Written by Janne Pullat, Head of Health Data, Metrosert
The OECD – the Organisation for Economic Co-operation and Development – is an international organisation bringing together 38 member countries with the aim of supporting them in advancing economic and social well-being. The OECD’s mission is not to act as a political influencer, but to provide a reliable data repository, systematic analysis, and evidence-based recommendations that help countries make informed decisions. For this reason, OECD statistics and reports are among the world’s most influential benchmarks in the field of health care.
Health at a Glance (Health at a Glance 2025 | OECD) is one of the organisation’s key and most widely used publications. It is compiled every two years, drawing on official health statistics from member countries, data from international organisations and thorough methodological validation to ensure comparability across countries. The report’s aim is to present a brief, clear, and substantive overview of health system performance, expenditures, quality, and access. It is not merely a collection of statistics, but a mirror through which countries can see their strengths and weaknesses and assess the trends shaping the future of healthcare.
The importance of this report lies in two aspects: first, it allows countries to understand themselves against a real international context, and second, it helps policymakers make decisions based not on isolated indicators but on a holistic understanding of the system.
This background shapes the core of the Health at a Glance 2025 report. The OECD notes that while healthcare is recovering from the pandemic, it is clearly entering a new era where established balances are shifting and new pressures are emerging. Life expectancy is gradually returning to its pre-pandemic upward trajectory, reaching 81.1 years on average across the OECD, but this recovery is uneven. In several countries, including multiple European OECD members, life expectancy remains below pre-pandemic levels. Yet even more significant is that although life years are increasing, they are not always years lived in good health. Women live longer but spend more years with health limitations; the same pattern is seen among men, though to a lesser extent. This issue is particularly acute in Estonia, where healthy life expectancy remains significantly below the European average.
One of the strongest messages in the OECD report is the sustained rise of chronic diseases. Healthcare is dealing less with isolated, random cases and more with the daily management of long-term conditions. More than eighty percent of primary care patients over the age of 45 live with at least one chronic illness, and half live with at least two. This means health systems – including Estonia’s – must be built around continuity, coordination and integrated care rather than primarily acute treatment. At the same time, the mental health burden among young people is growing. When more than half of 15-year-olds in OECD countries report recurrent health and mood problems, it signals deeper changes in young people’s living environments and calls for better psychological support from health systems.
The funding landscape is becoming more complex. Health care accounts for around fifteen percent of government spending on average, and expenditures are rising. Yet the OECD increasingly emphasises that more funding does not automatically translate into better outcomes. Some countries spend significantly less on health care yet achieve better health indicators and lower avoidable mortality rates. Thus, the focus is shifting from the size of expenditures to their quality. For Estonia, this message is particularly relevant, as our health-care funding remains below the OECD average and requires not only more resources but also sharper attention to the impact of every euro.
Formal access does not necessarily guarantee meaningful access. While universal health coverage exists in many countries, including Estonia, people’s experiences tell a different story. Satisfaction with healthcare accessibility across OECD countries is moderate and declining in many places. Estonia has one of the highest levels of unmet medical need among OECD members, and an indicator above eight percent points to systemic strain where long waiting lists, staff shortages and limited funding interact. Income also plays a strong role: people with lower incomes are more likely to go without needed care, and the OECD sees this pattern as one of healthcare’s most significant hidden inequalities.
In terms of health risks, trends familiar to Estonia are becoming more pronounced. Obesity, alcohol consumption, smoking and youth vaping are on the rise, and the health impact of air pollution is increasing due to intensified urbanisation. Although Estonia’s air quality is better than in many OECD countries, our population’s health is nevertheless shaped by nutrition, physical activity and behavioural patterns that define our health profile for decades.
The most pressing issue is the workforce. The OECD describes shortages of healthcare workers as a key challenge for system resilience. The supply of new doctors and nurses cannot keep pace with demand, and the share of foreign-trained professionals is rising. Estonia faces the same situation: the ageing of family doctors, the shortage of nurses and the severe lack of care workers are already shaping patient experiences and the length of care pathways.
One of the most significant shifts is the rise of digital health and artificial intelligence. The OECD stresses that digital technologies are no longer convenience tools but are becoming core healthcare infrastructure. E-consultations, patient portals, telemedicine and AI-based tools are shaping new care pathways. Estonia has been a pioneer in this field for years, and our e-health solutions are internationally recognised. Yet technological progress does not eliminate digital inequality. Older people and those with lower digital skills may not benefit from new solutions and may even be left behind. For this reason, the OECD emphasises that the digital transition must be inclusive and built on a strong data ecosystem. Otherwise, technology may turn from a solution into a barrier.
In summary, Health at a Glance 2025 does not portray crisis or triumph, but a reality in which systems are changing and must change. Healthcare is no longer a system that simply responds to illness; it must evolve into one that manages health, reduces disease burden and enables people to live longer and better lives. For Estonia, the report’s primary lesson is the need for smarter, value-based and people-centred healthcare organisation. This means strengthening prevention, elevating the role of primary care, supporting digital development across all population groups, and embracing data-driven governance that enables both clinicians and AI tools to make better decisions. A changing world demands a changing healthcare system – and Estonia’s future depends on whether we become an example of such transformation or a system strained under its pressure.
Read the OECD report: Health at a Glance 2025.
