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's activity report 2022

The joint-stock company Rakvere Hospital began operations from October 1, 2002. The sole owner of the shares is

Non-profit association RAKVERE HOSPITAL. The board of the joint-stock company consists of six members elected by the general meeting and the board is single-member (chairman of the board).

The main activity of the joint-stock company Rakvere Hospital is the provision of medical services as a general hospital.

Significant events of the financial year

Our main contract partner in the provision of health care services is the Estonian Health Insurance Fund (Health Insurance Fund), whose contract-related financing accounted for 84.9% of the hospital's sales revenue in the reporting year (2021 85.0%).

In the 2022 financial year, the vaccination program coordinated by the Estonian Health Insurance Fund, the Health Board, and the Ministry of Social Affairs continued, in which our hospital actively participated and which also brought us additional income.

In addition to COVID-19 vaccination, there was also an expanded scope of influenza vaccination.

The energy crisis deepened during the financial year, caused by the rapid rise in the stock exchange price of electricity. As a result, district heating prices also increased. The price pressure caused by the energy crisis is also forecasted for 2023. The Estonian Health Insurance Fund partially compensated hospitals for the costs caused by the sharp rise in energy prices through changes in the price list. As the compensation took place at the end of the financial year, the hospital had to cope with bearing additional costs, which in turn slowed down the launch of many planned investment activities.

In the 2022 financial year, we had to temporarily suspend the provision of basic services, so-called 'continuity interruptions', due to a shortage of labor, specifically due to a shortage of qualified labor. We do not have enough anesthesiologists, surgeons, gynecologists, and rehabilitation workers. We must also note the shortage of nursing staff, without whom it is difficult to ensure the continuity of services. Modern medicine increasingly needs professionally trained nurses who could be employed in operating, intensive care, and emergency medicine departments. The rapid development of medical technology requires professional expertise and a constant readiness to further educate oneself. The hospital has actively supported training activities, as evidenced by an 84% increase in training costs compared to the previous financial year.

In 2022, the workload of the maternity and gynecology department decreased by 22%, mainly due to a very large decrease in the number of births. According to statistics, a similar trend is nationwide. The problem is that the small number of births significantly increases the cost of this service. The costs of maintaining readiness are significantly higher than the revenue from the corresponding services received through the Estonian Health Insurance Fund's financing model. In addition to other expenses, it is important to maintain and develop medical competence, which is directly dependent on the sufficient quantity of existing services.

The financing methodology of the emergency medical department's treatment services, established by the Estonian Health Insurance Fund, continues to be a problem. The current financing model does not cover the actual costs of providing a service that meets the needs of the region's residents, especially in terms of wage costs and ensuring sufficient staff. The hospital contributes additional funds every year to maintain the operation of the emergency medical department, which in 2022 amounted to approximately 160,000 euros, to ensure the quality and availability of the service. General hospitals are very different and the workload of the emergency department can only be compared based on triage categories, not the type of hospital. The sizes of the regions are also different.