Local population responsibility in Finnish health centres in 1989-1993

Abstract

Background: Since 1991, the working patterns in Finnish primary care health centres have been changing from traditional group practices towards local population responsibility (LPR) with personal patient lists. As a result, it was expected the services would change notably. Methods: A controlled intervention study included 30 health centres changing their working pattern to LPR and 30 control health centres. We studied the use of health services in both primary and secondary care in the areas served by these health centres during the transition phase from 1989 to 1993. Data were collected from national statistics. Results: The application of LPR was associated with an initial increase in physician consultations. Consultations for preventive care decreased in both LPR and control health centres. The use of specialized care and consultations with private physicians particularly decreased in large LPR municipalities. Conclusions: The most significant changes occurred in the working patterns of large health centres that had introduced LPR. A wide range of variations between the health centres was observed for all activities in both groups.