In Estonia, a patient transferred from one hospital to another to continue treatment may be charged the inpatient stay fee again, even if it concerns the same health issue. The law allows this fee to be charged to an insured patient for no more than 10 calendar days within a single course of treatment.
A new count at another hospital
As ERR News reports, after a patient is transferred to another medical institution, the second hospital may consider the hospitalization a new case and charge the fee for up to another 10 days. Such a situation may arise, in particular, when treatment is continued at a hospital located closer to the patient’s home.
Siiri Lahe, chair of the Management Board of the Health Insurance Fund, has appealed to Minister of Social Affairs Carmen Joller. She noted that hospitals and patients interpret the concept of a single case or course of treatment differently.
Payment data are not shared
According to Lahe, hospitals use separate information systems, and information about inpatient stay fees is not transferred to the nationwide digital health record. As a result, medical institutions do not have a system to track whether a patient paid an inpatient fee at a previous hospital and to what extent.
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Lahe compared this practice to the fee for an appointment with a medical specialist: the law does not allow it to be charged again for a follow-up appointment within the same service. In her view, charging the inpatient stay fee again may seem unfair to patients and cause confusion.
Possible clarification of the rules
Heli Paluste, a healthcare network expert at the Ministry of Social Affairs, said that for the patient, this is indeed a single course of treatment. At the same time, the law does not establish exceptions for the inpatient fee similar to those that apply to appointment fees when a patient is transferred between institutions.
According to her, hospitals are independent institutions, so after a patient is transferred and admitted, another medical institution considers it a new case. The Health Insurance Fund also considers and finances such cases as separate courses of treatment at each hospital. Paluste said that the rules and practice of charging the inpatient fee will likely need to be discussed separately with hospitals and the fund so that patient contributions are calculated clearly and fairly.
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