More patients traveling outside home county for doctor visits across Estonia
Getting to a doctor increasingly requires traveling farther from home as services concentrate in larger centers. For example, residents of Võru and Põlva counties make nearly 70 percent of their doctor visits outside their home county.
Finding a suitable appointment time at the Tartu University Hospital has recently been a challenge for Olga Margulis, who lives in Tartu. In September, she searched for a pediatric ophthalmologist appointment, but because the issue required quick attention and no times were available in the coming months, she decided to go to a private clinic. Her family has also needed a pediatric surgeon, which meant traveling to a smaller county hospital.
"We had concerns about adenoids and needed a consultation to determine whether surgery was necessary. We couldn't get an appointment at Tartu University Hospital and found one at Põlva Hospital. I don't remember exactly whether the hospital had no times at all or the queue was extremely long. At Põlva Hospital, a surgeon from Tartu consulted us and referred us for surgery at the university hospital, where he performed it," Margulis said.
Many patients from Tartu and Tallinn also end up at Viljandi Hospital, where a doctor from Tartu may meet a patient from Tallinn — or vice versa.
"In the last four years, the share of patients with permanent residence in Tartu County has increased significantly. In 2022, we had about 500 such contacts per year; today it is nearly 5,000. So the mantra that regional movement from smaller hospitals goes only toward Tartu University Hospital does not hold. I cannot state it absolutely, but there are specialties where I know the waiting time at a large hospital is four to six months, while here you can get help in under a month," said Mart Kull, member of the management board of Viljandi Hospital.
The Health Insurance Fund explains the movement from big cities to smaller regions by noting that demand for certain specialists — such as dermatologists, gynecologists, and psychologists — exceeds the capacity to provide services.
"In most cases, demand quickly exceeds capacity in places with large populations. Mental health services in Viljandi County may be somewhat more accessible than in Tallinn," said Marko Tähnas, head of the specialist care portfolio at the Health Insurance Fund.
The fund also acknowledges that services are concentrating in larger centers. Traveling to another county for medical care has increased almost everywhere in Estonia. In Võru County, such visits make up two‑thirds of all doctor appointments.
"If service usage is not very high, it makes sense to concentrate it in fewer locations, because performing the service more frequently with the same team in the same facilities ensures quality," Tähnas said.
--
Editor: Johanna Alvin, Argo Ideon
