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Productivity and its Drivers in Finnish Primary Care 1988-2003


  • Järviö, Maija-Liisa
  • Luoma, Kalevi
  • Räty, Tarmo
  • Aaltonen, Juho


We measure productivity changes of primary care in Finland between 1988 and 2003 as a ratio of key services produced and real operating costs. In the second stage we estimate a truncated regression model that quantifies the contribution of certain internal and exogenous factors to productivity. We use newly developed techniques to correct asymptotic bias in non-parametric efficiency scores and bootstrap the confidence intervals for the explanatory model parameter estimates. The bias accounts on average 2.8 percent decrease in efficiency level. From 1997 to 2003 the average productivity declined 13.7 percent; the result is insensitive to estimated bias. Even if standard parametric confidence intervals do not generally apply when efficiency scores are regressed, our bootstrapped intervals are almost equal to parametric ones. Of the correlates used the increased income subject to municipal taxation accounted for three percentage points of the productivity decrease. The correlates, that are expected to decrease the need of primary care services, had a negative impact on productivity, implying that health centres have not been able to adjust their resource usage correspondingly. Organisational changes that have taken place within primary care have not resulted in desired productivity improvements.

Suggested Citation

  • 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.
  • Handle: RePEc:fer:resrep:118

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    References listed on IDEAS

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    8. 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.
    9. Kiander, Jaakko & Hjerppe, Reino, 2004. "Technology Policy and Knowledge-based Growth in Small Countries," Research Reports 110, VATT Institute for Economic Research.
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    Cited by:

    1. Melanie Cozad & Bruno Wichmann, 2013. "Efficiency of health care delivery systems: effects of health insurance coverage," Applied Economics, Taylor & Francis Journals, vol. 45(29), pages 4082-4094, October.
    2. Luoma, Kalevi & Moisio, Antti & Aaltonen, Juho, 2007. "Secessions of Municipal Health Centre Federations: Expenditure and Productivity Effects," Discussion Papers 425, VATT Institute for Economic Research.
    3. Aaltonen, Juho, 2007. "Determinants of Health Care Expenditures in Finnish Hospital Districts 1993-2005," Discussion Papers 429, VATT Institute for Economic Research.


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