If healthcare quality were graded like a school essay on a 10-point scale, people would rate it at about a six. Medical professionals give a slightly higher score — 6.6.

"Patients are more critical — even those who have not used healthcare services or visited a doctor. Perhaps there is a general perception that things are not in a good state in Estonia. Those who have seen a doctor in the past 12 months have a significantly more positive view of the quality of healthcare in Estonia," said Maria Suurna, head of healthcare quality policy at the Ministry of Social Affairs.

For both patients and doctors, the most pressing issue is timely access to care. However, while patients complain about long waiting lists, doctors see the problem elsewhere.

"If a patient wants to see Estonia's top surgeon or specialist even for a minor health concern, medical professionals understand that many issues could actually be resolved at an appropriate level of care. This is where patient awareness comes into play — so that people understand or there is a system in place to start at a lower level," Suurna said.

The study also found that, in people's view, the quality of care is not the same everywhere. Dissatisfaction is highest in Ida-Viru County, while people in Southern Estonia complain the least. One indicator of healthcare quality is the reporting of cases to the Health Board when something during treatment does not go as planned. Of 1,600 healthcare providers, only 200 have reported patient safety incidents. In addition, patients themselves are often left uninformed.

"It should be a normal part of healthcare that when an adverse event occurs, it is disclosed — whether to the patient or their relatives. Right now, it's a bit like finding your car dented in a parking lot: you come out, see the damage, but don't know who did it or where. You understand something happened," said Külli Friedemann, head of the healthcare services department at the Health Board.

According to Minister of Social Affairs Karmen Joller (Reform), doctors have wanted a unified quality system for decades and plans are now in place to create one so that care would be provided at the same standard across Estonia.

"One part of the quality system is clinical agreements and clinical guidelines. This means there are clear guidelines on how to treat specific health conditions. There are also agreements — for example, between family physicians and emergency departments — on when a person should turn to one or the other. In addition, there are guidelines for patients so they can clearly understand where to seek care and when," Joller said.

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