nfhk2011 pia hakamaki_parallel201
DESCRIPTION
Economic Assessment of Health Promotion in Finnish Primary Health Care. Pia Hakamäki (Researcher, THL) & Timo Ståhl (Development Manager, PhD, Adjunct professor, THL)TRANSCRIPT
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Economic Assessment of Health Promotion in Finnish Primary Health Care
25.8.2011
Pia Hakamäki (Researcher, THL) &
Timo Ståhl (Development Manager, PhD, Adjunct professor, THL)
Contents
• Issue
• Project description
– Objectives and focus
– Definition of health promotion work
– Different steps of economic assessment
• Results
– Calculating the share and costs of health promotion
• Conclusions and summary
2TEVA – Economic Assessment of Health Promotion in Finnish Municipalities/Pia Hakamäki25.08.2011
Issue
1. Health promotion (HP) belongs to the work of every administrative field
2. Lack of knowledge about the cost-effectiveness of HP activities carried out as normal procedures of the everyday work of organisations
3. Information is needed in each sector in order to support planning and decision-making in municipalities¹
3TEVA – Economic Assessment of Health Promotion in Finnish Municipalities/Pia Hakamäki25.08.2011
Project description
• Started in 2008 (–2012)
• Working group co-ordinated by THL
• Five municipalities:
– Salo (population 55 235)
– Oulu (141 671)
– Kauniainen (8 689)
– Muurame (9 256) and
– Tampere (213 217)
• In co-operation with municipal experts from various administrative sectors, the Association of Finnish Local and Regional Authorities
4TEVA – Economic Assessment of Health Promotion in Finnish Municipalities/Pia Hakamäki25.08.2011
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Project objectives 2008-2012
• To outline key health promotion functions in different municipal administrative sectors
• To calculate the resources spent on health promotion, and to determine outputs and effects (later also cost-effectiveness)
• To provide municipalities with a model for the economic assessment of health promotion
• To produce comparable data
TEVA – Economic Assessment of Health Promotion in Finnish Municipalities/Pia Hakamäki25.08.2011
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Project focuses
• Health promotion in the municipal service system
• Services purchased are also included, but separate interventions are not
• Limited to children, young people and families with children
• ²Administrative sectors:
1. ³primary health care, social services, education and general administration
2. culture and leisure department, sports and youth administration, environmental and technical administration
TEVA – Economic Assessment of Health Promotion in Finnish Municipalities/Pia Hakamäki25.08.2011
HP activities in three sectors
7TEVA – Economic Assessment of Health Promotion in Finnish Municipalities/Pia Hakamäki
DaycarePromoting
healthy growth
and development
School welfare
services
Rehabilitation
services
Maternal and
child health
clinics
Support for the
long-term
unemployed
Integration
work
Substance
abuse prevention
and mental
health work
Home-help
services
Family
mediation
Child guidance
and family
counselling
School
health careGeneral
practice
Oral
health care
Other public
health core
functions
School
environment
Community
actions
School welfare
activity
Special
educational
supportPreventive
child
welfare
work
Health
promotion
25.08.2011
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1. Determination of health promotion work and limitations
2. Calculating the proportion of health promotion work
3. Cost calculation
4. Outputs of health promotion work
5. Effects of health promotion work
6. Utilisation of comparable data to
support decision-making
Different steps of economic assessment of health promotion (HP) work
TEVA – Economic Assessment of Health Promotion in Finnish Municipalities/Pia Hakamäki
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Calculating the proportion of health promotion work
25.08.2011 TEVA – Economic Assessment of Health Promotion in Finnish Municipalities/Pia Hakamäki
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• Use of existing information systems
1. Client visits and routine classification
– Preventive/medical treatment visits, percentage
2. Number of visits
3. Procedures
4. Group activities
Extra: Appointment books
– Total hours spent on health promotion
Primary health care
25.08.2011
Results of the proportion of health promotion work • Maternal and child health clinics 95–98 %
• School health care
– public health nurses 62–76%
– school doctors 91–92 %
• Oral health care
– orthodontic therapists 41–45 %
– dentists and dental nurses 2–3 %
• Rehabilitation services 7–11 %
11TEVA – Economic Assessment of Health Promotion in Finnish Municipalities/Pia Hakamäki25.08.2011
Calculating costs
• Calculation model
→ takes into account personnel costs but also other costs
→ consistent with all adminstrative sectors
TEVA – Economic Assessment of Health Promotion in Finnish Municipalities/Pia Hakamäki 1225.08.2011
Results of the costs of health promotion work, 2008/2009
According to preliminary results of two municipalities:
• 11 and 17 % of the primary health care costs
• 3 and 4 % of the total health care costs
• The cost of the health promotion work was EUR 243 and 331 per 0–16-year-old child per year.
13TEVA – Economic Assessment of Health Promotion in Finnish Municipalities/Pia Hakamäki25.08.2011
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Conclusions
• Defining health promotion work is a challenging but possible
• Very difficult to get comparable data on costs
→ documentation and transparency of assessment
→ calculation is focused on personal costs
• The municipal information systems already hold large amounts of data; the goal is to describe how to utilise this data
• Determining comparable outputs and effects!
25.08.2011
• The big challenge …
… does the organisation provide incentives (fiscal) that encourage cross-system working?
15TEVA – EconomicaAssessment of Health Promotion in Finnish Municipalities/Pia Hakamäki25.08.2011
Sources
• ¹Kiiskinen, Vehko, Matikainen, Natunen & Aromaa (2008). Terveyden edistämisen mahdollisuudet. Vaikuttavuus ja kustannusvaikuttavuus. Sosiaali- ja terveysministeriö Julkaisuja 2008:1.
• ²Perttilä, Hakamäki, Hujanen & Ståhl. (2009). Terveyden edistämisen taloudellinen arviointi kunnissa. THL. Avauksia 8/2009. Available in electronic format:
www.thl.fi/thl-client/pdfs/9c078431-6be6-4c41-ab57-16a14f74432c
• ³Hakamäki, Perttilä, Hujanen & Ståhl. 2011. Terveyden edistämisen taloudellinen arviointi kunnissa. THL. Raportti 11/2011
http://www.thl.fi/thl-client/pdfs/f920b92c-f4e3-4b60-b3e4-69763e1acb30
• Linna 2009. Ehkäisevän terveydenhuollon osuus perusterveydenhuollon avotoiminnan potilasepisodeista ja kokonaisvoimavarojen käytöstä. Terveystaloustiede. THL. Avauksia 4/2009.
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Thank you!
Pia Hakamäki
e.mail: [email protected]
GSM: + 358 40 5188685
Mika Vuori
e.mail: [email protected]
Sanna Kilpeläinen