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Expanding choice of primary care in Finland: much debate but little change so far

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  • Tynkkynen, Liina-Kaisa
  • Chydenius, Miisa
  • Saloranta, Anna
  • Keskimäki, Ilmo

Abstract

“Putting the patient in the driver's seat” is one of the top issues on the health policy agenda in Finland. One of the means believed to promote patient empowerment and patient centeredness is the introduction and further expansion of choice policies with accompanying competition between public and private service providers. However, the Finnish health care system has a highly decentralized administration with multiple funding sources and three different types of providers that people can seek primary care from (municipal health centers, occupational health care services, and private sector providers). This complicates the implementation of choice at the level of primary health care. In this paper, we describe the current policy debates and initiatives promoting the expansion of the choice of primary care provider in Finland. We examine the legislation and policies that have contributed to the current, complex service system in Finland. In light of this examination, we critically discuss the current debate on choice policies as well as the introduction of choice in the context of primary health care.

Suggested Citation

  • Tynkkynen, Liina-Kaisa & Chydenius, Miisa & Saloranta, Anna & Keskimäki, Ilmo, 2016. "Expanding choice of primary care in Finland: much debate but little change so far," Health Policy, Elsevier, vol. 120(3), pages 227-234.
    • Handle: RePEc:eee:hepoli:v:120:y:2016:i:3:p:227-234
    DOI: 10.1016/j.healthpol.2016.01.015
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    References listed on IDEAS

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    1. Le Grand, Julian, 2009. "Choice and competition in publicly funded health care," Health Economics, Policy and Law, Cambridge University Press, vol. 4(4), pages 479-488, October.
    2. Ahgren, Bengt, 2010. "Competition and integration in Swedish health care," Health Policy, Elsevier, vol. 96(2), pages 91-97, July.
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    Cited by:

    1. Tynkkynen, Liina-Kaisa & Alexandersen, Nina & Kaarbøe, Oddvar & Anell, Anders & Lehto, Juhani & Vrangbӕk, Karsten, 2018. "Development of voluntary private health insurance in Nordic countries – An exploratory study on country-specific contextual factors," Health Policy, Elsevier, vol. 122(5), pages 485-492.
    2. Sara Barsanti & Manila Bonciani & Federico Vola & Luca Pirisi, 2016. "Innovatori, indecisi, bisognosi o autonomi. I medici di medicina generale tra integrazione e accountability," MECOSAN, FrancoAngeli Editore, vol. 2016(98), pages 9-39.
    3. Alvaro S Almeida, 2016. "The Role Of Private Non-Profit Healthcare Organizations In Nhs Systems: Implications For The Portuguese Hospital Devolution Program," FEP Working Papers 577, Universidade do Porto, Faculdade de Economia do Porto.
    4. Jolanki, Outi & Tynkkynen, Liina-Kaisa, 2018. "Primary health care nurses’ views on patients’ abilities and resources to make choices and take decisions on health care," Health Policy, Elsevier, vol. 122(9), pages 957-962.

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