Does equal availability of geographical and human resources guarantee access to family doctors in Estonia?
OBJECTIVE
To describe allocation of posts of trained family doctors geographically; to assess the patients' consultation rate and family doctors' workload geographically; and to evaluate comprehensiveness of the work of family doctors.


METHODS
Data for the description of training in family medicine and the system of primary health care in Estonia were drawn from the health statistics of the Ministry of Social Affairs of Estonia and from data of the Estonian Health Insurance Fund. The comprehensiveness of work was expressed as the percentage of newborn babies on the practice lists of family doctors out of the total births in Estonia during 1999-2002.


RESULTS
Altogether 979 doctors became family medicine specialists during 1991-2004, which corresponds to Estonia's need--one family doctor per 1,600+/-400 inhabitants. The rate of visits to family doctors has increased during recent years and in 2002 one inhabitant made 2.7 visits per year on average. Family doctors received an average of 22 visits per day throughout 2002. The number of home visits increased: in 2002 every fifth person and almost every second child in Estonia was visited by a doctor. According to the registration of newborns on family doctors lists, the comprehensiveness of family practice rose: in 2002, 83% of all newborns were registered with family doctors.


CONCLUSIONS
The allocation of family doctors geographically according to population density ensures access to medical services in their localities. The registration of newborns with family doctors shows the comprehensiveness of the work of family doctors. Elaboration of the indicators for the analysis of accessibility of family doctors services, using national statistics, helps evaluate the development and further planning of the primary health care system.
Maaroos
Heidi-Ingrid
HI
Department of Family Medicine, Tartu University, School of Medicine, Tartu, Estonia. heidi-ingrid.maaroos@kliinikum.ee
Meiesaar
Kersti
K
D004957:Estonia; D005194:Family Practice; D005843:Geography; D006297:Health Services Accessibility; D010820:Physicians / Q000600:supply & distribution*; D040841:Resource Allocation