This paper summarizes an assessment of the state of health care integration in Estonia and its driving forces. In the absence of a widely accepted definition, this study defines health care integration as:

i) the delivery of care in the appropriate care setting and

ii) coordination and continuity of care across care settings.

The study focuses on integration issues related to the prevention and treatment of chronic diseases, with particular attention to the role and functioning of primary care and equity issues. The findings of this analysis therefore do not provide a comprehensive assessment of quality within specific care settings (i.e., primary care, acute inpatient care, etc.), nor of overall health system performance. Yet, they constitute one of several inputs that may be relevant for future policy changes.

These study findings are based on a quantitative analysis of health insurance claims data plus stakeholder interviews and focus group discussions as part of a joint research agenda between the Estonian Health Insurance Fund (the EHIF) and the World Bank Group (WBG).

The paper is structured as follows: Section 2 provides an overview of the Estonian health care system, section 3 outlines the rationale for assessing the state of health care, section 4 provides a brief overview of the methodological approach, section 5 discusses study findings with respect to key challenges as well as possible underlying problems and causes and section 6 concludes.