Motivating Improved Healthcare Using Holistic Patient Contracts in Estonia
Wednesday, November 19, 2025 11:00 AM Eastern Time (US & Canada)
Abstract
This seminar presents the impacts of family doctors writing an explicit contract with at-risk patients for increased holistic primary care, using a system-wide experiment in Estonia. We tracked healthcare utilization, diagnosis, prescription, hospitalization, and mortality outcomes through the universe of patient records. The intervention was designed to shift the relational contract between the two parties away from episodic curative care and towards a holistic plan for patient welfare. The program caused increased screening, diagnosis and treatment of chronic health issues among enrolled patients by about 10%. For doctor-identified `mild-risk' patients, we observed causal two-year reductions in all-cause mortality of 40%.
Presenters
