Ovaskainen P T, Rautava P T, Ojanlatva A, Päkkilä J K, Päivärinta R M
Department of Public Health, University of Turku, Lemminkäisenkatu 1, FIN-20014 Turku, Finland.
Health Policy. 2003 Dec;66(3):229-38. doi: 10.1016/s0168-8510(03)00116-7.
Long-term health care planning is presently not based on the needs of the population at the local level in Finland but rather, it is based on retroactive economic values and already realised budget in hospital and primary health care. The existing health care structure and its health care practices continue to guide the supply of services. While we have the most extensive databases on primary health care and hospital services, such tools are not used in the broadest possible sense in the present health care planning at the local level. Simple and informative indicators available to health care planners and decision-makers from databases at the local level were used to appraise the use of health care services. Statistical profiles of health care clients were classified by age groups within the health authority area (population of 13,000) of Paimio-Sauvo in south-western Finland with the intent to explain utilisation of primary health care services, their coverage, and repeat visits as well as groups not using those services. Physicians recorded reasons for each patient visit with the ICD-10 categories. In the case municipalities, primary health care services provided 100% coverage to children of 0-6 years of age and more than 70% coverage to other groups. Most primary health care expenditures were assessed for people 65 years or older in 2000. As an example of a municipality, hospital and primary health care expenditures within Paimio varied from 24 to 30.4% of the total obligations for the last 10 years.
目前，芬兰的长期医疗保健规划并非基于地方层面民众的需求，而是基于追溯性经济价值以及医院和初级医疗保健已实现的预算。现有的医疗保健结构及其医疗保健实践继续主导着服务供给。尽管我们拥有关于初级医疗保健和医院服务最广泛的数据库，但在地方层面当前的医疗保健规划中，这些工具并未得到最广泛的应用。地方层面数据库为医疗保健规划者和决策者提供的简单且信息丰富的指标，被用于评估医疗保健服务的使用情况。在芬兰西南部派米奥 - 索沃卫生当局辖区（人口13000）内，按年龄组对医疗保健客户的统计概况进行了分类，旨在解释初级医疗保健服务的使用情况、其覆盖范围、复诊情况以及未使用这些服务的群体。医生使用国际疾病分类第十版（ICD - 10）类别记录每位患者就诊的原因。在相关市，初级医疗保健服务为0至6岁儿童提供了100%的覆盖，为其他群体提供了超过70%的覆盖。2000年，大多数初级医疗保健支出是针对65岁及以上人群的。以一个市为例，派米奥的医院和初级医疗保健支出在过去10年中占总义务的24%至30.4%。
