Regional inequalities in health and health care in Finland and Norway.
One of the main health policy goals in Finland and Norway is to decrease regional differences in health status and in accessibility of health services. The purpose of this paper is to analyze how this policy has been implemented, how its goals have been achieved, and what the obstacles are to it. It is of special interest to assess whether the centralized Finnish planning system has been more successful in the implementation of this policy, than the more decentralized system in Norway. Of these two countries, only Norway has applied any objective computing criteria for assessing the relative need of health care resources in each province or municipality. Neither of these two countries is using any relevant statistical indicators to describe the present situation, or time-related trends in regional inequities. According to available data the regional inequalities in health status and in the provision of health services have in both countries remained more or less unchanged over the last two decades. In future a more exact definition of the concept of equity, better methods for assessing the need for services, and an improved system of health statistics and indicators for monitoring progress in equity is needed. Also the potential of the health care policy in decreasing inequities in health should be questioned at a more fundamental level.
National Agency for Welfare and Health, Helsinki, Finland.
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D003659:Decision Making, Organizational; D005387:Finland; D015276:Health Care Rationing / Q000191:economics*; D006291:Health Policy / Q000191:economics; D006297:Health Services Accessibility; D006304:Health Status; D009664:Norway; D012040:Regional Health Planning / Q000191:economics / Q000458:organization & administration*; D013222:State Medicine / Q000191:economics / Q000458:organization & administration