Primary care in Finland has several key principles: it is residence-based and provides universal and equal access to health services. Local municipalities are responsible for organizing primary care and some specialized care. Primary care includes services from general practitioners, nurses, dental and oral health care, maternity and child services, and some home care. Current challenges include an expanding scope of duties without additional resources, resulting in lower quality chronic care. There is also a shortage of health professionals, especially doctors and dentists. The system focuses more on planning than patients, with limited choice and influence. Efforts are underway to improve access, quality, patient-centeredness, prevention, leadership, and the role of health professionals.

1. Primary care in Finland
Minerva Krohn
1.4.2016
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2. • Minerva Krohn
• Chief physician in Primary care
• THL
• minerva.krohn@thl.fi
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3. Key principles of the Finnish health care
system
• Residence-based, universal and equal right to health services
• Local authorities (municipalities) are responsible for
organising primary health care and specialised medical care
• Big change in organising responsibility in 2017
• Public services are mainly funded by tax revenues collected
by the state and municipalities.
– Client charges are collected covering 5–10 % of costs.

4. Primary health care
• Municipalities arrange PHC according to local circumstances
independently, with the neighbouring municipalities or by purchasing
• Primary health care includes:
– consultation by general practitioner & public health nurse
– health counselling, preventive work and vaccinations
– oral/dental health care
– maternity and child health clinics
– school health care
– home nursing
– laboratory & imaging services
– inpatient care only to a minor extent

5. Current challenges of primary care in Finland
• Blurring mission of primary care
– expansion of duties without new resources
– quality of care in chronic conditions poor/average
• Shortage of personnel
– especially doctors and dentists
• System centred planning (vs. patient centred)
– problems in access to care
– no patient choice in public primary care
– little patient influence

6. What are we trying to achieve?
• Good access to services that are of good quality and EBM
• Focus on patients and more choice
• Work based on promoting health and prevention
• Better leadership
• Health professionals
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7. .3.2016 7

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9. Chronic care model
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11. Patient centered care
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12. Health and care plan
• tool designed to improve the comprehensive care of the
patients with long-term conditions and multiple health
conditions
• done by the health care professionals together with the patient
• increases the involvement of the patient to their own care and
guarantees the continuity of the care
• the health and care plan has been included in the health care
act, and it should be done especially when a patient has
chronic or long-term conditions or many different health
conditions
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13. Terveysportti
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14. Triple Aim
4.4.2016 15
Sote
Population health
Cost per
capita
Experience of
care
Patients
professional
Policy makers

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