New regional service models guarantee availability of health and social services
Urbanisation will continue, and health and social services will probably be increasingly concentrated in growth centres. To prevent regional differences from escalating, service solutions must be customised by region. Services in smaller communities can be guaranteed by leveraging new service concepts and with regional cooperation. Centralisation of hospital services will improve productivity and save on costs.
These are the key findings in a report produced by the National Institute for Health and Welfare (THL), the Finnish Environment Institute and the VTT Technical Research Centre of Finland Ltd. The investigation reported was undertaken as part of the implementation of the Government Plan for Analysis, Assessment and Research for the year 2015 and drew on population prognoses in order to assess future service needs, service placement and regional economies up to 2030.
“The providing of health and social services cannot be managed with a one-solution-fits-all approach in the various regions. We must first identify the baseline situation and future outlook in each region,” says Chief Administrative Physician Eeva Reissell from the National Institute for Health and Welfare.
Multi-centre model is the most sustainable solution
The most sustainable solution found is to improve availability of services through what is known as the multi-centre model. This means a dual approach of centralising services in population centres on the one hand but safeguarding key services in rural central communities on the other. It is a solution that allows for alleviation of the escalation of regional differences.
The report notes that there is a case to be made for the centralising of non-urgent care and specialised-level services. If the hospital with emergency care is far away, the service level may be improved with a good emergency services medical response. Senior Research Scientist Antti Rehunen from the Finnish Environment Institute notes that health clinics are crucial providers of local services and important for the ageing population.
“Health clinics should be placed in city centres, community centres and public transport nodes so that they will be accessible by other means than by car. Some health clinics may offer lighter services such as guidance, measurements, testing and social services. Some services may be offered as house calls or digital services. A larger percentage of services than before can be offered to customers at locations other than healthcare facilities,” says Rehunen.
Placement of hospitals affects regional economy
The way in which health and social services are provided affect regional and community structures. An analysis of regional economies shows that centralisation of hospital functions curbs cost growth and increases productivity. “Hospital services are being centralised everywhere in industrialised countries. The aim is to link them more closely to the adapted service networks,” says Reissell.
At the same time, however, customers’ travel costs will increase, and there will be significant changes in the location of jobs. “In counties left without a hospital providing extensive emergency care, professionals will leave to find work elsewhere, which will cause a decline in the region's employment, private consumption and attractiveness. Conversely, the attractiveness of cities that have hospitals providing extensive emergency care will increase thanks to broad career opportunities and a high level of service,” says Senior Principal Scientist Juha Honkatukia from VTT Technical Research Centre of Finland.
Housing solutions for the elderly will have huge economic impact
As the population ages, the costs of institutional care and housing services may double in the next few decades. However, there are substantial differences between regions in the volume of institutional care required.
“The cost increase could be halved if housing services were scaled nationwide in the same way as they are in the most efficient counties. If an increasing percentage of elderly people were to be able to continue living at home thanks to improved functional capacity, home care and other services, we could achieve cost savings of hundreds of millions of euros per year,” say Juha Honkatukia and Antti Rehunen.
Further information
Senior Research Scientist Antti Rehunen, Finnish Environment Institute, tel. 0295 251 550
Chief Administrative Physician Eeva Reissell, National Institute for Health and Welfare (THL), tel. 0295 524 7655
Senior Principal Scientist Juha Honkatukia, VTT Technical Research Centre of Finland Ltd, tel. 040 304 5561