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Seppo Lehto MD, PhD, FESC, Cardiologist
Adjunct Professor, University of Eastern Finland, Chief of Health Services Varkaus Hospital, Unit of Kuopio University Hospital, Finland
National CVD Prevention Coordinator for Finland
This report was prepared by:
Finland’s health care system is complex and decentralised. Primary care offers multiple services in health centres and occupational units. Secondary care is provided by hospitals organised by municipality-owned hospital districts, and tertiary care is delivered in five university hospitals. There were 51 cardiologists per million inhabitants in Finland in 2017.
Costs for health care are 9.4% of Finland’s gross domestic product (GDP), which is slightly below the average in EU. All permanent residents are entitled to health insurance coverage. A wide range of health services are publicly covered.
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There has been a remarkable reduction in coronary heart disease incidence and mortality over the past 40 years in Finland. The starting point was the famous North Karelia Project, which aimed at reducing the levels of smoking, blood cholesterol and blood pressure.
The prevalence of major CVD risk factors in Finland 2017:
Finland has joined the WHO’s Global Strategy on Diet, Physical Activity and Health. In 2017, the Finnish “Focus on Prevention” declaration summarises major objectives.
There are several ways to accomplish cardiac rehabilitation in Finland. Some of them are focused on physical rehabilitation; other programs consist of education as well.
Cardiac rehabilitation should be recommended for every patient. Unfortunately, one of the problems in Finnish health care system is the lack of coordination between secondary and primary care; and patients are not guided systematically to cardiac rehabilitation. There are opportunities for rehabilitation, but they are not utilised as desired.
Many behavioural risk factors are much more prevalent among disadvantaged groups, and social inequality is a major problem. Actions are needed to diminish this social inequality in health.
The Finnish health care system is going to be reformed within next years. The aims are to improve the equity, access and effectiveness of health and social care services while ensuring efficiency gains and containing costs. An important challenge is to promote greater care coordination between primary care and hospitals.
Note: The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.
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