Population's Ratings of Health and Health Care

Age – the seniority of respondents at the time the survey was taken expressed in full years – i.e. the respondents’ age in his/her last birthday prior to the survey.

Healthcare personnel – persons who have received professional healthcare education and are actively engaged in providing healthcare services (doctors, dentists, nursing staff or other medical specialists and assistant specialists).

Medical services (healthcare services) – any and all activities performed by healthcare personnel (doctors, dentists, nurses and midwives) for the prevention, diagnosis and cure of diseases, injuries or poisonings in order to alleviate a person’s suffering, avoid further deterioration of his/her overall health and progression of disease and to facilitate a recovery.

Nationality – is defined by a person’s self-identity as an individual in a way not predetermined by the person’s mother tongue. As the category of nationality was not used in earlier surveys all data referring to polls taken prior to 2005 made use of the concept of mother tongue instead.

The purpose of the survey “Population's Ratings of Health and Health Care” is to gain insight into how the country’s population perceives its health and how it rates the overall level of healthcare services provided in Estonia. The survey is aimed at Estonian residents between ages of 15–74.

The nationwide survey, ordered by the Estonian Health Insurance Fund and Ministry of Social Affairs, has been carried out on an annual basis since 2000. The methodology used involved until 2013 taking oral interviews with written down answers, since 2014 by combining CATI (Computer Assisted Telephone Interview) and CAWI (Computer Assisted Web Interview) method. Total of approximately 1500 respondents are interviewed. The interviews are conducted in Estonian and Russian. As of 2009 respondents are chosen by using the proportional random sample method, which superseded the auxiliary random-sample augmented omnibus method utilized previously. Results gathered by the aforementioned methodology are subsequently weighted by socio-demographic indicators taken from national population register data.

Alterations to wording of survey questions

Residents’ assessment of individual health condition – self-esitmated health

Prior to 2006 the following wording was used – “How do you assess your health condition, is it...” As of 2006, the question has been altered to use the following wording “How do you assess your overall health condition, is it...”. Standardized answers given in 2002–2004 have been redesignated to coincide with answers given in subsequent years by equating “generally good” with “rather good” and “generally bad” with “rather bad”. Standardized answers given in 2010 and 2011 have been redesignated to coincide with subsequent years by replacing “difficult to say” with “unable to answer”. The aforementioned alterations are applied across the board, taking into account all respondents.

Occurrence of long-term illness or health problems

Beginning with 2011 the survey has included the following question “Do you suffer from any long-term (i.e. chronic) illnesses or health issues”? (Long-term illnesses are defined as illnesses which have a duration of at least 6 months). Surveys conducted in 2005–2010 included the following question – “Do you suffer from any long-term (i.e. chronic) illness or health issues which have hindered carrying out daily activities? (Long-term illnesses are defined as illnesses which have lasted, or are likely to last at least 6 months). Up to 2005 the question was as follows: “Do you suffer from any long-term (i.e. chronic) illness or health issues? (Long-term illnesses are defined as illnesses which have lasted, or are likely to last at least 6 months). As of 2010 standardized answers have been redesignated to coincide with subsequent years by equating “no and difficult to say” with “no”. The aforementioned alterations are applied across the board, taking into account all respondents (excluding respondents who have failed to give a reply).

Satisfaction with doctors or healthcare personnel

Prior to 2005, the following question was put forth: “How do you rate the work of your family doctor/specialist doctor/family nurse? (in case of multiple appointments please give an answer with respect to the last visit)?” During 2006–2008 the following wording was used “Based on your last appointment, were you satisfied with the work of your family doctor/nurse?” As of 2009, the following question was used “Based on your last appointment, how satisfied were you with the work of your family doctor/nurse?”. The wording of other questions (related to dentists and specialized doctors) remained unaltered from 2006–2008.

With regard to people who visited physicians and healthcare officials or who otherwise used healthcare services, only those respondents’ answers are registered who did so during the previous 12 months. Data referring to levels of satisfaction as regards the work of family nurses for years 2005–2007 is given only for those people whose visits took place 12 months prior to the survey. The same applies for years 2008 and after.

Satisfaction with the services provided by the Estonian Health Insurance Fund

Up to 2005 the following question was put to the respondents: “How are you satisfied with the services provided by the Health Insurance Fund, do you...”. During 2006–2010 the following wording was used: “Did you rate your interaction with the Health Insurance Fund as being...?” As of 2011 the following wording has been used “How satisfied were you with your interaction with the Health Insurance Fund?”.

Satisfaction with hospital care

Up to 2005 the following question was put to the respondents: “How did you rate the treatment given in the HOSPITAL? (in case of multiple appointments please give an answer with respect to the last visit).” Up to 2005 the following wording was used – “What is your overall assessment of your hospital stay?”. During 2006–2010 the following wording was used “With regard to your last stay in the hospital, would you rate the experience as...?”. As of 2011 the following wording has been used “How satisfied were you with your last stay in hospital”.

Satisfaction with service provided by emergency centre operators

Up to 2010 the following wording was used: “How were you satisfied with the work of the operator answering your 112 call?”. As of 2011 the following wording has been used “How satisfied were you with the work of the operator answering your 112 call?”

Satisfaction with the ambulance crews

Up to 2007 the following wording was used: “How were you satisfied with the ambulance crew?”. During 2008–2010 the following wording was used: “How were you satisfied with the work of the ambulance crew?”. As of 2011 the following wording has been used: “How satisfied were you with the work of the ambulance crew?”

Satisfaction surveys concerning hospitals, emergency centre operators, and ambulance crews have been compiled based on the responses given by respondents who called an ambulance, interacted with the emergency centre operators or visited hospitals during 24 months prior to the survey. Satisfaction surveys concerning hospital treatment conducted in 2002–2004 gathered data from persons who had been hospitalised during 12 months prior to the survey.

Standardized answers provided in 2001, 2010 and 2011 surveys have been redesignated to coincide with subsequent years. Optional answers for 2010 and 2011: "difficult to say / can’t remember" = "unable to answer" and 2001 "rather satisfied" = "generally satisfied", "rather dissatisfied" = "generally dissatisfied" and "not at all satisfied" = "not satisfied at all". Questionnaire regarding satisfaction with the family nurse contains an additional optional answer “I do not know about my family nurse” besides the standard “unable to answer”.

The aforementioned alterations are applied across the board, taking into account all respondents (excluding respondents who have failed to give a reply).

Evaluation of the accessibility and quality of healthcare services

As of 2009 the following wording has been used: “In your opinion, what is the quality/availability of healthcare provided in Estonia today?”
During 2005–2008 the following wording was used “In your opinion, would you assess the quality/availability of medical care provided in Estonia today as being... ”
During 2004 the following wording was used: “What is the quality/availability of national healthcare provided in Estonia today, is it...?”
During 2003 the following wording was used: “What is the quality of national healthcare provided in Estonia today, is the quality/availability...?”
During 2002 the following wording was used: “What is the quality of national healthcare provided in Estonia today, is the availability/quality...?”
Until 2001 the following wording was used: “What is the level of national healthcare provided in Estonia today, is the availability/quality...?”

Optional answers for 2010 and 2011 have been redesignated to coincide with previous years: 'difficult to say' = 'unable to answer'. All respondents have been taken into account (excluding respondents who have failed to give a reply).

Rating the healthcare system

Beginning with 2009 the following wording has been used: “How would you rate the healthcare system in Estonia today?”
Until 2008, the following wording was used: “How would you rate the healthcare system in Estonia today – is it...?”

Optional answers for 2010 and 2011 have been redesignated to coincide with previous years: 'difficult to say' = 'unable to answer'. All respondents have been taken into account (excluding respondents who have failed to give a reply).

Satisfaction with the family doctor system, providing access to a doctor regardless of the health concern in question

As of 2011 the following wording has been used in the questionnaire: “How happy are you with the family doctor system, which provides direct access to a doctor regardless of your health concern?”
In 2010 the following wording was used in the questionnaire: “How happy are you with the family doctor system, which provides direct access to a doctor regardless of your health concern? Are you...?”
In 2009 the following wording was used: “How happy are you with the family doctor system, which provides direct access to a doctor regardless of your health concern?”
Between 2004–2008 the following wording was used: How happy are you with the family doctor system, which provides direct access to a doctor regardless of your health concern? Are you...?”
In 2003 the following wording was used: “How happy are you with the fact that you can turn to your family doctor regardless of your health concern? (The question seeks to understand satisfaction levels with the family doctor system”).
Up until 2002 the following wording was used: “How happy are you that you can turn to your family doctor regardless of your health concern? (The question seeks to understand satisfaction levels with the family doctor system”).

Optional answers for 2010 and 2011 have been redesignated to coincide with previous years: 'difficult to say' = 'unable to answer'. All respondents have been taken into account (excluding respondents who have failed to give a reply).

Satisfaction with the selection of medical services covered by the national health insurance scheme

As of 2005 the following question has been used: “How satisfied are you with the selection of health services covered by the health insurance? Are you-...?
In 2004 the following question was used: “How satisfied are you with the selection of health services covered by the national health insurance? Are you-...?
Until 2003 the following wording was used: “Are you satisfied with the selection of health services covered by the national health insurance?

All respondents have been taken into account (excluding respondents who have failed to give a reply).

Annual reports based on the surveys are published on the websites of the Ministry of Social Affairs and Estonian Health Insurance Fund (in Estonian).

The questionnaire formula is added to the annex of the survey (in Estonian).

Ministry of Social Affairs

E-mail: info[at]sm.ee