Finland: Health system review

TitleFinland: Health system review
Publication TypeBook
Year of Publication2008
AuthorsVuorenkoski L
Secondary AuthorsMossialos E, Busse R, Figueras J, McKee M, Saltman R
Series TitleHealth Systems in Transition
Volume10 (4)
Number of Pages168 p.
PublisherWHO Regional Office for Europe
KeywordsDelivery of health Care; Evaluation Studies; Financing, Health; Finland; Health care Reform; Health System Plans
AbstractThe Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. According to various indicators, the health of the Finnish population has considerably improved over the last few decades. Average life expectancy has improved throughout the 20th century, especially during the last three decades, reaching 76 years for men and 83 years for women in 2005. Although overall mortality has fallen, the socioeconomic inequality in mortality seems to be increasing. The most significant public health problems are circulatory diseases, malignant tumours, musculoskeletal diseases, diabetes and mental health problems. In practice in Finland there are three different health care systems which receive public funding: municipal health care, private health care and occupational health care systems. The largest share of health care services is provided by the municipal health care. There are also different public financing mechanisms for health care services in Finland: municipal financing based on taxes and National Health Insurance (NHI) financing based on compulsory insurance fees. The Finnish health care system offers relatively good quality health services for reasonable cost with quite high public satisfaction. The most visible problems are long waiting times and personnel shortages in some municipalities. The most important state level reforms from the beginning of the 1990s are: the deregulation of state steering of municipal health services and related changes in state administration; the introduction of the ‘National Project to Ensure the Future of Health Care’; the extension of public dental health care to all age groups; the introduction of the waiting time guarantee; a project to restructure municipalities and services; and the development of the national electronic patient record system. Future challenges for the decentralized Finnish health care system are: strengthening steering capacity for strategic priorities and resources; revitalizing the gradually weakening primary care system; improving cooperation between municipal primary and secondary care; improving cooperation between health care and personal social services; and addressing dual financing in publicly subsidized health care.