Arst on hea haiguste ennetaja

Mis on haiguste ennetamine? Haiguste ennetamine kõlab eesti keeles ilmselt paljude arstide jaoks kontekstivälisena, sest räägib millestki, mis kuulub aega enne seda, kui patsient oma terviseprobleemiga arsti juurde jõuab. Kui haigus ennetatud, siis pole ju arsti vajagi! Selline arusaam sobib hästi hierarhilisse tervishoiusüsteemi, kus kõige all on patsient ja tema järel aste-astmelt velsker ja jaoskonnaarst kuni tippkirurgini välja. Tänapäeval toimivad edukalt aga tervishoiusüsteemid, mis on pigem integreeritud kui hierarhilised. Lõpptulemuse – terve inimese saavutamiseks on samavõrd olulised nii südamekirurgi, dietoloogi, perearsti kui ka perekonnaliikmete ja sageli ka sotsiaaltöötaja ning mitmete teiste oskused

The Development of eServices in an Enlarged EU: eGovernment and eHealth in Estonia

In 2005, IPTS launched a project which aimed to assess the developments in eGoverment, eHealth and eLearning in the 10 New Member States at national, and at cross-country level. At that time, the 10 New Member States were Cyprus, the Czech Republic, Estonia, Hungary, Latvia, Lithuania, Malta, Poland, and Slovakia. A report for each country was produced, describing its government and health systems and the role played by eGovernment and eHealth within these systems. Each report then analyzes, on the basis of desk research and expert interviews, the major achievements, shortcomings, drivers and barriers in the development of eGovernment and eHealth in one of the countries in question. This analysis provides the basis for the identification and discussion of national policy options to address the major challenges and to suggest R&D issues relevant to the needs of each country ¿ in this case, Estonia. In addition to national monographs, the project has delivered a synthesis report, which offers an integrated view of the developments of each application domain in the New Member States. Furthermore, a prospective report looking across and beyond the development of the eGoverment, eHealth and eLearning areas has been developed to summarize policy challenges and options for the development of eServices and the Information Society towards the goals of Lisbon and i2010.JRC.J.4-Information Societ

Rinnavähi sõeluuringu programmi hindamise tulemused

Eestis on rinnavähi varajase avastamise sõeluuringut, mis on haigekassa rahastatav sihtotstarbeline ennetusprojekt, korraldatud alates 2002. aastast. Ravikindlustusraha efektiivse ja sihtotstarbelise kasutamise tagamiseks tehti 2006. aastal “Rinnavähi varajase avastamise projekti 2002–2006” välishindamine. Sõeluuringu tulemuslikkus ja juhtimise korraldus vastab üldjoontes rahvusvahelistele standarditele. Uuringuprogrammi puudusteks on see, et ei ole kaasatud ravikindlustuseta isikud, samuti puudub isikustatud sõeluuringu andmebaas. Vajalik oleks uuringurühma laiendada, haarates kaasa 60–69aastased ja ravikindlustuseta naised. Eesti Arst 2007; 86 (11): 791–79

Meditsiinilise erivajadustega laste üldhariduse korralduse analüüs

Uuringu ülesandeks on analüüsida kehalistest haigustest tingitud hariduslike erivajadustega ehk meditsiiniliste erivajadustega lastele suunatud üldhariduse korraldust Eestis ning pakkuda välja lahendusi, kuidas luua neile eeldusi igakülgseks arenemiseks teistega võrdväärsetel alustel. Lähtuvalt eelnimetatud eesmärgist on uuringul järgmised lähteülesanded: 1) analüüsida laste arvu Eestis, kes vajavad kehalise haiguse tõttu pidevat meditsiinilist hoolt (st on meditsiiniliste erivajadustega), sh koolis: 2) analüüsida meditsiiniliste erivajadustega lastele suunatud hariduskorraldust Eestis olemasolevate andmete, analüüside ja prognooside põhjal; 3) koondada rahvusvaheline kogemus meditsiiniliste erivajadustega lastele hariduse andmise korraldusest mujal maailmas; 4) selgitada välja meditsiiniliste erivajadustega laste üldhariduse saamise erinevad võimalused võrdväärselt kõigi teiste lastega

Cholecystectomy and Diagnosis-Related Groups (DRGs): patient classification and hospital reimbursement in 11 European countries

Background: As part of the EuroDRG project, researchers from eleven countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Sweden, and Spain) compared how their Diagnosis-Related Groups (DRG) systems deal with cholecystectomy patients. The study aims to assist surgeons and national authorities to optimize their DRG systems. Methods: National or regional databases were used to identify hospital cases with a procedure of cholecystectomy. DRG classification algorithms and indicators of resource consumption were compared for those DRGs that individually contained at least 1% of cases. Six standardised case vignettes were defined, and quasi prices according to national DRG-based hospital payment systems were ascertained and compared to an index case. Results: European DRG systems vary widely: they classify cholecystectomy patients according to different sets of variables into diverging numbers of DRGs (between two DRGs in Austria and Poland to nine DRGs in England). The most complex DRG is valued at four times more resource intensive than the index case in Ireland but only 1.3 times more resource intensive than the index case in Austria. Conclusion: Large variations in the classification of cholecystectomy patients raise concerns whether all systems rely on the most appropriate classification variables. Surgeons, hospital managers and national DRG authorities should consider how other countries’ DRG systems classify cholecystectomy patients in order to optimize their DRG systems and to ensure fair and appropriate reimbursemen

Sanatoorsed koolid. Kellele ja miks?

Käesolev analüüs vaagib, milline võiks olla muutunud olukorras seni toiminud sanatoorsete koolide roll ning millised oleksid alternatiivsed võimalused erivajadustega lastele heal tasemel hariduse andmiseks nn tavakoolides. Analüüsi käigus võtame vaatluse alla need õpilased, kes on normintellektiga ja kellel takistab tavakoolis käimist nende kehaline tervis. Valdava arusaama kohaselt peaksid sellised lapsed õppima sanatoorses koolis

Cholecystectomy and Diagnosis-Related Groups (DRGs): Patient Classification and Hospital Reimbursement in 11 European Countries

Background: As part of the EuroDRG project, researchers from eleven countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Sweden, and Spain) compared how their Diagnosis-Related Groups (DRG) systems deal with cholecystectomy patients. The study aims to assist surgeons and national authorities to optimize their DRG systems. Methods:National or regional databases were used to identify hospital cases with a procedure of cholecystectomy. DRG classification algorithms and indicators of resource consumption were compared for those DRGs that individually contained at least 1% of cases. Six standardised case vignettes were defined, and quasi prices according to national DRG-based hospital payment systems were ascertained and compared to an index case. Results:European DRG systems vary widely: they classify cholecystectomy patients according to different sets of variables into diverging numbers of DRGs (between two DRGs in Austria and Poland to nine DRGs in England). The most complex DRG is valued at four times more resource intensive than the index case in Ireland but only 1.3 times more resource intensive than the index case in Austria. Conclusion:Large variations in the classification of cholecystectomy patients raise concerns whether all systems rely on the most appropriate classification variables. Surgeons, hospital managers and national DRG authorities should consider how other countries’ DRG systems classify cholecystectomy patients in order to optimize their DRG systems and to ensure fair and appropriate reimbursement

Strategic Intelligence Monitor on Personal Health Systems, Phase 2: Country Study Estonia

This study presents and discusses the status of integrated personal health systems (IPHS) in Estonia. It aims to illustrate through case studies the patient and health monitoring systems that are available, the level of implementation of these systems, the impact they have on the general socio-economic context, as well as their cost-effectiveness where applicable. The analysis presented in this report is based on interviews with key experts and stakeholders from Estonia and a substantial secondary data collection.JRC.J.3-Information Societ