The Finnish Hospital System

Author:

Heikki Punnonen

Development Chief

Local and Regional Government Finland

Finnish patients with acute illnesses are usually taken to a municipal hospital or go there by themselves. If the illness cannot be diagnosed during an examination carried out by a health centre physician, a company doctor or a private physician, the patient will be referred to hospital for further examinations. Nearly all Finnish babies are delivered in municipal hospitals. Most operations are performed in municipal hospitals.

In Finland, it is the responsibility of the municipality of residence to make sure that patients receive the medical treatment they need. According to the Constitution of Finland, “the public authorities shall guarantee for everyone [...] adequate social, health and medical services and promote the health of the population”. Citizens are equal and equally entitled to receive medical care regardless of their municipality of residence.

Finnish medical care is financed by taxes. Medical care is included in the municipal basic services provided for citizens. Healthcare is based on the health centres maintained by municipalities or federations of municipalities, and their number was 257 in 2005. In order to provide specialist medical care, a municipality must belong to a federation of municipalities of a hospital district. Each hospital district has at least one hospital that provides 24-hour services.

Specialist Care

Health centres, the occupational healthcare system and private clinics treat basic diseases. When the patient’s symptoms or disease require special examinations or equipment and specialist care, the doctor will refer the patient to a hospital. In 2005, 60% of hospital referrals came from health centre physicians and 21% from private physicians.

The shortage of specialists has been a problem for the hospital districts and hospitals located in more remote areas. In relation to other special fields, child and adolescent psychiatry has suffered the most from the shortage. In addition, there has been a shortage of anaesthesiologists, orthopaedic physicians and eye surgeons in some hospitals.

The occupational healthcare system and private clinics and hospitals fulfil the service system formed by the health centres and hospital districts. Last year, there were 39 private hospitals, some of which very small. A part of them has specialised in, for instance, orthopaedic operations or the treatment of rheumatism. The proportion of patient days in private hospitals has been approximately 3.5%.

Reforms

Municipal specialist medical care is continuously being reformed. The number of hospitals, their production units and hospital beds are decreasing. Part of the present services will become purchased services. Services will be provided in a more flexible, mobile and efficient manner than before. Some services will be more often centralised to centres of expertise. Correspondingly, other services will be decentralised more often than today. In future, electronic

communications and networks between different actors will play a key role. Special emphasis will be placed on their development.