title: Transfer of patients from health care centres to special care services: analysis of travel distances in Nordic countries.
abstract: OBJECTIVE
  This paper highlights the importance of analysing patient transportation in Nordic circumpolar areas. The research questions we asked are as follows: How many Finnish patients have been transferred to special care intra-country and inter-country in 2009? Does it make any difference to health care policymakers if patients are transferred inter-country?
  
  
  METHODS
  We analysed the differences in distances from health care centres to special care services within Finland, Sweden and Norway and considered the health care policy implications.
  
  
  METHODS
  An analysis of the time required to drive between service providers using the "Google distance meter" (http://maps.google.com/); conducting interviews with key Finnish stakeholders; and undertaking a quantitative analyses of referral data from the Lapland Hospital District.
  
  
  RESULTS
  Finnish patients are generally not transferred for health care services across national borders even if the distances are shorter.
  
  
  CONCLUSIONS
  Finnish patients have limited access to health care services in circumpolar areas across the Nordic countries for 2 reasons. First, health professionals in Norway and Sweden do not speak Finnish, which presents a language problem. Second, the Social Insurance Institution of Finland does not cover the expenditures of travel or the costs of medicine. In addition, it seems that in circumpolar areas the density of Finnish service providers is greater than Swedish ones, causing many Swedish citizens to transfer to Finnish health care providers every year. However, future research is needed to determine the precise reasons for this.
authors.affiliation: Faculty of Social Sciences and Business Studies, Department of Social and Health Management, University of Eastern Finland, Kuopio, Finland. jari.vuori@uef.fi
authors.forename: Jari
authors.initials: J
authors.lastname: Vuori
authors.forename: Marika
authors.initials: M
authors.lastname: Kylänen
authors.forename: Jonathan
authors.initials: J
authors.lastname: Tritter
mesh_terms: D005387:Finland; D006801:Humans; D007407:Interviews as Topic; D008511:Medicine; D009664:Norway; D012017:Referral and Consultation / Q000706:statistics & numerical data; D013548:Sweden; D014187:Transportation of Patients / Q000706:statistics & numerical data*; D014195:Travel