Integrating Health and Social Services in Finland: Regional Approaches and Governance Models

Abstract

Introduction:The study explores regional approaches to integrated care, focusing on regions with regular municipality-based and integrated unified health and social care administration. The aim is to describe a governance approach that supports care integration in the regions. Methods:The study draws on analysis of integrated care governance using an extensive collection of administrative documents (n = 176) on regional health and social services within 20 specialised care authorities. The document data were supplemented with interviews of national health and social system evaluation officers. In our analysis, we used deductive content analysis and identified conceptual approaches of social and health care integration according to elements of integrated care governance.Results: Overall, integrated care governance was relatively well advanced. All regional authorities had established at least some preconditions for integrated governance. The stage of integration varied in the different elements of integrated care governance. The regions with unified integrated administrations enabled the more advanced models of integrated care. Conclusions:Various models for cooperation between regional health and social care authorities have emerged in the regions to identify good integrated care practices. The study suggests that the applied theoretical framework and presented elements of integrated care governance can be used to monitor development of care integration.

Knowledge management in a regional integrated health and social care system

“…The Finnish health and social care reform illustrate how national information steering and active inter-regional co-operation and knowledge exchange are required to achieve system-level integration (cf. Tiirinki et al, 2022;Gr€ one and Garcie-Barbiero, 2001). The case also shows how legislative changes, new actors and new tasks and roles follow from the integration agenda (Martin and Knowles, 2020;Shortell et al, 2000) calling for a major shift in how KM is perceived (Laihonen and Kokko, 2020).…”

“…The Finnish health and social care reform illustrate how national information steering and active inter-regional co-operation and knowledge exchange are required to achieve system-level integration (cf. Tiirinki et al. , 2022; Gröne and Garcie-Barbiero, 2001).…”

“…Gr€ one and Garcia- Barbero, 2001) but in Finland social services also become part of the integrated service structure (cf. Tiirinki et al, 2022). In Finland, KM is widely considered one of the key enablers of the reform and this study illustrates how establishing a new level of governance creates new requirements for KM due to changing roles and accountabilities.…”

Searching for alternative health and social care integration measurement tools – a rapid review of the existing systematic models

“…As a marked objective, the Finnish health and social care system strongly promotes integrated health and social services (Tiirinki et al, 2022). The reform has been considered necessary to ensure equal services, reduce inequalities in health and well-being and curb the growth in costs.…”

“…Health care integration aims to provide the proper care at the right time, in the right place and by the right provider. Clients who require multidisciplinary services often use both social and health care services, and thus, integration between different sectors is more important from orientation, effectiveness and cost viewpoints (Tiirinki et al. , 2022).…”