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Economic Assessment of Health Promotion in Finnish Primary Health Care. Pia Hakamäki (Researcher, THL) & Timo Ståhl (Development Manager, PhD, Adjunct professor, THL) …

Economic Assessment of Health Promotion in Finnish Primary Health Care. Pia Hakamäki (Researcher, THL) & Timo Ståhl (Development Manager, PhD, Adjunct professor, THL)

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  • 1. Economic Assessment of Health Promotion in Finnish Primary Health Care 25.8.2011 Pia Hakamäki (Researcher, THL) &Timo Ståhl (Development Manager, PhD, Adjunct professor, THL) 1
  • 2. Contents• Issue• Project description – Objectives and focus – Definition of health promotion work – Different steps of economic assessment• Results – Calculating the share and costs of health promotion• Conclusions and summary25.08.2011 TEVA – Economic Assessment of Health Promotion in Finnish Municipalities/Pia Hakamäki 2
  • 3. Issue1. Health promotion (HP) belongs to the work of every administrative field2. Lack of knowledge about the cost-effectiveness of HP activities carried out as normal procedures of the everyday work of organisations3. Information is needed in each sector in order to support planning and decision-making in municipalities¹25.08.2011 TEVA – Economic Assessment of Health Promotion in Finnish Municipalities/Pia Hakamäki 3
  • 4. Project description• Started in 2008 (–2012)• Working group co-ordinated by THL• Five municipalities: – Salo (population 55 235) – Oulu (141 671) – Kauniainen (8 689) – Muurame (9 256) and – Tampere (213 217)• In co-operation with municipal experts from various administrative sectors, the Association of Finnish Local and Regional Authorities25.08.2011 TEVA – Economic Assessment of Health Promotion in Finnish Municipalities/Pia Hakamäki 4
  • 5. Project objectives 2008-2012• To outline key health promotion functions in different municipal administrative sectors• To calculate the resources spent on health promotion, and to determine outputs and effects (later also cost- effectiveness)• To provide municipalities with a model for the economic assessment of health promotion• To produce comparable data25.08.2011 TEVA – Economic Assessment of Health Promotion in Finnish Municipalities/Pia Hakamäki 5
  • 6. Project focuses• Health promotion in the municipal service system• Services purchased are also included, but separate interventions are not• Limited to children, young people and families with children• ²Administrative sectors: 1. ³primary health care, social services, education and general administration 2. culture and leisure department, sports and youth administration, environmental and technical administration 25.08.2011 TEVA – Economic Assessment of Health Promotion in Finnish Municipalities/Pia Hakamäki 6
  • 7. HP activities in three sectors Promoting Daycare Child guidance healthy growth and family and development counselling Special Family educational mediation support Preventive School welfare child activity welfare workSchool welfare Home-help services services SubstanceCommunity Health abuse prevention actions and mental promotion health work School Integration environment work Other public Support for the health core long-term functions unemployed Maternal and Rehabilitation child health services clinics Oral School health care General health care practice25.08.2011 TEVA – Economic Assessment of Health Promotion in Finnish Municipalities/Pia Hakamäki 7
  • 8. Different steps of economic assessment of health promotion (HP) work 6. Utilisation of comparable data to support decision-making 5. Effects of health promotion work 4. Outputs of health promotion work 3. Cost calculation 2. Calculating the proportion of health promotion work 1. Determination of health promotion work and limitations25.08.2011 TEVA – Economic Assessment of Health Promotion in Finnish Municipalities/Pia Hakamäki 8
  • 9. Calculating the proportion of health promotion work25.08.2011 TEVA – Economic Assessment of Health Promotion in Finnish Municipalities/Pia Hakamäki 9
  • 10. Primary health care• Use of existing information systems 1. Client visits and routine classification – Preventive/medical treatment visits, percentage 2. Number of visits 3. Procedures 4. Group activitiesExtra: Appointment books – Total hours spent on health promotion25.08.2011 TEVA – Economic Assessment of Health Promotion in Finnish Municipalities/Pia Hakamäki 10
  • 11. Results of the proportion of healthpromotion work• Maternal and child health clinics 95–98 %• School health care – public health nurses 62–76% – school doctors 91–92 %• Oral health care – orthodontic therapists 41–45 % – dentists and dental nurses 2–3 %• Rehabilitation services 7–11 %25.08.2011 TEVA – Economic Assessment of Health Promotion in Finnish Municipalities/Pia Hakamäki 11
  • 12. Calculating costs• Calculation model → takes into account personnel costs but also other costs → consistent with all adminstrative sectors25.08.2011 TEVA – Economic Assessment of Health Promotion in Finnish Municipalities/Pia Hakamäki 12
  • 13. Results of the costs of healthpromotion work, 2008/2009According to preliminary results of two municipalities:• 11 and 17 % of the primary health care costs• 3 and 4 % of the total health care costs• The cost of the health promotion work was EUR 243 and 331 per 0–16-year-old child per year.25.08.2011 TEVA – Economic Assessment of Health Promotion in Finnish Municipalities/Pia Hakamäki 13
  • 14. Conclusions• Defining health promotion work is a challenging but possible• Very difficult to get comparable data on costs → documentation and transparency of assessment → calculation is focused on personal costs• The municipal information systems already hold large amounts of data; the goal is to describe how to utilise this data• Determining comparable outputs and effects!25.08.2011 TEVA – EconomicaAssessment of Health Promotion in Finnish Municipalities/Pia Hakamäki 14
  • 15. • The big challenge … … does the organisation provide incentives (fiscal) that encourage cross-system working?25.08.2011 TEVA – EconomicaAssessment of Health Promotion in Finnish Municipalities/Pia Hakamäki 15
  • 16. Sources• ¹Kiiskinen, Vehko, Matikainen, Natunen & Aromaa (2008). Terveyden edistämisen mahdollisuudet. Vaikuttavuus ja kustannusvaikuttavuus. Sosiaali- ja terveysministeriö Julkaisuja 2008:1.• ²Perttilä, Hakamäki, Hujanen & Ståhl. (2009). Terveyden edistämisen taloudellinen arviointi kunnissa. THL. Avauksia 8/2009. Available in electronic format: www.thl.fi/thl-client/pdfs/9c078431-6be6-4c41-ab57-16a14f74432c• ³Hakamäki, Perttilä, Hujanen & Ståhl. 2011. Terveyden edistämisen taloudellinen arviointi kunnissa. THL. Raportti 11/2011 http://www.thl.fi/thl-client/pdfs/f920b92c-f4e3-4b60-b3e4-69763e1acb30• Linna 2009. Ehkäisevän terveydenhuollon osuus perusterveydenhuollon avotoiminnan potilasepisodeista ja kokonaisvoimavarojen käytöstä. Terveystaloustiede. THL. Avauksia 4/2009.25.08.2011 TEVA – Economic Assessment of Health Promotion in Finnish Municipalities/Pia Hakamäki 16
  • 17. Thank you! Pia Hakamäki e.mail: pia.hakamaki@thl.fi GSM: + 358 40 5188685 Mika Vuori e.mail: mika.vuori@thl.fi Sanna Kilpeläinen 17