The Roles and Relative Contributions of Municipal Health Centres and Alternative Service Providers in the Management of Type 2 Diabetes and Hypertension in Finland
Abstract
Background
Management of long term illnesses is considered to be one of the core tasks of primary health care. In Finland, parallel to the municipal health centres, first line care is also offered by hospital outpatient clinics, occupational health services and private medical services. The role of occupational health services as providers of curative care is a specifically Finnish phenomenon. As the clinical records of the different providers are neither linked nor statistically aggregated, their relative contributions to outpatient care are not known in detail. In this article, we describe on the basis of the information retrieved from the medical records of the municipal health centres how the clinical responsibility for patients with type 2 diabetes and hypertension appears to be divided amongst the four groups of service providers.
Methods
Using manual scrutiny, we analyzed the medical records of the municipal health centres of those type 2 diabetes patients (N = 830) and hypertension patients (N = 1939) who had been granted the right to high reimbursement rates for prescription medicines for either of the two illnesses based on clinical criteria. The sample was representative of the whole of Finland and its cities and rural municipalities.
Results
Around 76% of the patients with type 2 diabetes, and 57% of the patients with hypertension were receiving their care through the municipal health centres. For 16% of patients with hypertension there was no evidence in the health centre records of their being recipients of care for hypertension. In urban cities and municipalities, about one third of those of working age were interpreted as being in the care of occupational health services. This interpretation was based on occasional references or other entries in the patient records at the municipal health centres.
Conclusion
The share of occupational health services in addition to municipal health centres in the management of chronic illnesses is significant. The absence of information on management of hypertension for a significant proportion of patients raises concerns.
Authors
Simo Kokko, Lauri Virta, Tuulikki Vehko
Additional Information
- Peer-Reviewed: yes.
- Open Access: no.
- Cite as: Kokko, S., Virta, L., & Vehko, T. (2015). Terveyskeskusten hoitovastuu tyypin 2 diabetesta ja verenpainetautia sairastavista. Suomen lääkärilehti, 70(44), 2945–2949. https://www.laakarilehti.fi/tieteessa/terveydenhuoltoartikkelit/terveyskeskusten-hoitovastuu-tyypin-2-diabetesta-ja-verenpainetautia-sairastavista/
