HealthDataNavigator Understand strengths and weaknesses of existing data bases and projects

Finland

Population (2011): 5.401.267
GDP per capita, US$ PPP at current prices (2011): 37,642.43
Health expenditure per capita, US$ PPP (2010): 3,251
Life expectancy at birth, years (2010): 80.2

Health care in Finland consists of a highly decentralized, three-level publicly funded health care system and a much smaller private health care sector. Although the Ministry of Social Affairs and Health has the highest decision making authority, the municipalities (local governments) are responsible in providing health care to their residents. Every municipality has a responsibility to offer health care services to their residents and it is usually provided municipal health care centers.

Primary care is obtained from the health care centers employing general practitioners and nurses that provide most day-to-day medical services. The former are also gatekeepers to the more specialized services in the secondary and tertiary care sectors.

The health care system receives funding from two sources. Municipal financing is based on local taxes and is used to provide health care services. Municipalities also have a right to collect user fees, and receive state subsidies if their tax levy is not adequate for providing the public services required, based on the demographic factors on their area.

Health System Data in Finland

All major health care providers (hospitals, primary health care units, pharmacies) annually deliver person-level data collected and abstracted from their patient administration systems to government agencies who are by law the responsible register-keepers. The National Institute for Welfare and Health (THL), the Social Insurance institution of Finland, Statistics Finland and the Finnish Institute of Occupational Health are the central sources of health system data. Individual level data can be linked using the unique and national personal identification code. Data linkage is allowed provided that the researcher has received permission from the authorities. Generally, user requests for individual level data sets are subject to tight review procedures before permission is granted and data retrieval often involve some costs.The Finnish Information Centre for Register Research maintains a web site which contains information on register controller organisations and their web-sites.

 

Health Status

Aggregate data
  • Causes of death register: Statistics Finland collects and files causes of death (according to ICD-10-Codes) for all citizens in Finland. pfeil zu
  • SOTKAnet (THL) provides data on demographic variables and healthcare provision at regional level as well as epidemiological key themes (e.g. life expectancy, mortality, cancer incidence, self-reported health)
  • KELASTO database maintained by the Social insurance institution provides annual data on drug reimbursements, sickness leave, rehabilitation and other allowances. pfeil zu
Individual level data
  • Statistics Finland maintains records on the causes of death and mortality data pfeil zu
  • The national birth registry maintained by THL includes key information on all births
  • Finnish Cancer Registry is a complete census of all cancer patients. pfeil zu
  • THL hosts a database for a defined set of communicable diseases, reporting is mandatory for health care professionals
  • The “Finnish Health Interview Survey 2000/2011”administered by THL provides detailed information on self-perceived health, chronic diseases and mental conditions, life quality, health impairment in a periodically conducted survey.pfeil zu
  • Finn Risk Surveys pfeil zu

Quality (valued outcomes)

Aggregate data
  • SOTKAnet reports several indicators reflecting the quality/effectiveness of the health services e.g. cancer mortality and suicide rates, or the effectiveness of hospital services by different indicators developed in the PERFECT/EUROHOPE - projects pfeil zu
  • The PERFECT reporting in THL  (hospitals in figures) provides data on regional and hospital level effectiveness (e.g. 1 year mortality) for a selection of patient/disease groups
  • The Waiting list reporting system in THL provides region level statistics for waiting lists regarding elective operations
Individual level data 
  • Finnish Cancer Registry maintained by THL contains information on diagnoses and mortality pfeil zu
  • The Waiting list reporting system in THL contains information on observed waiting times and the persons waiting in elective operations
  • The national discharge register provides patient information including diagnoses and treatments for adverse effects, and deaths within a hospital or institution giving inpatient treatment. pfeil zu
  • The Finnish Patient Insurance Centre handles the compensation procedures for patient injuries that occur in Finland and maintain a database which includes all these incidents.

Efficiency/Economy

Physical Inputs (infrastructure)

Aggregate data

  • THL collects data on health care personnel (numbers per employee category and average wages) in Finnish municipalities.
  • Hospital benchmarking database (THL) collects the operating costs of all public hospitals divided into specialty unit level within a hospital. The operating costs can be divided into cost categories (e.g. capital and personnel costs) pfeil zu

Activity/Utilization

Aggregate data

  • SOTKAnet provides data on the frequency of consultations of primary care physicians and other personnel, hospital discharges and bed-days, the use of long-term care including average length of stay, all by region pfeil zu
  • KELASTO database provides provides annual data on drug reimbursements, sickness leave, rehabilitation and other allowances pfeil zu
  • Hospital benchmarking database (THL) (hospitals in figures): hospital, hospital specialty unit and regional level data is available for various indicators for activity/utilization: DRGs, bed-days, discharges,outpatient visits pfeil zu
Individual level data
  • The Finnish Health Interview Survey “TERVEYS 2000/2011” administered by THL provides detailed information on self-perceived health, chronic diseases and mental conditions, life quality, health impairment. pfeil zu
  • The national discharge register and the hospital benchmarking database (THL) contain key inpatient and outpatient data abstractions from the operative systems in hospitals (length of stay, in which ward etc.), patient (age, gender etc.) and medical data (main and additional diagnoses, selected treatment pfeil zu
  • AVOHILMO (THL) provides data for all patient encounters within the publicly provided primary care (primary health care centers) in Finland since 2011. pfeil zu

Cost and Expenditure

Aggregate data

  • THL provides a table compatible with SHA tables showing main aggregates of private and public health expenditure and investment and publishes periodically the list of national reference (unit) prices of all important health and social services.
  • KELASTO database reports the payments for reimbursed drugs, rehabilitation, private health care services,sickness absence day and other special benefits reimbursed by the social security. pfeil zu
  • SOTKAnet provides data on costs by region. Data covers total costs and costs for primary care, hospital care and social care per capita. pfeil zu
  • The hospital benchmarking database (THL) contains hospital and hospital specialty level total operating costs pfeil zu

Individual level data

  • The hospital benchmarking database (THL) contains patient level bottom-up based cost accounting data for ca. 30% all hospital inpatient and outpatient care in the country. National DRG cost weights are based on these data. pfeil zu

Access/Equity

Individual level data

  • THL administers research datasets which combine socio-demographic data (age, gender, occupation, income) as well as information on diagnoses and treatment in in- and outpatient care

Non-health care determinants

Aggregate data

  • SOTKAnet (THL) provides data on demographic variables and various life-style indicators at regional level as well as epidemiological key themes. pfeil zu

Individual level data

  • The Finnish Health Interview Survey “TERVEYS 2000/2011” and the FINRISK survey administered by THL provide information on body weight and height, smoking habits, alcohol consumption, physical activity, sleep disorder, eating. pfeil zu

Health System Design and Context