When the National Health Care System Is Regional: Regional Differences in Neuropsychiatric Care for Adolescents
Abstract
The Finnish government has committed itself to reducing health inequalities. However, we noticed that there were marked regional differences in the use of neuropsychiatric services for adolescents in 2012. The Finnish health care system is organised into three administrative levels. On the local level, more than 300 municipalities provide primary health care services, and on the regional level 20 hospital districts provide specialised health care services. The national structures of the health care system are the Current Care Guidelines (Käypä hoito) and the Social Insurance Institution of Finland (Kela).
This paper describes 1) regional differences in the use of specialised neuropsychiatric services for adolescents and 2) factors in the existing health care system that contribute to regional differences and manifestations of these factors in specialised health care actions. The study is based on register and administrative document sources as well as interviews with specialised health care consultants.
The findings show that national guidelines do not provide sufficient policy direction to ensure that citizens are treated equally regardless of their place of residence. National adaptation training courses arranged by Kela for adolescents with neuropsychiatric disorders and their families are often physically too far away for both families and specialised health care providers. On the regional level, efforts to promote greater equality through care chains are effectively hampered by the inherent heterogeneity of municipalities within the same hospital district. Professional and administrative cooperation between the neuropsychiatric health care system and the education system on the local level is dependent on individual schools.
Authors
Riikka Lämsä, Päivi Santalahti, Henna Haravuori, Taina Huurre, Annamari Tuulio-Henriksson, Mauri Marttunen
Additional Information
- Peer-Reviewed: yes.
- Open Access: yes.
- Cite as: Lämsä, R., Santalahti, P., Haravuori, H., Huurre, T., Tuulio-Henriksson, A., & Marttunen, M. (2017). Valtakunnallisen terveydenhuoltojärjestelmän paikallisuus: Nuorten neuropsykiatrisen hoidon alueellisista eroista. Yhteiskuntapolitiikka, 82(3), 284–295. https://urn.fi/URN:NBN:fi-fe201706157292
