Estonia plans care coordinators to reduce hospital re admissions

The Estonian government plans to introduce care coordinators by May 2028 to help people with extensive care needs manage their health at home.

The Riigikogu social affairs committee discussed the reform, which aims to prevent patients from returning to emergency departments shortly after completing hospital treatments. Care coordinators will create personalized plans for patients that outline necessary medical treatments and social assistance. These plans will include the individual's own goals for maintaining their health and input from their family members.

While the Ministry of Social Affairs maintains the reform is on schedule, some members of the social affairs committee have questioned the feasibility of the timeline due to ongoing analyses and differing views across different counties. The government is currently running pilots for the program. In Ida-Viru County, ten coordinators already work in two hospitals and three family medicine centers. The EU's Just Transition Fund provides salaries and software for these staff members until 2027.

Proponents of the reform point to a clinical study at Viljandi Hospital where assigning a coordinator to high-risk patients reduced emergency hospitalization costs by 32 percent. These reforms occur as the Health Insurance Fund forecasts nearly €2.7 billion in expenditure for next year. The government aims to balance the fund by 2030 as the deficit is expected to fall from about €90 million to €44 million.

To manage these costs, the Minister of Social Affairs Karmen Joller recently dropped a plan for state payments to cover children's healthcare, which would have cost €109 million by 2032.