The document discusses the proposed assessment of counties' ability to organize health and social services in Finland. Under new legislation, the National Institute for Health and Welfare (THL) would be tasked with annually assessing each county's performance based on dimensions like quality, access, costs and equality across various service areas. The assessment would analyze counties' self-reports and reports from the supervisory authority, as well as 50 statistical indicators. THL would then provide an expert assessment of each county to the Ministry of Social Affairs and Health. The assessment aims to evaluate whether services meet population needs equally and are efficiently and cost-effectively delivered across Finland's 18 counties.

1. From knowledge to assessment
Assessment of performance in social and health care
Pekka Rissanen, Director of Assessment, Professor

2. Basis for assessment
 Social and health care legislation – proposed and prevailing
legislation
 The proposed Act of Organising Health and Social Services,
the National Institute for Health and Welfare (THL) will have a
task of assessing counties ability to organise services
– Equality: Does the access and availability of servicies in the
counties respond equally to the population’s needs?
– Sufficiency of funding: Costs, production efficiency and cost-
effectiveness
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3. Basis for … (cont.)
 According to the proposed Act, the THL has the duty to
annually
– Analyse reports produced by the counties (18 in total) and the
supervisory authority
– on health and social services
– and provide a national expert assessment of each county for the
Ministry of Social Affairs and Health
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4. Dimensions of assessment: performance dimensions (5),
service areas (~ 10) and counties (18)
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5. Service areas to be
assessed
Qualtiy and
effectiveness
Access and
availability
Costs of services
& production
efficiency
Customer
orientation
Equality
Wellfare and health
promotion
Preventive services
Primary health care
Specialised medical care
Services for children,
young people and
families
Social services for older
people
Mental health services
Substance abuse
services
Services for the disabled
Social services for
working age people
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6. Assessment of social and health
services
some results from assessment training
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7. Access and
availability
 Primary health care
 Home care 24/7 –
services
 Assessment of need
for child protection in
due time
 Social services
 Hospital services
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8. Social services for
working age population
 Stuctural unemployment
 Activation measures
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9. Primary health care
 Polyclinic visits (in
primary care)
 Visits to MD’s
 Other than MD-visits
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10. Specialised
(somatic) health care
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 Costs/ inhabitant,
need adjusted
 Use of services,
need adjusted
 Production
efficiency

11. Forecast of soc&hc
expenditure (whole
country)
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 Specialised health
care
 Primary health care
 Social services

12. Expert assessment will be completed annually
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13. Knowledge basis for the expert assessment
 Self-reports from the counties
 Reports of each county from the supervisory authority
 Different kinds of documents and interviews
 About 50 registries or statistics - a huge number of statistical
indicators on
 Population’s needs for soc & hc services
 Resources and organisations of services
 Output
 Effectiveness
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14. Assessment organisation in the THL
 Healthcare and Social Services Evaluation Unit (JOSA)
– Co-operation with the counties, the ministries and supervisory
authorities
– Collection of ”qualitative data”
– Reports to the Ministry of Social Affairs and Healht
– Small core team of full-time experts (9 persons at present)
 Network of experts (at present 78 persons) in different fields
of social and health care
– Selection of indicators for assessments
– Expert assessments of the counties for the core team
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15. Kiitos!
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