title: Satisfaction with the access to the health services of the people with chronic conditions in Estonia.
abstract: After the implementation of the primary health care reform in Estonia, most of chronic conditions are managed by family doctors (FD) in collaboration with specialists. Although the general population has demonstrated the increase in satisfaction with health care after the reform, it has been questioned if people with chronic diseases have been left on a more disadvantaged position in the new system with some restrictions in the access to specialists.
  
  
  OBJECTIVE
  To investigate the satisfaction of people with chronic conditions with the access to the health services and compare them to those who did not have a chronic illness.
  
  
  METHODS
  In November 2005, a random sample of Estonian residents aged 15-74 were personally interviewed using structured questionnaires (n=1446), 29% of them reported to have a chronic illness.
  
  
  RESULTS
  The people with chronic conditions were less satisfied with the access to the health services. They were more satisfied with their family doctors, but less with the health insurance system and they often reported their problems in seeing the specialist. Compared to other respondents, the people with chronic conditions visited their FDs and specialists more often, but no significant differences were found between their waiting times to see the FD or a specialist.
  
  
  CONCLUSIONS
  In Estonia, the people with chronic conditions do not have organisational barriers in their access to the health services. As frequent users of health services, they perceive the shortages of the health system more obviously than the rest of the population and it may reflect their satisfaction with the different aspects of the health system as well as the access to the health services.
authors.affiliation: Department of Internal Medicine, University of Tartu, Estonia. kaja.polluste@ut.ee
authors.forename: Kaja
authors.initials: K
authors.lastname: Põlluste
authors.forename: Ruth
authors.initials: R
authors.lastname: Kalda
authors.forename: Margus
authors.initials: M
authors.lastname: Lember
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D004957:Estonia; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction