A Slower Rate of Cost Growth in Occupational Health Care and the Cost of Care by Age and Sex
Abstract
Occupational health (OH) services’ share of total health expenditure is only 4.2 per cent, even though a third of the population or 1.9 million people of working age come within the scope of the services. OH services play an important role in extending working lives and their role can be regarded as stable given that the social partners have highlighted the need to maintain current financing levels. The government’s goal to improve cost-competitiveness and increase the number of people employed by 110 000 would require, besides raising the employment rate, the proportion of older workers in the labour force to be higher than it currently is. As system-level research on the use and costs of OH services is scarce, it is difficult to assess how the use and cost of the services may change in the coming years. The challenge in system-level research on OH services is that no individual-level information is collected in national patient registries, such as is the case with other areas of health care. The focus of this article is to produce new information on the costs. Based on statistical data and individual study, OH services are described and analysed from the perspective of expenditures at the national level, which highlights both the diversity of the OH financing structure and the individual role that different sources of financing play within it. The article also presents research results on the cost of OH services by age and sex in one large city, which reveals age differences among men and women in terms of the costs.
The article examines OH services on the basis of both statistics and registers collected by the Social Insurance Institution, Statistics Finland and the National Institute for Health and Welfare. We also undertook an age- and gender-specific analysis of OH services as a part of outpatient primary care within a single large town (Oulu) in 2013. We collected data from OH service providers concerning the utilisation of the services and the costs. This enabled us to evaluate the use of outpatient primary care among men and women aged 0 to 100 years and to analyse the cost of such care.
The increase in the cost of OH services has outpaced that of other health services and of prescription drugs. The costs of OH services grew faster than those for other health care in the period up to 2008 as the number of employed persons grew. During the sluggish economic growth of the recent years, the increase in costs has slowed down. In the coming years, the aging of the working-age population may accelerate the growth of costs. Analysed by age group and gender, OH services account for about a half of the total expenditure on outpatient primary care for persons of working age. Costs increase dramatically with age, and the cost differences between genders can be characterised as substantial. Costs depend on the age of the worker: based on research carried out in Oulu, the cost of OH services produced for a 60-year-old worker is about twice that for a 30-year-old. Men use a broader range of OH services, but women use more services overall. A 40-year-old woman uses as much OH service resources as a 50-year-old man.
The growth in OH expenditure is naturally driven by economic development. Since it is linked to the prevailing economic conditions, OH expenditure growth has slowed in the current economic recession. Because of the different funding structure of OH services and the role played by employers, growth in OH expenditure cannot be addressed in the same way as other expenditure growth. Further, in view of the fact that expenditures increase dramatically with age, there is a need to examine the health care situation of those who are at the end of their career and thus will soon no longer have access to OH services. The development of OH services evaluation and research would be best served by collecting patient-level registers at the Social Insurance Institution, where the data on occupational health service use could be combined in real-time with data on sickness benefits, rehabilitation and disability with the overall goal of keeping workers fit for work. Thus, services could be designed and targeted more accurately to meet the needs of workers and jobs.
Authors
Timo Hujanen, Hennamari Mikkola
Additional Information
- Peer-Reviewed: yes.
- Open Access: yes.
- Cite as: Hujanen, T., & Mikkola, H. (2016). Työterveyshuollon kustannuskehitys. Suomen lääkärilehti, 71(21), 1537–1540.
https://www.laakarilehti.fi/tieteessa/terveydenhuoltoartikkelit/tyoterveyshuollon-kustannuskehitys/
