IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v14y2005is1ps101-s118.html
   My bibliography  Save this article

The impact of changes in Finland's health care system

Author

Listed:
  • Unto Häkkinen

Abstract

The most important reform in Finnish health care in the last decade occurred at the beginning of 1993 as part of a broader change to the entire state subsidy system. This reform reduced central government control and increased the freedom of the municipalities in the provision of health services. In addition, an unusually severe economic recession in the early 1990s affected Finnish health care. Currently, the most important economic decisions in the health care system are made by the 432 municipalities, which decide annually the amount of money to be devoted to health care as well as dividing resources in different sectors within the area of health. The changes in measures of productivity (based on activity‐based measures in output) in the system are more closely associated with direct economic constraints (of municipalities) than with changes in financial incentive structures. Studies on equity in utilisation indicate that the Finnish health care system met the challenges of the 1991–1994 recession. Inequity in utilisation still prevails, however, and can be partly explained by the specific characteristics of the Finnish health care system. In future one needs to take more careful account of the rather unusual incentives that affect the behaviour of political decision‐makers, providers and patients. Copyright © 2005 John Wiley & Sons, Ltd.

Suggested Citation

  • Unto Häkkinen, 2005. "The impact of changes in Finland's health care system," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages 101-118, September.
    • Handle: RePEc:wly:hlthec:v:14:y:2005:i:s1:p:s101-s118
    DOI: 10.1002/hec.1030
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.1030
    Download Restriction: no
    File URL: https://libkey.io/10.1002/hec.1030?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Wagstaff, Adam & van Doorslaer, Eddy & van der Burg, Hattem & Calonge, Samuel & Christiansen, Terkel & Citoni, Guido & Gerdtham, Ulf-G & Gerfin, Mike & Gross, Lorna & Hakinnen, Unto, 1999. "Equity in the finance of health care: some further international comparisons1," Journal of Health Economics, Elsevier, vol. 18(3), pages 263-290, June.
    2. Eddy van Doorslaer & Cristina Masseria, 2004. "Income-Related Inequality in the Use of Medical Care in 21 OECD Countries," OECD Health Working Papers 14, OECD Publishing.
    3. van Doorslaer, Eddy & Wagstaff, Adam & Bleichrodt, Han & Calonge, Samuel & Gerdtham, Ulf-G. & Gerfin, Michael & Geurts, Jose & Gross, Lorna & Hakkinen, Unto & Leu, Robert E., 1997. "Income-related inequalities in health: some international comparisons," Journal of Health Economics, Elsevier, vol. 16(1), pages 93-112, February.
    4. van Doorslaer, Eddy & Wagstaff, Adam & van der Burg, Hattem & Christiansen, Terkel & De Graeve, Diana & Duchesne, Inge & Gerdtham, Ulf-G & Gerfin, Michael & Geurts, Jose & Gross, Lorna, 2000. "Equity in the delivery of health care in Europe and the US," Journal of Health Economics, Elsevier, vol. 19(5), pages 553-583, September.
    5. Kakwani, Nanak & Wagstaff, Adam & van Doorslaer, Eddy, 1997. "Socioeconomic inequalities in health: Measurement, computation, and statistical inference," Journal of Econometrics, Elsevier, vol. 77(1), pages 87-103, March.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Järviö, Maija-Liisa & Luoma, Kalevi & Räty, Tarmo & Aaltonen, Juho, 2005. "Productivity and its Drivers in Finnish Primary Care 1988-2003," Research Reports 118, VATT Institute for Economic Research.
    2. Barros, Carlos Pestana & Menezes, Antonio & Vieira, José António Cabral & Peypoch, Nicolas & Solonandrasana, Bernardin, 2007. "An Analysis of Hospital Efficiency and Productivity Growth Using the Luenberger Productivity Indicator," IZA Discussion Papers 2689, Institute of Labor Economics (IZA).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Jones, Andrew M. & Rice, Nigel & Robone, Silvana & Dias, Pedro Rosa, 2011. "Inequality and polarisation in health systems' responsiveness: A cross-country analysis," Journal of Health Economics, Elsevier, vol. 30(4), pages 616-625, July.
    2. E. Xie, 2011. "Income-related inequalities of health and health care utilization," Frontiers of Economics in China, Springer;Higher Education Press, vol. 6(1), pages 131-156, March.
    3. Xander Koolman & Eddy van Doorslaer, 2004. "On the interpretation of a concentration index of inequality," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 649-656, July.
    4. Mª Luz González Alvarez & Antonio Clavero Barranquero, 2008. "An analysis of income-related inequalities in the health care use by dynamic models," Hacienda Pública Española / Review of Public Economics, IEF, vol. 186(3), pages 9-42, October.
    5. Hai Zhong, 2010. "On decomposing the inequality and inequity change in health care utilization: change in means, or change in the distributions?," International Journal of Health Economics and Management, Springer, vol. 10(4), pages 369-386, December.
    6. I. Josa & A. Aguado, 2020. "Measuring Unidimensional Inequality: Practical Framework for the Choice of an Appropriate Measure," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 149(2), pages 541-570, June.
    7. Hai Zhong, 2010. "The impact of missing data in the estimation of concentration index: a potential source of bias," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(3), pages 255-266, June.
    8. Teresa Bago d'Uva & Eddy Van Doorslaer & Maarten Lindeboom & Owen O'Donnell, 2008. "Does reporting heterogeneity bias the measurement of health disparities?," Health Economics, John Wiley & Sons, Ltd., vol. 17(3), pages 351-375, March.
    9. Matthew Sutton, 2002. "Vertical and horizontal aspects of socio‐economic inequity in general practitioner contacts in Scotland," Health Economics, John Wiley & Sons, Ltd., vol. 11(6), pages 537-549, September.
    10. Sato, Azusa, 2012. "Do Inequalities in Health Care Utilization in Developing Countries Change When We Take into Account Traditional Medicines?," World Development, Elsevier, vol. 40(11), pages 2275-2289.
    11. Xu, Ke Tom, 2006. "State-level variations in income-related inequality in health and health achievement in the US," Social Science & Medicine, Elsevier, vol. 63(2), pages 457-464, July.
    12. Eddy van Doorslaer & Owen O'Donnell, 2008. "Measurement and Explanation of Inequality in Health and Health Care in Low-Income Settings," WIDER Working Paper Series DP2008-04, World Institute for Development Economic Research (UNU-WIDER).
    13. Cavagnero, Eleonora & Bilger, Marcel, 2010. "Equity during an economic crisis: Financing of the Argentine health system," Journal of Health Economics, Elsevier, vol. 29(4), pages 479-488, July.
    14. Pascual Saez, Marta & Cantarero Prieto, David, 2013. "Understanding Health Economics: A Review of Efficiency, Equity and Inequalities Studies /Entendiendo la Economía de la Salud: Una revisión de los estudios sobre eficiencia, equidad y desigualdades," Estudios de Economia Aplicada, Estudios de Economia Aplicada, vol. 31, pages 281-302, Septiembr.
    15. Roberto Montero Granados & José Jesús Martín Martín & Juan de Dios Jiménez Aguilera, 2008. "Horizontal Inequity in Access to Healthcare Services and Educational Level in Spain," FEG Working Paper Series 08/03, Faculty of Economics and Business (University of Granada).
    16. Wagstaff, Adam*Doorslaer, Eddy van, 2001. "Paying for health care : quantifying fairness, catastrophe, and impoverishment, with applications to Vietnam, 1993-98," Policy Research Working Paper Series 2715, The World Bank.
    17. Yasushi Ohkusa & Chika Honda, 2003. "Updated Horizontal Inequity in Health Care Utilization in Japan: Comparisons with OECD Countries Using an Original Survey," ISER Discussion Paper 0585, Institute of Social and Economic Research, Osaka University.
    18. Mohammad Hajizadeh & Luke Brian Connelly & James Robert Gerard Butler, 2014. "Health Policy and Equity of Health Care Financing in Australia: 1973–2010," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 60(2), pages 298-322, June.
    19. Brendan Walsh & Mary Silles & Ciaran O'Neill, 2012. "The Role Of Private Medical Insurance In Socio‐Economic Inequalities In Cancer Screening Uptake In Ireland," Health Economics, John Wiley & Sons, Ltd., vol. 21(10), pages 1250-1256, October.
    20. Hugh Gravelle, 2003. "Measuring income related inequality in health: standardisation and the partial concentration index," Health Economics, John Wiley & Sons, Ltd., vol. 12(10), pages 803-819, October.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:hlthec:v:14:y:2005:i:s1:p:s101-s118. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.