Occupational Health Care as Part of the Health and Social Services System: Network Project on Integration and Cost Perspectives
Background: Nearly 2 million Finns are covered by occupational health care. Occupational health care services are financed by tax-like contributions from the employer and the employee; the state’s share of funding is less than 1%. In the future, the wellbeing services counties will also be responsible for services for working-age people, so the role and activities of occupational health care have caused a lot of social debate for this reason. It has already been shown that the functional integration of occupational health care, specialised medical care, and primary health care (the Responsible work ability support, or TYÖOTE, approach) can significantly increase the productivity of working-age people with partial work ability.
Need: The occupational health care statistics and data have not been systematically reviewed and so far they have not been subject to research at Kela. The register data of the Oulu project contain information on the use of occupational health care services as part of the overall health care system. A project to assess the impact of the Kela reimbursement reform is underway with the help of funding granted pursuant to the Act on the Rehabilitation Services and Allowances Provided by Kela (KKRL, 15.7.2005/566) (University of Tampere). More information on the effectiveness of occupational health care would be needed both from Kela’s point of view and to support the knowledge management of the wellbeing services counties.
Research questions
A In order to investigate the integration of occupational health care into health and social services, the following perspectives are studied:
- How does occupational health care integrate into the activities of the wellbeing services county and operate in co-operation with specialised and primary health care?
- How many support measures for work ability are implemented in occupational health care before a referral is made to specialised medical care? What is the effectiveness of referral to occupational health care?
- Treatment episodes for mental health and MSDs
- How many occupational health care customers also use other health care services?
- Digital services for occupational health care
B In order to estimate the overall cost of medical care for working-age people, the following aspects are examined:
- The costs associated with waiting/queuing for health services and ways to control the overall associated costs.
- The change in the costs of convalescence after the use of health services as a result of the establishment and consolidation of the practice of referral to occupational health care (the TYÖOTE Responsible work ability support approach).
- Duration of the waiting/queuing time prior to hospital treatment, duration of convalescence, and the effectiveness of the operating model for referring people to occupational health care
The overall project consists of subprojects
- Sub-study: Occupational health care as part of health and social services integration – support measures for work ability, functionality of the referral model and treatment episodes (Finnish Institute of Occupational Health)
- Sub-study: Referral to occupational health care in the integration of health and social services (Finnish Institute of Occupational Health)
- Sub-study: Parallel use of services by occupational health care customers (University of Tampere)
- Sub-study: Remote services in occupational health care (University of Tampere)
- Sub-study: Kela benefits and overall costs for orthopaedic patients of working age (TYKS, Kela)
- Sub-study: Functional and working capacity and productivity costs of working-age people (UEF, TYKS, Kela)
Materials and methods
The Finnish Institute of Occupational Health studies occupational health care as part of the health and social services system. The reform of Kela’s reimbursement criteria is being studied at the University of Tampere with the support of previous funding awarded in accordance with the Act on the Rehabilitation Services and Allowances provided by Kela (the KKRL Act, 566/2005). A new project at the University of Tampere relates to the digital services in occupational health care, which are studied using interview and service provider data, among others. The co-operation project between UEF and TYKS assesses the total costs of service use by orthopaedic patients of working age (incl. both direct and sickness-related productivity costs estimated with the PALY indicator). In addition, a review of the connection between waiting times for access to treatment and the treatment outcomes, the duration of convalescence, and the productivity of employed persons of working age assessed with the PALY indicator will be carried out. Kela’s research unit also examines the cost perspectives involving functional ability, work ability, and Kela’s benefits. Kela’s register data (sickness allowance, rehabilitation benefits, disability pensions) combined with the Healthy Finland Survey data collected in 2023 will be used as data. The levels of functional and work ability of different population groups and their significance from the perspective of productivity are also assessed in this data with the help of the PALY indicator (collaboration between UEF & Kela).
In a research network project, the main objective is promoted across organisational boundaries. The facilitator is Kela’s research unit, whose task it is to coordinate the meetings held by the network. The network is a tool for creating customer value and project impact, with the aim of producing results that have a broad impact.
Benefits for Kela and society: occupational health care is of great importance in terms of supporting the work ability of working-age people, but more detailed information on effectiveness is required. Kela reimbursement categories and other aspects of occupational health care operations have been criticised in various contexts. There is currently not enough evidence-based information, so broad-based network co-operation is necessary.
Researchers
- Riitta Luoto, Leading Researcher
- Timo Hujanen
- Hanna Hakulinen
- Eva Helaskoski
- Kaj Husman
- Pauliina Kangas
- Janne Martikainen
- Riitta Sauni
- Ilkka Vohlonen
- Ville Äärimaa
Project Implementation Period
1.2.2023-31.3.2025
