Regional Availability of Private Physicians’ Services in 2008−2012
Abstract
Background
The Finnish health care system is under reform and one of the main aims is to expand the freedom of choice to include not only the public providers but also the private ones. The utilization of private health care services has been widely studied, but their regional accessibility has not been previously analyzed. The aim of this study was to describe the statics and dynamics of the regional dispersion of the industry in detail. In addition we aimed to analyze the patient flow in different regions and their specialty-specific differences.
Methods
The analysis is based on the statistical register of the National Health Insurance for private physicians’ services in the years 2008−2012. We define relevant specialty-specific (N = 5) sub-regional (N = 67) markets. The separate markets are described by population of the region, urbanity, number of appointments and usage: utilization relative to the population size and indicators of the extent of localness, LIFO and LOFI ratios. The data are described with tabulation, and non-parametric analysis of variance is used to study the differences between the markets.
Results
Depending on the specialty, the number of private physicians’ markets defined varied between 36 and 50 and a considerable share of 86−94% of the population lived within the defined markets in 2012. The markets existed and were established most often in urban and highly populated areas. The smaller the size of the industry the more the industry was concentrated in highly populated urban areas.
The number of geographical markets had increased during 2008−2012 in all of the five specialties by 24 altogether. Consequently, the share of the population living within the markets had increased by 3 percentage points on average.
Market establishment also appeared to increase the usage of private services in the sub-region. Travelling outside the home markets was rather rare in general; however markets of different specialties and urbanity differed notably in respect of the localness of the usage of services.
Conclusions
The regional dispersion of the markets for private physicians’ services improved the availability of private physician appointments during 2008−2012 in Finland, especially for the non-urban and less populated sub-regions. In 2012 the markets covered the major share of the population.
Location is an important source of market power in the industry as it is a considerable determinant of the patient’s choice of provider. The providers competed almost only for customers within the sub-regional boundaries.
Authors
Riina Hiltunen, Hennamari Mikkola, Jouni Saarni
Additional Information
- Peer-Reviewed: yes.
- Open Access: yes.
- Cite as: Hiltunen, R., Mikkola, H., & Saarni, J. (2016). Yksityisten lääkäripalvelujen alueellinen saatavuus vuosina 2008–2012. Suomen lääkärilehti, 44(71), 2805–2813. https://www.laakarilehti.fi/tieteessa/terveydenhuoltoartikkelit/yksityisten-laakaripalvelujen-alueellinen-saatavuus-vuosina-2008-ndash-2012/
