Long-term care reform in Slovenia: financing perspective - Eva Zver, SloveniaOECD Governance
This presentation was made by Eva Zver, Slovenia, at the 4th meeting of the Joint DELSA/GOV-SBO Network on Fiscal Sustainability of Health Systems, held in Paris on 16-17 February 2015.
Parental Carers of Disabled Child--rentaiwan japan finlandCare Connect
Parent-carers in Taiwan and Japan: lifelong caring responsibilities within a familistic welfare system
Prof Yueh-Ching Chou, Institute of Health and Welfare Policy, National Yang-Ming University, Taiwan
Prof Toshiko Nakano, Faculty of Sociology and Social Work, Meiji Gakuin University, Tokyo, Japan
Prof Antti Teittinen, Adjunct Professor and Research Manager, Centre for Research and Development, Finnish Association on Intellectual and Developmental Disabilities
Carers and Work-Care Reconciliation International Conference
University of Leeds, 13th August 2013
Long-term care reform in Slovenia: financing perspective - Eva Zver, SloveniaOECD Governance
This presentation was made by Eva Zver, Slovenia, at the 4th meeting of the Joint DELSA/GOV-SBO Network on Fiscal Sustainability of Health Systems, held in Paris on 16-17 February 2015.
Parental Carers of Disabled Child--rentaiwan japan finlandCare Connect
Parent-carers in Taiwan and Japan: lifelong caring responsibilities within a familistic welfare system
Prof Yueh-Ching Chou, Institute of Health and Welfare Policy, National Yang-Ming University, Taiwan
Prof Toshiko Nakano, Faculty of Sociology and Social Work, Meiji Gakuin University, Tokyo, Japan
Prof Antti Teittinen, Adjunct Professor and Research Manager, Centre for Research and Development, Finnish Association on Intellectual and Developmental Disabilities
Carers and Work-Care Reconciliation International Conference
University of Leeds, 13th August 2013
Topic The Care Act: Implications for Homeless Health Care
Presenter Karl Mason
Social Work Lead - Trauma, Emergency and Acute Medicine Kings Lead KHP Homeless Pathway Team Kings
Hi Friends
This is supa bouy
I am a mentor, Friend for all Management Aspirants, Any query related to anything in Management, Do write me @ supabuoy@gmail.com.
I will try to assist the best way I can.
Cheers to lyf…!!!
Supa Bouy
A basic income experiment was conducted in Finland in 2017–2018 to find ways to reshape the social security system. Evaluation study of the basic income experiment is underway.
The Care Act - Consultation on guidance and regulations: Personalisation and ...Think Local Act Personal
Presentation gives an overview of the personalisation features within the Care Act guidance and regulations.Presentations was delivered by Kevin Kitching at the 'Personalisation and the Care Act consultation events' hosted by TLAP, Department of Health, the Local Government Association (LGA) and Association of Directors of Adult Social Services (ADASS) on Monday 21st July 2014 in London and 23 July 2014 in Manchester.
Kevin Kitching gave the presentation. He is the Personalisation Policy Manger Social Care, Local Government and Care Partnerships Directorate at the Department of Health.
Social security in india and need of new policyAnand Rai
This explains the meaning of social security and also provides the account of social security programmes in India and their current status. This also illustrates the proposed changes in Policy as well as in structure of social security by central govt.
Workshop E Work-care reconciliation in different welfare systems - Nordic SatesCare Connect
Dr Outi Jolanki, Postdoctoral Research Fellow, University of Jyväskylä, Finland
Carers and Work-Care Reconciliation International Conference
University of Leeds, 13th August 2013
Terveyden edistämisen taloudelliset vaikutukset pitkällä aikavälillä.Eero Siljander
Impact of public health promotion policies on % of GDP-shares. Simulated by SOME model developed at STM-ministry in collaboration with Rolf Myhrman and Antti Alila.
Topic The Care Act: Implications for Homeless Health Care
Presenter Karl Mason
Social Work Lead - Trauma, Emergency and Acute Medicine Kings Lead KHP Homeless Pathway Team Kings
Hi Friends
This is supa bouy
I am a mentor, Friend for all Management Aspirants, Any query related to anything in Management, Do write me @ supabuoy@gmail.com.
I will try to assist the best way I can.
Cheers to lyf…!!!
Supa Bouy
A basic income experiment was conducted in Finland in 2017–2018 to find ways to reshape the social security system. Evaluation study of the basic income experiment is underway.
The Care Act - Consultation on guidance and regulations: Personalisation and ...Think Local Act Personal
Presentation gives an overview of the personalisation features within the Care Act guidance and regulations.Presentations was delivered by Kevin Kitching at the 'Personalisation and the Care Act consultation events' hosted by TLAP, Department of Health, the Local Government Association (LGA) and Association of Directors of Adult Social Services (ADASS) on Monday 21st July 2014 in London and 23 July 2014 in Manchester.
Kevin Kitching gave the presentation. He is the Personalisation Policy Manger Social Care, Local Government and Care Partnerships Directorate at the Department of Health.
Social security in india and need of new policyAnand Rai
This explains the meaning of social security and also provides the account of social security programmes in India and their current status. This also illustrates the proposed changes in Policy as well as in structure of social security by central govt.
Workshop E Work-care reconciliation in different welfare systems - Nordic SatesCare Connect
Dr Outi Jolanki, Postdoctoral Research Fellow, University of Jyväskylä, Finland
Carers and Work-Care Reconciliation International Conference
University of Leeds, 13th August 2013
Terveyden edistämisen taloudelliset vaikutukset pitkällä aikavälillä.Eero Siljander
Impact of public health promotion policies on % of GDP-shares. Simulated by SOME model developed at STM-ministry in collaboration with Rolf Myhrman and Antti Alila.
Terveystaloustiede, uusi, trendit, kansanterveys, Suomi. Health economics, Finland, results.
Uusia tutkimustuloksia terveystaloustieteen ja epidemiologian alueelta Suomessa. Diabetes kasvaa räjähdysmäisesti, Stroke ja sydänsairaudet vähenevät. Diabetes on a massive increase, stroke and coronary events on the decrease in Finland. Potential savings in health care could amount to 500 M. euros per year with efficient and productive SOTE-services.
Elderly care conference 2017 - The state of social care: the commissioning la...Browne Jacobson LLP
Joy looks at 'what is social care in the 21st Century and why it is important?' including the current state of the social care market and taking a look at the future.
Large Scale roll-out of telehealth/Telecare : approach and examples – Scotla...flanderscare
Wat is de toekomst van zorg op afstand in Vlaanderen? Dat was de centrale vraag van het event van 17 juni. 100 deelnemers dachten hier samen over na. Studiebezoeken aan andere Europese regio's toonden dat daar reeds op grote schaal met telecare en telehealth gewerkt en geëxperimenteerd wordt.
Hi Friends
This is supa bouy
I am a mentor, Friend for all Management Aspirants, Any query related to anything in Management, Do write me @ supabuoy@gmail.com.
I will try to assist the best way I can.
Cheers to lyf…!!!
Supa Bouy
General presentation on Key Project "Home care for older people will be developed and informal care enhanced in
all age groups"
Anja Noro, Project Manager, Ministry of Social Affairs and Health, Finland
Tony O'Brien Director General of the HSE - Opening Slides from The National H...myhomecare
This slideshow is from Tony O'Brien, Director General of the HSE. Tony recently opened Irelands first ever National Homecare Conference which took place on 28th March in The Ballsbridge Hotel in Dublin.
Kainuu is a forerunner in Finland in terms of integrating primary health care services with specialized medical care as well as social services:
• Kainuu Social Welfare and Health Care Joint Authority (Kainuun sote) provides all social welfare and health care services except children’s day care for seven municipalities plus partially for one.
• the biggest employer in the region with about 3 200 employees
• financed by member municipalities
• Budget 2013 309 M€
• provides also HR as well as financial and data administration services for member municipalities.
This describes the background problem, concept of health insurance, enrollment procedure, benefits,and implementation status of health insurance in Nepal, issues/concerns (discussion), take home message
Tuire Santamäki-Vuori, Finnish Institute for Health and WelfareTHL
JPI More Years Better Lives workshop: Integrating policies, programmes and services in an ageing society (30 October 2019)
https://thl.fi/en/web/thlfi-en/whats-new/events/thl-s-eu-2019-side-events/demographic-change-equality-and-wellbeing
Artificial Intelligence, IoT and Machine Learning of Sports. Especially soccer but applicable to NHL, KHL, SM-liiga, Mestis etc. Fenwick, Corsi, FOW, PPG, PIM etc. player and ice hockey match analysis.
Eero Siljander project managing work at Monzuun Oy, www.monzuun.com. Co-operation with HVAC engineering at www.hvac.fi. Data Science of IoT and real-estate and building automation. Selecting IoT framework and software and sensor systems. Calibrating engine power and electricity usage by artificial intelligence, machine learning and statistical analysis.
Here is 4-ALL you need a list of things to develop and improve in your project managers work. Try to set a clear Product, Concept or Functional Algorithm goal = A truely NEW finding or Achievementor Product ! (not evo-version of something existing).
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
1. Social protection and ageing of the
Finnish population
Head of Functional Capacity Unit, Research Manager, Minna- Liisa Luoma
&
Senior researcher, Eero Siljander, CHESS/THL.
9.6.2014 Esityksen nimi / Tekijä 1
2. Content of the presentation
• Nordic model of welfare
• Social protection
– Strategies : Pension reform (2005), & New Health care act
(2011)
• Income security ES
• Long term care ES
• Financing the services ES
– Strategies : National Framework for high quality services for
older people, New draft Act on care Services for the elderly
(MLL)
• Preventive services (MLL)
• Housing services (MLL)
• Home services & nursing care (MLL)
• Memory rehabilitation (MLL)
9.6.2014 Esityksen nimi / Tekijä 2
3. Social protection and ageing of the population
Social protection promotion in society aims to strengthen
people's participation and to prevent poverty and social
exclusion.
Social protection for older people consists of services and income
security, arranged as a part of social care and health care.
The aim of the ageing policy is to further older people's
– Functional capacity
– Independent living
– Active involvement in society
9.6.2014 Esityksen nimi / Tekijä 3
4. Mira Koivusilta | Nordic Congress on Gerontology | Reykjavik | 2 June 2010 4
• TÄHÄN KUVA
5. The population context – rapid ageing scenario.
• Tackling the “ageing of society” issue is important:
• - Expansion of long-term care services and pension finance to be
expected because of population structure change and longevity.
• - Cost-effectiveness and quality of services need to be addressed.
• - Informal care and home care of older people rising on the political
agenda.
• Facts:
• Population of 5,4 million people: 2 748 733 women and 2 652 534
men in 2011 .
• 65 % 15-64 years old and It is forecasted that the number over 65+
population will double from current 900 000 to 1,8 million by 2060.
• It is forecasted that the demographic dependency ratio will change
from 50,3 in 2008 to:
• - 70,5 (+ 40 percent) by year 2026.
• - 79,1 (+ 60 percent) by 2060.
• (this is the ratio of under 15 and 65+ to 15-64 working ages)
9.6.2014 Esityksen nimi / Tekijä 5
6. Welfare-mix in Finland/Older People
SOCIAL SUPPORT NETWORK OF AN OLDER
PERSON
•Complementary provider
•Spouse, children, relatives
•Friends, neighbours
•70 % of the need of social care
PUBLIC SERVICES
•Primary provider
•Provided by the local authorities (municipalities)
•Purchased from private or public providers (the
purchasing-provider model
•30 % of the need of social care
COMMERCIAL, FOR-
PROFIT SERVICES,
FIRMS
• Supplementary provider
•Private professionals
•Private enterprises
•Increasing especially in
home care, service
housing and leisure
activities
•“silver markets”
NON-GOVERNMENTAL
ORGANISATIONS – NGO’S
•Supplementary provider
•Organisations and
foundations
•Voluntary work
7. Nordic model – the welfare state
• Finland is a Beveridge -orientated welfare state, belonging to
the so called Nordic welfare model, together with
Scandinavian countries
• state and public sector major provider, tax-financed, state having a
guiding role in form of legislation, recommendations, national
development programs and information guidance
• The government subsidises social and health care services
provided by the municipalities through state grants.
– Every municipality is in principle (n=336) is a service organizing unit.
Median and mean inhabitant size is low = 5000 - 6000.
– However, in practise co-organizing is also applicable and for many
municipalities the only reasonable option.
– Finland is unique in the EU in health and social care service finance and
production with widespread responsibility.
– Reforms of municipal structure is top priority of the current Katainen
administration. The target is to ensure financially strong enough local
government units for the future.
9.6.2014 Esityksen nimi / Tekijä 7
9. Social and elderly care services in a
municipality
9.6.2014 Esityksen nimi / Tekijä 9
10. Non-
institutional
care
Mix-type
services
Mix-type
services
Mostly long-
term care
Non-
institutional
care
Inpatient
specialised health care
- somatic
- psychiatric
Day hospitals/day centres
Day and night care etc.
Residential home
HEALTH CARE
SOCIAL SERVICES
LONG-TERM CARE AND
SOCIAL SERVICES FOR
OLDER PEOPLE
Home help
Support services
- meals-on-wheels, transport
service etc.
Support for informal care
Home nursing
Outpatient primary health
care
Outpatient specialised health
care
- somatic
- psychiatric
Service housing (ordinary/ with 24-hour
assistance)
Inpatient care in
primary health care
Emergency
inpatient care
Emergency/
long-term
inpatient care
Gerontological
Social Work
11. CURRENT HEALTH CARE SYSTEM
AND ITS CHALLENGES
9.6.2014 Esityksen nimi / Tekijä 11
15. Finland - New Health and social care legislation.
New Health care act (enacted in 2011)
• - freedom of provider choice in primary and
specialized care (at this stage regional but will
be expanded to cover whole country later),
• - enforced access timetables (tighter time limits
to waiting lists),
• - vouchers and new providers (enabling
vouchers for social and health care services,
more public-private partnership & private
producers).
• - nurse prescription rights (limited to a list of
basic drugs and some antibiotics).
• - New social care and old people care acts
expected to be in force under current
administration. Under construction.
9.6.2014 Esityksen nimi / Tekijä 15
16. Financing of health and LTC care - Finland (A)
• health care is financed by state, municipalities,
employers, employees and patients/clients.
• Households finance 62,7 % and companies 37,3 %.
• Multi-channel funding, cost-shifting, sub-optimizing
strategies (proposal by THL to make one-channel
funded, 2011).
• Use of private health care is partially compensated by
the public insurance. Dental care is 50 percent private.
• Municipalities get state subsidies/grants, and they collect
local taxes to finance the public costs.
• One of highest client fee -systems among the OECD-
countries. 85 of net disposable income in LTC for
example.
9.6.2014 Esityksen nimi / Tekijä 16
19. INCOME SECURITY
• employee pension
• national pension
• housing allowance
• care allowance
9.6.2014 Esityksen nimi / Tekijä 19
20. Pension system (1) – Finland.
• two main schemes, both are statutory public schemes
– (1) National pension scheme for 65+, co-ordinated
with other pensions and incomes
– (2) Employment Pension Schemes to secure the level
of consumption attained, flexible retirement age from
63 to 68.
– (2+)extra bonus if staying in work 63+, increase to 4.5
% in accrue rate (compared to under 2).
– Future pensions will decrease as compared to wages
by a so-called life-time multiplier. This is due to
population longevity. The current replacement rate is
60 of gross income.
– Private (voluntary) Pension Schemes are becoming
more popular. Private (voluntary) LTC care insurance
is on the planning table as well.
9.6.2014 Esityksen nimi / Tekijä 20
21. Pension types, supplements and allowances (2)
• Types:
• A) old-age pension, B) disability pension, C)
unemployment pension, D) part-time pension, E)
rehabilitation benefits, F) survivors’ pension, farmers’ G)
early retirement aid.
• Details:
– Housing allowance for pensioners, pensioner's care allowance,
war veteran's supplements.
– family care allowance and services to support informal care at
home.
– tax deductions for purchasing help for cleaning and other home
works, garden works, renovations, care etc. (apply for all
population groups, not just the old).
– At the end of 2011, there were 1,483,000 pension recipients, the
majority of whom drew an old-age pension (77 %) second largest
group was surviving spouse’s pensions (18%) and third largest
disability pensions (18 %).
9.6.2014 Esityksen nimi / Tekijä 21
22. Key figures – pensions (3)
• The average total pension calculated for all pension recipients
is the average figure for the most extensive group of pension
recipients possible. In 2011, this figure was EUR 1,328/
month. The figure includes pensions paid abroad as well as
survivors' pensions. There is no ceiling on pension levels.
• If the group of pension recipients is limited to persons residing
in Finland who receive only a pension based on their own
working career (pension in their own right), the average total
pension at the end of 2011 amounted to EUR 1,415/month.
Part-time pensions are not included in these calculations.
• According to the results, the median of the replacement ratio
of retired employees in the early 2000s was approximately 60
percent of the wage-earner’s earnings from a few years ago.
• By 2030 the life-time multiplier is expected to reduce the
replacement ratio to below 50 percent maybe even 40.
9.6.2014 Esityksen nimi / Tekijä 22
25. Longevity, services and social expenditure as %
of Gross domestic product (GDP) – Scenarios.
9.6.2014 Esityksen nimi / Tekijä 25
- If service and care needs
are postponed by 100 or 50
percent with longevity then
major savings in social
expenditure are expected.
(Myhrman, Alila, Siljander,
2009)
- The scenario presented
earlier indicates the same
result with 3 years
postponement in LTC care.
(Häkkinen, 2008).
The Key in curbing
expenditure is reduction in
morbidity in common
population diseases and
postponement of LTC care.
28. References – more information
• See THL, Ministry and Finnish Centre for Pensions web-
pages:
• www.thl.fi
• www.etk.fi
• www.stm.fi
• Literature:
• Myhrman R. & Alila A. & Siljander E. (2009): Scenarios on
Finnish health and social expenditures in the long-run –
SOME-model (in finnish language), Ministry of Social Affairs
and health – publication, 7:2009.
• Häkkinen U., Martikainen P., Noro A., Nihtilä E., Peltola M.
(2008). Aging, health expenditure, proximity to death and
income in Finland. Health Economics, Policy and Law, 3: 165-
195.
9.6.2014 Esityksen nimi / Tekijä 28
30. Social protection: care services
National Framework for high
quality services for older
people, New draft Act on
care Services for the
elderly (Mll)
• Preventive services (MLL)
• Housing services (MLL)
• Home services & nursing
care (MLL)
• Memory rehabilitation
(MLL)
9.6.2014 Esityksen nimi / Tekijä 30
31. National Framework for High-Quality
Services for Older People
09/06/2014 31
The framework aims at promoting old-age health
and welfare and improving the quality and
effectiveness of services.
http://www.stm.fi/julkaisut/julkaisuja-
sarja/nayta/_julkaisu/1063089#en
32. National Framework for High-Quality Services
for Older People 2001, 2008, (2013)
• the aim is to promote the health and welfare of older people
and to boost the quality and effectiveness of services
• is designed to help municipalities and cooperation districts to
develop their services for older people on a basis of local
needs and resources, jointly with the third sector, private-
sector service providers, and clients, their relations and other
local residents.
• It sets national quantitative targets for services for older
people that municipalities and cooperation districts can use
as a basis for fixing their own targets.
09/06/2014 32
33. Framework stresses importance of….
• the structure of a joint advice and service centre network of
social and health care
– Low threshold
– Able assess and monitor the functional capacity and health
• increasing the number of home visits promoting wellbeing
and establishing them as an integral part of the service
provision for older people
– Risk groups
• Rehabilitation and rehabilitative care that begin
immediately after acute treatment bring results
09/06/2014 33
35. • Prevention services
– Older people's functional capacity is supported using preventive
services and rehabilitation. These services include Senior Info,
home visits, day centres, and vaccinations.
• Service needs assessment
– All over 75 years of age and those receiving a special care
allowance should have an assessment of their non-emergency
service needs by the seventh working day from the day of
contact.
– If an older person requires home services, informal care,
institutional care, services for older people, social assistance or
other social care services, for these to be granted a municipal
official assesses the client's service needs.
– In urgent situations, the need for all services must be assessed at
once, regardless of age.
9.6.2014 Esityksen nimi / Tekijä 35
36. Increasing the number of home visits
promoting wellbeing
• ‘The target group is selected on the basis of either (1) age or
(2) the age and if the person belongs to a risk group.
• to be targeted primarily to persons aged 70–85 years who do
not receive regular services or to a certain age class within
this group.
• During a home visit an overall assessment will be made of
the person’s functional capacity, the risk factors in the
housing environment will be considered, and guidance given
for self-motivated promotion of wellbeing.
• The clients are also told about the services available in the
municipality
09/06/2014 36
37. Housing services
• Older people's independent
housing is supported by
housing services by
granting reimbursements
for housing renovation
work
• by providing service
accommodation.
•
9.6.2014 Esityksen nimi / Tekijä 37
38. Home services and home nursing care
• Home service and home
nursing care assist when
an older person requires
help at home due to
diminished functional
capacity or illness.
• Support services are used
to supplement home
services, for instance to
provide meals, home
cleaning, bathing clients
and transport.
•
9.6.2014 Esityksen nimi / Tekijä 38
39. Home Care
• the percentage of people in
need of continuous 24-hour
care varied between 4.3 to
and 22.9 %
• Just under a quarter
(22.8%) of clients receiving
home-care services had
had more than 60 visits a
month.
• It was estimated by the staff
that a great majority
(84.2%) of clients had
received the treatment best
suited to their needs, that
is, home care.
9.6.2014 Esityksen nimi / Tekijä 39
40. Informal care allowance
Municipalities may grant informal care support for a relative or friend
of a person being cared for.
9.6.2014 Esityksen nimi / Tekijä 40
41. Support for informal care
• In 2010, municipal support for informal care was granted to
some 37 000 care givers for older, this support involving
approximately the same number of care receivers.
• In 2012 Minimum amount 364,35 €/ month and If the carer is
unable to be gainfully employed during a transitional stage with
the nature of care being heavy support is 728,69 €/month
• The person receiving support for informal care is entitled to
have at least two days off in any month during which the nature
of the care is extremely restraining. The municipality provides
for the care during the statutory time off.
09/06/2014 41
42. Memory rehabilitation
• Social and health care
professionals offer
guidance and advice for
people with memory
disorders in need of special
services.
• Many municipalities have
nurses, advisers or
coordinators for memory
disorders. Also, the regional
specialists and support
centres of the associations
for memory disorders and
dementia provide advice
and guidance.
9.6.2014 Esityksen nimi / Tekijä 42
44. The new draft Act on Care Services for the
Elderly
• Access to social services for the elderly to be made
easier and faster
• The basis for access to services will be the capabilities of the
elderly person, rather than age in itself.
• Right to apply for services orally as well as in writing
• In urgent cases, make decision on, and arrange, services
without delay.
• non-urgent services have been approved, right to receive the
service within three months of the approval decision
• Granting services required by the elderly would be facilitated
by the service need's clarification from a number of
perspectives.
09/06/2014 44
45. Act on Care Services for the Elderly (II)
• Municipalities must provide systematic support for the
elderly
• Municipality must draw up a plan on measures for promoting
the wellbeing, health, capabilities and independent living of,
as well as arranging and developing services
• Municipalities must have a sufficient level of expertise on the
following areas: the promotion of wellbeing and health,
geriatric care and social work, geriatrics, safe medication,
nutrition, rehabilitation and oral healthcare.
• Service units providing services for the aged must have
sufficient staff, whose qualifications and duty structures match
the number of elderly clients and the service need set by their
capabilities.
9.6.2014 Esityksen nimi / Tekijä 45
49. Esityksen nimi / Tekijä
Sustainable Strategies:
Socio-economic Security
• Pension reform 2005
- longer working life: 63-68 years
- rise in employment rate of 63+
higher min. pension for lowest 10% (2011)
• Strategy for Social Protection 2015 (2010)
(health, work, poverty, services)
• Health promotion HIAP 2006
Universal Social Health Insurance
- including home care services
- Act on Support for Informal Care 2006
• National Framework for High-Quality Services for Older People 2001,
2008
KASTE framework 2008-11
• The new draft Act on Care Services for the Elderly 2013