Estonian Institute for Health Development (TAI) analyst Aia Simm said that emergency departments saw nearly 30,000 fewer visits last year than the year before. "One possible reason may be that a higher visit fee was introduced in April of last year," Simm suggested. While the fee had previously been €5, it was raised to €20 last April.

Aime Keis, head of the emergency department at Tartu University Hospital, said the higher visit fee has not affected the number of patients at the hospital. However, short-term effects from various public awareness campaigns have been noticeable.

Several changes have been introduced in an effort to reduce the burden on emergency departments. According to analyst Simm, however, ERs are still effectively performing the role of family physicians and family nurses.

"People go to the emergency department when they cannot get an appointment with their family physician or family nurse quickly enough," Simm said. As a result, emergency departments continue to face a heavy workload. She added that a large share of patients seeking emergency care do not require hospitalization. "After receiving initial treatment, 80 percent are sent home for further care."

Marit Märk, head of the emergency medicine center at North Estonia Medical Center (PERH), noted that nearly half of patients visiting the hospital's ER have relatively minor health concerns. She added that an initial assessment shows around one-third of them do not require emergency care.

Unlike Tartu University Hospital, PERH plans to introduce a system this summer allowing patients with less serious concerns to be referred to a family physician or pharmacy after their initial triage. Märk said the goal is to ensure patients receive the most appropriate care. The hospital also wants to make sure emergency departments can focus on patients in need of urgent treatment, particularly in situations where ERs are overcrowded.

Nikita Panjuškin, head of the healthcare services department at the Ministry of Social Affairs, said plans are underway to introduce longer-term, systemic solutions aimed at reducing the burden on emergency departments.

"If we think purely in financial terms today, all healthcare providers are interested in ordering more analyses, examinations and appointments because that is how they are funded," the official explained.

The healthcare system is currently preparing to introduce outcome-based financing. Under the model, healthcare providers would receive more funding based on better treatment outcomes. According to Panjuškin, this could help improve the quality of care and lead to healthier patients overall. He acknowledged that this could also reduce pressure on emergency rooms.

"That is because there would be fewer flare-ups of chronic illnesses and fewer new illnesses developing, which I believe is the main factor affecting emergency medicine," Panjuškin said.

At the same time, the Ministry of Social Affairs representative acknowledged that this is not a measure that can be implemented today and produce results tomorrow, but rather one that could begin delivering results over the course of years.

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