor: Helen Wright

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