The Finnish healthcare service grid and access in rural Finland

The Finnish healthcare service grid and access in rural Finland Kimmo Parhiala, M.Soc.Sc Development Manager, National Institute for Health and Welfare TW: @parhialakimmo 20.6.2017 The Finnish healthcare service grid and access in rural Finland / Parhiala 1

Persistent rural healthcare challenges (Ford, D.) The challenge of population demographics Rural areas are sparsely populated and more increasingly, this population experiences further erosion as young people move away from these areas to attend school and find work. For those who remain, the demographic is becoming proportionately older. The challenge of place (or geographic realities!) A second challenge is that of place where rural communities face unique geographic realities. There are often large distances between farms and reasonably sized towns or major urban centers where health services may be available. These geographic realities directly impact the ease of access to and utilization of health services. The challenge of professionals The distributive resource constraint, particularly when it comes to providers. Although rural residents tend to understand and accept that there will not be as many providers available to them as in more urban areas, they do expect a reasonable level of service and response. Achieving a critical mass of health professionals is also a problem. 20.6.2017 The Finnish healthcare service grid and access in rural Finland / Parhiala 2

20.6.2017 The Finnish healthcare service grid and access in rural Finland / Parhiala 3

Area classification by SYKE (Finnish Environment Institute) Sisempi kaupunkialue (Inner urban area): kaupunkien tiivis yhtenäinen tehokkaasti rakennettu alue. Ulompi kaupunkialue (Outer urban area): sisemmän kaupunkialueen reunasta yhtenäisesti jatkuvan taajamarakenteen reunalle ulottuva kaupunkimaisen tehokkuuden alue. Kaupungin kehysalue: (Sub-urban area) kaupunkiin välittömästi kytkeytyvä osa kaupungin ja maaseudun välivyöhykkeestä. Maaseudun paikalliskeskukset (Countryside localisation area): suurempien kaupunkialueiden ulkopuolella sijaitsevat taajamakeskukset, pikkukaupungit ja isot kirkonkylät. Kaupungin läheinen maaseutu: (Close-tourban countryside area) Maaseutumainen alue, joka on toiminnallisesti ja fyysisesti lähellä kaupunkialueita. Ydinmaaseutu (Main countryside area): intensiivistä maankäyttöä ja/tai paikallistasolla elinkeinorakenteeltaan monipuolista suhteellisen tiiviisti asuttua maaseutua. Harvaan asuttu maaseutu (Rural countryside area): harvaan asuttua aluetta, jossa toiminnoiltaan monipuolisia keskittymiä ei ole tai ne ovat pieniä ja sijaitsevat etäällä toisistaan. Alueen maa-alueesta suurin osa on metsää. 20.6.2017 The Finnish healthcare service grid and access in rural Finland / Parhiala 7

Analysis of the Finnish service grid Organisations and their suborganisations must register to use national data system service platform Kanta. Kanta is the national data system services for healthcare services, pharmacies and citizens. The services include the electronic prescription, Pharmaceutical Database, My Kanta pages, and Patient Data Repository. The services are deployed in phases throughout Finland. The first to be introduced are the electronic prescription, Pharmaceutical Database, and My Health Information. Organisational data is collected into a register. This data has not been used before in depth. Data (incl. street addresses) was geocoded and a PostGIS geospatial database was formed from the data. Service organisations and suborganisations were categorized into classes. Data on private organisations were linked to the database from National Supervisory Authority. The geocoded and categorized data can be viewed and analysed further for the purpose of county monitoring stated in the new health and social care reform law proposal. N= 54,300 organisations. (81,5 % of these could be classified) 20.6.2017 The Finnish healthcare service grid and access in rural Finland / Parhiala 9

Analysis of the Finnish Service Grid 20.6.2017 The Finnish healthcare service grid and access in rural Finland / Parhiala 10

Special health care Primary health care 20.6.2017 The Finnish healthcare service grid and access in rural Finland / Parhiala 13

Conclusions Changes in the service grid can be now monitored. Q: How does the patient choice reform is going to effect rural areas? Service classification is challenging especially for public sector organisations private sector has to hand out more information to officials. How can digital services be mapped? Location From where the service is provided to where the service is used 20.6.2017 The Finnish healthcare service grid and access in rural Finland / Parhiala 15

Thank you! Kimmo Parhiala, M.Soc.Sc Development Manager, National Institute for Health and Welfare TW: @parhialakimmo 20.6.2017 The Finnish healthcare service grid and access in rural Finland / Parhiala 16