RESEARCH – September 2022

Profound unmet need for physical and occupational therapy in Estonia

Authors: Pärt Prommik, Helgi Kolk, Kaspar Tootsi, Ellen Käpp, Ülo Maiväli, Aare Märtson

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There may be approximately 440 000 people needing rehabilitation in Estonia. Physical and occupational therapy are among the most commonly offered rehabilitation services, but their accessibility is not studied in Estonia. Therefore, this study assesses the provision of these therapies in Estonia during 2009-2019, and evaluates the proportion used by hip fracture patients. The second aim of the study is to describe health care spending on rehabilitation during 2003-2019 in relation to other health services.
This study was based on the retrospective data obtained from the Estonian Health Insurance Fund and the National Institute for Health Development and Statistics Estonia. The provision of all physical and occupational therapy procedures during 2009-2019 was analysed. Hip fracture rehabilitation use was obtained from a previously published study.
An average of 191 405 occupational and physical therapy hours were provided a year. The yearly provision fluctuated during the observed years, but its magnitude remained relatively similar during 2009-2019. Hip fracture patients (n = 1 308) used 3.7% (7 013/191 405) of the total provision of these two therapies. The spending on rehabilitation remained similar, being persistently around 1% of the total health expenditure during 2003–2019.

There is a profound unmet need for physical and occupational therapy in Estonia. This may be explained by ongoing underprioritisation and under-funding of rehabilitation. There is an urgent need for increased spending on rehabilitation, allowing the Estonian Health Insurance Fund to carry out a health policy that adequately prioritises rehabilitation and considers its growing demand in the future.