Health Services In Finland Research Articles

Work ability meetings - Challenges and Resolutions, a survey to Finnish occupational physicians.

Work ability meetings (WAM) are an essential and common tool of disability management in occupational health services in Finland. Meetings are held between an employee, a supervisor, and an occupational physician (OP). The aim is mainly to support work ability. To describe challenges and resolutions in the meetings as described by OPs. An internet survey was emailed to the members (n = 1304) of the Finnish Society of Occupational Health Physicians in August 2014. We asked physicians to describe those WAMs they had attended, especially challenges and resolutions concerning WAM. A total of 302 (23%) OPs responded to the survey. Most severe of the challenges were personal conflicts and a lack of confidence between the parties at the workplace. Also, the participants' views may differ about the purpose and goal of the meeting. The respondents noted that the employer might be unable to organize modified work for disabled employees. As a resolution, OPs need to prepare well and maintain their professional and neutral role in WAMs in all cases. OPs also mentioned the need for training in insurance medicine and rehabilitation as well as skills as a mediator. WAM is a potential tool for return to work and disability management in collaboration between employees, employers, and occupational health when all the participants reach a common goal and become aware of their role in the process. OPs need to recognize possible conflicting interests and contact each party before WAM. Keeping confidentiality in WAMs is a crucial matter.

Characteristics of Multiprofessional and Client-Oriented Approach in Occupational Health Services: A Cross-Sectional Survey Among Occupational Health Professionals.

Multiprofessional and client-oriented approaches are considered key factors for successful occupational health services, and for impressive occupational health cooperation between a client organisation and occupational health service provider. The purpose of this study was to find out the views of occupational health physicians, occupational health nurses, occupational physiotherapists, and occupational health psychologists about multiprofessional and client-oriented working methods. These working methods describe the guidelines for good occupational health practice in Finland, also serving the framework of the present study. The survey was conducted in May and June 2022. The data consisted of answers to open-ended questions of a larger questionnaire. The data was analysed with the method of theory-related thematic analysis. Seven occupational health service providers committed to the study. Altogether 121 professionals responded to the question surveying the multiprofessional approach, and 119 professionals responded to the question of client-oriented approach. The results showed that both the multiprofessional and client-oriented approaches are closely related to each other, and the views of these approaches are in line with the good occupational health practice. Multiprofessional approach was most commonly described with the theme of sharing expertise. Respectively, the theme of smooth cooperation most commonly described the client-oriented approach. At its best, the answers showed that a multiprofessional working strategy takes into account the expertise of different professionals so that the client can be offered high-quality, accurate content and timely occupational health services. The results provide up-to-date information on working strategies of occupational health services in Finland. The results can be used in further development of multiprofessional and client-oriented work in occupational health services.

Good interaction skills are not enough - competency in mental health issues in child health clinics and school health services.

Mental health problems among children and adolescents are a worldwide issue of concern. Health professionals who have sufficient competency in mental health issues are crucial for responding to this situation. The aim of the study was to describe the competency in mental health issues required by the work of public health nurses in child health clinics and school health services. This qualitative, descriptive study was conducted with focus group interviews in March 2018. The sample consisted of public health nurses (n=24) who were working in child health clinics or school health services in Finland. The data were analysed using inductive and deductive content analysis. The competency in mental health issues required by the work of public health nurses was formulated from the identified strengths and topics required in continuing education. In total, 18 competencies were identified as covering mental health promotion, as well as the alleviation and treatment of symptoms and disorders. Intuitive and interpersonal competency was identified as the main strength of public health nurses. The theoretical and evidence-based competency regarding mental health issues was identified as a main topic needed in continuing education. Public health nurses in child health clinics and school health services need competency in mental health issues for the promotion of mental health, the alleviation of symptoms and treatment of disorders. The results indicate that good interactional skills are not enough: the current competency of public health nurses in mental health issues is insufficient and does not meet the requirements of the work. The results were consistent with existing knowledge, but also provide a more comprehensive and precise insight into the current situation. In the future, the results should be verified with more studies. There is also a need for intervention studies aiming to improve competency in mental health issues.

Revisiting the unholy alliance of health-care operations: payor–provider integration of occupational health services

PurposeTo investigate the effects of payor–provider integration on the operational performance of health service provision. The research explores whether integration governs agency problems and tilts the incentives of diverse actors toward more systematic outcomes.Design/methodology/approachA two stage multimethod case study of occupational health services. A qualitative stage aimed to understand the reasons, mechanisms, and outcomes of payor–provider integration. A quantitative stage evaluated the performance of the integrated hospital against fee-for-service partner hospitals with a sample of 2,726 patients.FindingsPayor–provider integration mitigates agency problems on multiple levels of the service system by complementing formal governance mechanisms with informal mechanisms. Compared to partner hospitals, the integrated hospital yielded 9% lower the total costs of occupational injuries achieved primarily by emphasizing conservative care and faster recovery.Research limitations/implicationsFocuses on occupational health services in Finland. Provides initial evidence of the effects of payor–provider integration on the operational performance.Practical implicationsVertical integration may provide systematic outcomes but requires mindful implementation of multiple mechanisms. Rigorous change management initiative is advised.Social implicationsFor patients, the research shows payor–provider integration of health services can be implemented in a manner that it reduces care costs while not compromising care quality and customer satisfaction.Originality/valueThis study provides a rare longitudinal analysis of payor–provider integration in health-care operations management. The study adds to the knowledge of operational performance improvement of health services.

Too Much, Too Little, the Wrong or the Right Kind? Negotiating Homes’ Material Stuff in the Context of Substance Abuse and Mental Health Home Visiting

This study asks what is regarded as (in)appropriate material stuff in home spaces, and how it is negotiated between professionals and clients in home visit interactions in three substance abuse and mental health services in Finland. In analysing negotiations between professionals and clients, three interpretational frames theorising its meanings and proper place in home spaces are applied, of which two are located in social anthropology and one in psychomedical ideas. The study demonstrates that negotiations on (in)appropriate material stuff deal with the cleanliness of the clients’ flats and the personal meanings of material objects in their homes. Both negotiations are connected to the institutional task of the services, which is aimed at supporting clients’ everyday lives in their communities and reducing their risk of losing their homes. When professionals enter clients’ homes with this institutional task, homes partially become institutional spaces and the privacy of the home is broken.

Multi-Local Living – An Opportunity for Rural Health Services in Finland?

Abstract In the simplest definition, multi-local living means that a person or family have more than one residence or place to stay. In Finland, multi-locality has become a common phenomenon in recent decades, but the effects of it are not yet considered in decision-making or planning. This is because the “invisible population” created by multi-locality is not reflected in traditional population statistics. The assumption in this article is that multi-locality would provide opportunities to improve accessibility of health and social services in rural areas. The assumption is tested in the North Kymenlaakso region, Finland. The results point to that one-stop services and mobile services are cost-efficient and flexible provision models for rural areas. The results call for making the increasing multi-locality in society more visible and to utilize it better than at present as a resource for the development of rural areas.

Virtual study trip to community mental health services in Finland

The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 5.120 (2020 JCR, received in June 2021)

Health Education and Communication in Occupational Health Services in Finland

This article discusses health education and communication in Occupational Health Services (OHS) based on a questionnaire study conducted in Finnish OHS in 2005. The study focused on educational activities carried out by OH professionals and directed at individual employees, work communities and groups, and representatives of client organisations. The questionnaire was sent to 1132 OH professionals--physicians, nurses, physiotherapists and psychologists--working in 130 OHS units, and representing different OHS providers in Finland. 635 respondents (162 physicians, 342 nurses, 96 physiotherapists, 35 psychologists) returned the questionnaire. The overall response rate was 58%. There were statistically significant differences in educational activities by different professional groups; differences were also related to the length of working experience in OHS. For all OH professionals, individual employees were the primary clients of health education and communication. Education was less often directed at work communities and representatives of client organisations. However, many issues related to health and well-being at work are not within the reach of individual employees. The impact of health education would be more evident if it also reached those organisational stakeholders with discretion in decision-making. Furthermore, OH personnel should pay attention to the social aspect of learning and work more with groups and work communities.

The use of videoconferencing for mental health services in Finland

The utilization of telemental health (TMH) services in Finland was surveyed in 2006. In total, 135 health-care units provided responses. Eighty-four responses were received from primary care units (health-care centres and clinics) and eight from other clinics, in all hospital districts. The overall rate of TMH consultations was 4 per 100,000 population. The highest TMH consultation per population ratio, 22 per 100,000, was in northern Finland. Most of the sites used telepsychiatry services for less than 10% of clinical outpatient services. The sites with over 20% utilization of clinical TMH services from all psychiatric consultations were all rural health centres. Compared with Finland, the utilization rates of TMH were higher in Canada; that might be due to differences between the countries in the organization of mental health services in primary and specialized care. In Finland TMH consultations made up only a very small proportion of all mental health services. The use of TMH was particularly common in remote areas; however, there were many rural centres that did not utilize clinical TMH. TMH was widely utilized for continuing and medical education.

Reductions in Postdischarge Suicide After Deinstitutionalization and Decentralization: A Nationwide Register Study in Finland

Reductions in Postdischarge Suicide After Deinstitutionalization and Decentralization: A Nationwide Register Study in Finland

Occupational health services in Finland—do they work well? Opinions of the managers

The employers are obligated by law to organize the occupational health services (OHS) for their employees in Finland. The coverage of OHS is high: 76% of the employed labour force and 85% of the salaried employees and wage-earners are covered by OHS. High coverage tells nothing about satisfaction of employers: are they satisfied with the functions of OHS? The objective of the study was to chart the opinions of the managers related to their experiences of collaboration with OHS. The data of the study were collected by a computer-assisted telephone interview in 2004 by the Finnish Institute of Occupational Health. The survey was based on a stratified random sample from the registers of Statistics Finland. The sample of workplaces represents the entire working population. The manager, the representative of the employees and the occupational health nurse were interviewed at the workplace. The original sample in 2004 consisted of 1000 workplaces, of which 812 managers (response rate 81%), 752 employees (response rate 93%) and 711 OHS personnel (response rate 88%) participated (almost 2300 persons). According to this study, the managers are quite satisfied with the functions of their OHS provider. OHS have to improve the systems for feedback, proposals for improvements and their knowledge of client workplaces' atmosphere.

From information to knowledge: the meaning of information-giving to patients who had experienced first-episode psychosis.

The reform of mental health services in Finland signifies that besides the structural development of services, the development of new approaches in care is needed. Besides the other elements, information-giving has an important role when supporting outpatients' and their caregivers' everyday lives. The aim of this study was to describe how patients with first-episode psychosis experienced the information-giving and the meaning of these experiences to these patients. The study was conducted by interviewing seven patients participating in the development of the combined model of psycho-education and need-adapted models. The data were gathered by open-ended questions and analysed within the phenomenological tradition, focusing on the understanding of the patient's experiences. The results show that patients' own understanding and acceptance of the psychotic experience affected their experiences of information-giving as well as the way their experiences were met during their care. The meaning of information was experienced with feelings of worthlessness, relief, confusion or confidence and coping. The results of this study address the importance of recognizing, hearing and appreciating patients' own experiences. Information-giving should be based on the patients' own experiences, appreciating them. With the information integrated into patients' own experiences they can be helped to turn to the future after the psychotic experience.

Integrating mental health services: the Finnish experience

The aim of this paper is to give a short description of the most important developments of mental health services in Finland during the 1990s, examine their influences on the organisation and provision of services, and describe shortly some national efforts to handle the new situation. The Finnish mental health service system experienced profound changes in the beginning of the 1990s. These included the integration of mental health services, being earlier under own separate administration, with other specialised health services, decentralisation of the financing of health services, and de-institutionalisation of the services. The same time Finland underwent the deepest economic recession in Western Europe, which resulted in cut-offs especially in the mental health budgets. Conducting extensive national research and development programmes in the field of mental health has been one typically Finnish way of supporting the mental health service development. The first of these national programmes was the Schizophrenia Project 1981-97, whose main aims were to decrease the incidence of new long-term patients and the prevalence of old long-stay patients by developing an integrated treatment model. The Suicide Prevention Project 1986-96 aimed at raising awareness of this special problem and decreasing by 20% the proportionally high suicide rate in Finland. The National Depression Programme 1994-98 focused at this clearly increasing public health concern by several research and development project targeted both to the general population and specifically to children, primary care and specialised services. The latest, still on-going Meaningful Life Programme 1998-2003 which main aim is, by multi-sectoral co-operation, to improve the quality of life for people suffering from or living with the threat of mental disorders. Furthermore, the government launched in 1999 a new Goal and Action Programme for Social Welfare and Health Care 2000-2003, in which mental health has been chosen as one of the eight priority areas.

Farmers' occupational health programme in Finland, 1979–1987

At the beginning of 1985, the National Board of Health in Finland issued directives for the initiation of farmers' occupational health services in municipal health care centres. The directives were based on the evaluation study on farmers' occupational health services in Finland. The main aim of this study is to analyse the current problems of the farmers' occupational health care system and to analyse how effective the system is. The efficiency of the occupational health services has been surveyed with postal inquiries twice, first in 1982 and later in 1986. The farmers' knowledge of appropriate means for reducing hazardous exposures had improved significantly since the initiation of the occupational health services. The effect of the occupational health services was evident particularly in the more effective use of personal safety devices. The limited resources at the municipal health care centres form the main obstacle in the provision of occupational health services for all farmers who would like to have them. 25–35% of the farmers in Finland (total 45,000 farmers) are willing to participate in the occupational health care system. Participation is voluntary for self-employed farmers.

Use of children's oral health services in Finland with special reference to heavy consumption.

The consumption of oral health services among 4-16-yr-old children in Finland is described, including an analysis of heavy consumption. Data representative of all Finnish children were collected for 4518 children from municipal health centers and homes. The response rate was 85%. Children with orthodontic visits during the year were excluded from the analyses. Of the preschoolchildren 12% and of the school-age children 4% did not use any oral health services during the studied year. Non-users did not differ from the others in terms of socioeconomic status, distance to a health center or type of residential area. Public oral health services were used very unevenly. Half of the children consumed only one-fifth of the services and the next one-third used about one-third of the services. The heavy consumers, about one-fifth of the total, used as much as half of all the services. Among preschoolchildren, the heavy consumers were mainly from lower socioeconomic groups. In contrast, no clear predictive factors were found for heavy consumption among the schoolchildren. Heavy consumers had more both treated and untreated caries than the other children did. Their treatment was mainly restorative; at least half of them did not receive adequate preventive care. Finnish public oral health care clearly should make more efforts to ensure that heavy consumers of dental services do not remain so.

The Development of Mental Health Services in Finland

The first mental hospital in Finland was established on the island of Seili in 1755. The Lapinlahti Hospital, which today functions as the psychiatric clinic of the University of Helsinki, was established in 1841. In 1889 a statute came into force requiring municipalities to provide care not only for the poor but also for the mentally ill by establishing special departments for chronic mental patients in connection with the poorhouses. The statute also enabled municipalities to establish common mental hospitals; in fact, many mental institutions came into being in this way in the early 1900s [1]. From the beginning, psychiatric care was thus primarily in the hands of municipalities, and this situation became stabilized through an act passed in 1929 concerning government subsidy. In 1940 there were about 8,400 beds for mental patients in hospitals and another 2,900 in communal homes, or a total of about 3.2 beds per 1,000 inhabitants [2]. Psychiatric outpatient care did not exist before World War П.

Primary care physicians and use of health services in Finland.

This article presents results from a study investigating the relationships between the availability of resources and the use of health services in Finland focusing on the health centre physician supply variable. The study uses observations from other studies on the subject and knowledge of the Finnish and other health services as a point of departure. It tries, by using the systems approach, to examine the effects on use of the health services resources considered to be important from the organizational and health policy points of view. The specific aim of the study was to investigate the relationships between the health centre physicians and other health centre resources and use in various health care sectors. The results suggest that the organization of primary health care, including the primary care physicians, has a profound potential effect on the use and costs of the total health care system.

Health Services in Finland

Health Services in Finland

Analysis of Relationships Between the Availability of Resources and the Use of Health Services in Finland

The relationship between the availability of resources and the use of health services was studied. This study covered the whole population of Finland. The unit of study was a health center area. The method of analysis was multiple regression involving the following variables: supply of health center physicians; supply of hospital physicians (reflecting the private medical sector); supply of sick-ward beds in old-age homes; supply of health center hospital beds; supply of public health nurses; and supply of general hospital beds. Several background variables also were included in the equations. It was concluded that a considerable change in the pattern of health services use was dependent on the number of physicians working in primary care in health centers. An increase in the number of these physicians and in physicians working at the outpatient departments of general hospitals is associated with a considerable increase in the number of visits per population to these facilities, a reduction in the need to hospitalize the population, and a considerable reduction in the rate of private-sector contact outside hospitals. The role of public health nurses appeared to be relatively important in reducing the number of health center hospital days, which probably is because of the home nursing activities of these nurses in health centers. This study demonstrated a significant relationship between the availability of most health services resource variables and the use of various services when other variables known to affect utilization were controlled for.

The costs of diseases and violence in Finland in 1972

The costs of diseases and violence are calculated considering production losses, compensations and costs of health services in Finland in 1972. The costs total 18.700 million Fmk (=4.500 million US $). The production losses make 75%, compensations 6%, and health services 18% of the total costs. About 83% of the costs can be classified according to the main disease group. In the order of magnitude they are diseases of the circulatory system (24% of the costs), mental disorders (18%), diseases of the musculoskeletal system and connective tissue (17%), and accidents, poisonings and violence (14%).