Health Status and Health Behaviour of Estonian Pre-school Children from Birth to 7 Years of Age on the Basis of the 2010 Birth Cohort Based on Estonian Health Insurance Claims

Sirli Tamm
There has been little research on the health of pre-school children in Estonia compared to other countries. To the best of author’s knowledge, no studies have been conducted in Estonia about the health and health behaviour of pre-school children throughout their pre-school years. Such studies are rare also in other countries. At the same time, routinely collected registry-based health data provide a great opportunity to investigate children´s health.

This study analysed the insurance claims submitted to Estonian Health Insurance Fund by family doctors, medical specialists and dentists (n = 991568) for all children born in 2010 (n = 16417) who used health care services in Estonia in 2010–2017. The aim of the study was to give an overview of how often and for which reasons health care providers were contacted; how many children had regular check-ups with family doctor, dentist and ophthalmologist; how many children completed the immunizations according to the national immunization schedule; and what was the health status of the children starting school.

The results of the study showed that approximately 60% of treatment cases of pre-school children were related to primary healthcare. Boys had more mental and behavioural disorders and injuries, while girls had more urinary tract disorders. Primary healthcare was most often addressed with children under the age of one - during this period preventive health examinations made up half of all referrals. However, many children were not tested to detect iron deficiency anaemia in their first year of life as required. Home visits were made for less than half of the children in their first year of life and regional differences occurred. Only 2% of children had regular health checks consistently with prescribed frequency. Regular check-ups on the 18th month, 3rd, 4th and 5th year were missed most often.

The first visit to the dentist took place quite late - a little before the age of 4, and regional differences were observed. Based on insurance claims, approximately half of the children had preventive ophthalmic examination, while eye and vision disorders occurred in almost one-fifth of all children.

There is a risk that the immunization schedule is not completed timely for many children - only about 40% of 7-year-old children had all the vaccines according to the immunization schedule. Most often the IPV-DTPa-Hib re-vaccinations were not completed on time.

The main health problems of children starting school were related to allergies, mental and behavioural disorders and vision disorders.
Graduation Thesis language
Graduation Thesis type
Master - Conversion Master in IT
Marek Oja, Sulev Reisberg
Defence year