Tynkkynen Liina-Kaisa, Chydenius Miisa, Saloranta Anna, Keskimäki Ilmo
University of Tampere, School of Health Sciences, FI-33014 Tampere, Finland; National Institute for Health and Welfare, PO Box 30, FI-00271 Helsinki, Finland.
University of Tampere, School of Health Sciences, FI-33014 Tampere, Finland.
Health Policy. 2016 Mar;120(3):227-34. doi: 10.1016/j.healthpol.2016.01.015. Epub 2016 Jan 19.
"Putting the patient in the driver's seat" is one of the top issues on the health policy agenda in Finland. One of the means believed to promote patient empowerment and patient centeredness is the introduction and further expansion of choice policies with accompanying competition between public and private service providers. However, the Finnish health care system has a highly decentralized administration with multiple funding sources and three different types of providers that people can seek primary care from (municipal health centers, occupational health care services, and private sector providers). This complicates the implementation of choice at the level of primary health care. In this paper, we describe the current policy debates and initiatives promoting the expansion of the choice of primary care provider in Finland. We examine the legislation and policies that have contributed to the current, complex service system in Finland. In light of this examination, we critically discuss the current debate on choice policies as well as the introduction of choice in the context of primary health care.
“让患者掌握主导权”是芬兰卫生政策议程上的首要问题之一。人们认为，促进患者赋权和以患者为中心的手段之一是推行并进一步扩大选择政策，同时让公共和私营服务提供者展开竞争。然而，芬兰医疗保健系统的行政管理高度分散，资金来源多样，有三种不同类型的提供者可供人们寻求初级保健服务（市政卫生中心、职业保健服务机构和私营部门提供者）。这使得初级卫生保健层面选择政策的实施变得复杂。在本文中，我们描述了芬兰当前关于促进扩大初级保健提供者选择范围的政策辩论和举措。我们审视了造就芬兰当前复杂服务体系的立法和政策。鉴于这一审视，我们批判性地讨论了当前关于选择政策的辩论以及在初级卫生保健背景下引入选择机制的情况。
