In 2023, current health expenditure amounted to 7.5% of GDP, matching the levels observed during the COVID-19 peak in 2020 and 2021. In absolute terms, health spending reached EUR 2.85 billion, reflecting an annual increase of EUR 325 million (equivalent to 12.9% growth).
While the rapid increase in healthcare costs in 2020 and 2021 was primarily due to additional expenses incurred during the COVID-19 crisis, the situation in 2022 began to return to pre-pandemic conditions. However, in 2023, expenditure once again increased significantly, primarily driven by rising wages of healthcare professionals. On 1 April 2023, the minimum hourly wages for doctors and nurses increased by 20%, as per collective agreements. The actual increase in hourly wages was even higher, amounting to approximately 25% for doctors and 21% for nurses, as observed from a comparison between wages in March 2024 and March 2023.
Public sector expenditure accounted for 76% of total healthcare costs in 2023. The Estonian Health Insurance Fund (EHIF) covered 67% of healthcare expenditure, returning to its pre-COVID-19 share. Meanwhile, the share of central government expenditure continued to decline (from 7% in 2022 to 5% in 2023), while the contribution of local governments increased marginally from 3% to 4%.
The share of out-of-pocket (OOP) payments in healthcare expenditure slightly declined to 22.1% in 2023 (from 23.1% in 2022), aligning closely with its average over the past five years. The largest components of OOP payments were dental care (33% of OOP), long-term care (17%), prescription medicines (15%), over-the-counter (OTC) medicines (12%), and outpatient specialist care (11%). Interestingly, although expenditure on prescription drugs increased by 15%, there was no corresponding increase in spending on OTC medicines, which instead saw a slight decline of 1%.
The share of voluntary healthcare financing (including voluntary health insurance, non-governmental organizations, and enterprises) in total healthcare expenditure remained negligible but stable at 2.1% in 2023. The role of voluntary health insurance continued to be minimal at 0.9%, showing a slight increase from 0.7% in 2022.