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Muutos III: Evaluation Research on the Changes and Reforms in Kela’s Rehabiliation

Published 8.7.2025Edited 9.3.2026

Muutos III is a coordination project comprising five studies: Lapland University of Applied Sciences and South-Eastern Finland University of Applied Sciences Xamk carry out a study on LAKU family rehabilitation, the Rehabilitation Foundation studies the KIILA rehabilitation, and the Institute of rehabilitation at Jyväskylä University of Applied Sciences Jamk studies Taito rehabilitation. Kela Research carries out two studies: Implementation of Telerehabilitation and Self-Rehabilitation in Rehabilitation Services Organised by Kela.

The studies in this project are mixed methods implementation studies that incorporates multiple perspectives. The objective is to study the implementation of rehabilitation services and to examine how different operators perceive the benefits and effects of the service. The project focuses on new, recently developed forms of rehabilitation and rehabilitation services that have undergone changes in their content or structure. In particular, the project produces information on how new rehabilitation services function as established rehabilitation services.

The project generates applicable data on the current status and development needs of rehabilitation services. The data can be applied to the organising and developing of Kela’s rehabilitation. Thus, evidence-based rehabilitation is strengthened.

Researchers

Project Implementation Period

1.4.2021–31.12.2024

Cooperation Partners

Project Results

This project produced practicable data on the current state of rehabilitation services and how they should be developed. The data have been used in the development of Kela-provided rehabilitation services, and they have thus helped establish a more solid base of evidence for these services.

Substudies

The aim of the study on LAKU family rehabilitation was to investigate professionals' perceptions and experiences of LAKU family rehabilitation, cooperation within the framework of the rehabilitation and implementation of the rehabilitation in cooperation with the families. The mixed-methods and multifaceted research material consisted of surveys and thematic interviews with rehabilitation providers as well as referring organisations and teachers.

The results of the study show that there are perceived challenges in access to services requiring neuropsychiatric expertise and that low-threshold services for early support are considered insufficient. LAKU family rehabilitation is perceived as a good service that complements or even replaces other services, with the advantage of involving the whole family and the long duration of the rehabilitation. The results call for more flexibility in the service description that takes into account the individual needs of the family. Attention should be paid to teachers' experience of being outsiders in supporting the child's rehabilitation. The lack of information and the different practices of organisations were identified as hindering cooperation. Professionals feel that family rehabilitation has had a positive impact on the child's and the family's actions. As aspects to be developed further, the study highlights the need to clarify services for children and families in order to respond to different challenges at different stages of life as well as the interaction between welfare services and education services.

The study on LAKU family rehabilitation was carried out by Lapland University of Applied Sciences (Anu Kippola-Pääkkönen, principal investigator and Tiina Lautamo) and South-Eastern Finland University of Applied Sciences, Xamk (Annastiina Vesterinen).

Publications

The study on Kiila rehabilitation examined the functioning and development needs of the Kiila vocational rehabilitation model. The target groups were (1) providers of Kiila rehabilitation, (2) occupational healthcare providers applying for and participating in Kiila rehabilitation, (3) workplace representatives of rehabilitation clients participating in Kiila rehabilitation, and (4) associations and unions applying for Kiila rehabilitation. The study was multi-method and multi-faceted in its design and methods. Data were collected through surveys and interviews.

Based on the results of the evaluation study, Kiila rehabilitation is a mainly well-functioning vocational rehabilitation service. According to the study, all types of Kiila rehabilitation are necessary, i.e. workplace or profession-specific courses and individual rehabilitation services. They make it possible to implement the rehabilitation model flexibly in different situations and in a manner suitable for different rehabilitation clients. The study recommends developing cooperation between different actors and engaging them in the Kiila rehabilitation process from the start. The cooperation involves the employer (the immediate supervisor) and the occupational healthcare provider. It ensures a good flow of information and the implementation of the changes required by the client, support for rehabilitation and follow-up.

The Kiila rehabilitation study was carried out by the Rehabilitation Foundation (Mika Ala-Kauhaluoma, principal investigator, Piia Pietilä, Jouni Puumalainen, Tuuli Vilhunen and Oskari Huolman).

Publications

The aim of the study on Taito rehabilitation was to produce practically applicable data on the implementation of the rehabilitation and on development needs. The study approached this aim in three ways: 1) client experiences and views, 2) professional experiences and views, and 3) interaction practices in rehabilitation. The multifaceted study used surveys, interviews and the recording and observation of individual and group visits in Taito rehabilitation as data.

According to the results, Taito rehabilitation appears to be broadly effective and an appreciated vocational rehabilitation service. The client base for Taito rehabilitation is very diverse, and most clients have a wide range of needs for support. Taito rehabilitation can meet the needs of a wide range of clients and is useful to them, although the benefits may be related to different levels of advancement on the vocational pathway. However, the results also show that the wide range of clients is a challenge for the implementation. In Taito rehabilitation, the challenges are most visible in the planning and implementation of the group sessions and in the timing of the rehabilitation process. Current forms of service organisation have untapped potential, in particular in terms of multiprofessional and group-based approaches.

The study on Taito rehabilitation was carried out by the Rehabilitation Institute of Jyväskylä University of Applied Sciences (Sanni Tiitinen, principal investigator, Outi Alakärppä, Mari Kantanen, Kaisa Malinen, Johanna Moilanen).

Publications and manuscripts

The study investigated the implementation and contents of Kela's rehabilitation services combining face-to-face rehabilitation and telerehabilitation. The services studied included five rehabilitation services, which were implemented as from 1 June 2021 in accordance with the revised service descriptions: Rehabilitation course for informal caregivers, ITU rehabilitation course for young persons, adaptation training course for adults with type 1 diabetes, adaptation training course for young persons with type 1 diabetes, adaptation training course for persons with metabolic syndrome (MBO) and type 2 diabetes. The study collected data from clients and service providers through electronic surveys at different stages of the rehabilitation process.

An important observation of the study is the experience of different actors that rehabilitation through remote access made it possible to participate in the rehabilitation in daily life in different life situations. On the other hand, it was not always possible to combine rehabilitation with daily life, for example because of a lack of sufficient space and quiet. The strengths of telerehabilitation that were identified were that it enables individual encounters and support. On the other hand, opportunities for remote group activities and peer support were identified as aspects to be developed further. With regard to professionals' skills, the results emphasised not only technical skills but also management of online interaction and guidance skills. 

The key contribution of the project is that it gathered together information on telerehabilitation across five types of rehabilitation targeting different target groups.

The study on the functioning of telerehabilitation (Etäkuntoutuksen toimivuus) was carried out by Kela’s Research Unit (Tuija Partanen, principal investigator, Hennariikka Heinijoki, Mia Kilkki, Maarit Karhula). The study on the functioning of telerehabilitation collaborated with Kela's study on the effectiveness of telerehabilitation (Etäkuntoutuksen vaikuttavuus) (Senior Researcher Saija Karinkanta and Researcher Johanna Nuojua).

Publications

The objectives of the study were to find out what kind of effects self-management interventions have been observed to have, what is meant by self-management in Kela’s rehabilitation, and how the implementation of self-management can be promoted. The study encompassed a systematic literature review of the effects of self-management in rehabilitation services as well as expert interviews on the implementation of self-management and the prerequisites for implementation.

A guide was drawn up on the basis of the literature review and the interviews with experts that describes the features of and implementation methods for self-management as part of the rehabilitation services provided by Kela and measures that facilitate the implementation of self-management. The key contents of the guide were described at the publication seminar held on 17 December 2024. The seminar has been recorded, and the recordings will continue to serve as educational material.

The study on self-rehabilitation in rehabilitation services organised by Kela was carried out between 1 January 2023 and 31 December 2024 by Kela’s Research Unit (Maarit Karhula, principal investigator, Anna-Marie Paavonen, Hennariikka Heinijoki).

Publications

 

Expertise has been gained in the Muutos III project especially in implementation research and research into the core elements of rehabilitation, and publications have been produced on the basis of this.

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