Elsevier

Health Policy

Volume 36, Issue 3, June 1996, Pages 245-259
Health Policy

Private medicine and socioeconomic differences in the rates of common surgical procedures in Finland

https://doi.org/10.1016/0168-8510(96)00816-0Get rights and content

Abstract

The aim of the study was to evaluate socioeconomic equity in access to surgical services in Finland and to explore the contribution of private sector procedures to any inequities. Data on nine common surgical procedures performed on patients aged 25 and over were obtained from the 1987–1988 Finnish Hospital Discharge Register. Socioeconomic indicators were linked to the procedure data by personal identity numbers from the 1987 population census, which was also used to derive the data on population at risk. The study revealed marked differences in rates across socioeconomic categories for several procedures. Some of these disparities are probably explained by variations in need for surgery across socioeconomic groups. However, for cataract operations and hip replacements due to arthrosis or deformity, the surgery rates favoured the better-off, despite low social status being considered a risk factor for these disorders. The correlation of disposable family income with hysterectomy and prostatectomy rates, and the low surgery rates for many procedures in the lowest income quintile also suggested socioeconomic disparities in access to services. The specific effect of private services is difficult to assess, but the private sector seems to have contributed to the socioeconomic differences in rates for, at least, hysterectomy, prostatectomy, and cataract operations. Although the Finnish health care system operates universal coverage without formal barriers to equal access, systematic socioeconomic inequity in the use of individual surgical treatments prevail. Part of these inequities is evidently due to private sector services.

References (54)

  • I. Keskimäki et al.

    Regional variation in surgical procedure rates in Finland

    Scandinavian Journal of Social Medicine

    (1994)
  • M. Madsen et al.

    Rates of Surgery in the Nordic Countries

    Variation Between and Within Nations, NOMESCO Publications 43: 1994

    (1994)
  • D. Sanders et al.
  • OECD

    Finland

  • R. Klein

    Ideology, class and the National Health Service

    Journal of Health Politics, Policy and Law

    (1979)
  • R. Klein
  • J.P. Nicholl et al.

    Role of the private sector in elective surgery in England and Wales, 1986

    British Medical Journal

    (1989)
  • Health services 1987

  • R. Salmela et al.
  • T. Hermanson et al.

    Letter from Helsinki. Finland's health care system. Universal access to health care in a capitalistic democracy

    Journal of American Medical Association

    (1994)
  • M. Pekurinen

    Health care in Finland

  • I. Keskimäki et al.

    Accuracy of data on diagnosis, procedures and accidents in the Finnish Hospital Discharge Register

    International Journal of Health Sciences

    (1991)
  • The OECD List of Social Indicators, Organisation for Economic Co-operation and Development, Paris,...
  • E. Pukkala

    Cancer risk by social class and occupation. A survey of 109 000 cancer cases among Finns of working age

  • Cited by (0)

    View full text