Health kiosks as an operating model for public healthcare?
“The health kiosk operating model may provide an excellent opportunity to reform the service structures of basic healthcare, manage municipal finances, reach high-risk groups early and increase customer and work satisfaction,” says Antti Kivelä, from Sitra’s Municipal Programme. The initiator of the health kiosk pilot project also believes that the health kiosk activities will help prevent the increase in health inequalities among the population.
The interim report, drawn up by the University of Tampere, studied the cost structure and service demand of the health kiosk in Lahti on the basis of operational statistics. One of the aims of the establishment of the health kiosk in Lahti was to reduce waiting times for health services by improving the availability of services. The 12,000-plus visits during the health kiosk’s first year of operation exceeded all expectations. “Visits to the nurse at the health kiosk represented 17 per cent of all corresponding visits at health care centres in Lahti. According to the survey, it seems that it has been possible to move some of the nurse-level visits from health care centres to the health kiosk. On the other hand, a low threshold service may also have created new demand,” says Jarmo Vakkuri, Professor of Local Government Accounting and Finance at the University of Tampere.
Men and young people, we welcome you to the health kiosk!
The objectives of the health kiosk activities in Lahti are to prevent illnesses and provide health consultation. The age structure of the population in Lahti city centre may partly explain why a typical customer of the kiosk is a woman aged over 70 living in Lahti. Various theme days have been organised to make the health kiosk more familiar to other groups, such as young people outside the school healthcare system and middle-aged men, who may have latent health problems. Lahti has not yet succeeded in reaching out to these groups. Healthcare professionals estimate that the health kiosk may have promoted access to care among risk groups by providing a low threshold service. Early detection of health problems enables the prevention of illnesses developing further and a decrease in the costs incurred by treatment.
Providing everyone with access to care without delay
“Health inequalities among the population are increasing because some have rapid access to care, for example, through occupational healthcare or with the help of insurance. However, the unemployed, some students and pensioners are at the mercy of public healthcare – and often, unfortunately, having to experience waiting lists for care. If Finnish municipalities had health kiosk activities, it would be possible for even these members of the public to get quicker access to care, service consultation and preventative health care. Consequently, health kiosk activities could contribute to quality of life and equal treatment of the public,” says Antti Kivelä.
Customer satisfaction does not have to mean high costs
During its first year of operation, the unit cost of one visit to the health kiosk in Lahti, including its roll out, was approximately EUR 18. The price/quality ratio of a health kiosk visit can be characterised as good, since the costs are low, visitor numbers high and customers are with the service. The health kiosk’s operating costs in its first year have been reasonably low compared with the reception activities in outpatient health care.
“At this stage, it is not yet possible to assess the cost-effectiveness of the service activity comprehensively; it is a question of re-allocating resources within the basic healthcare system. The city administration’s choices are important, since it is possible to implement the concept in various ways. If a municipality succeeds in incorporating the health kiosk concept in their healthcare policy objectives, the results will be good. If not, the result may be just higher costs. However, it is possible that the health kiosk could be a part of a low threshold model for basic healthcare, which when managed well could even have a financial significance,” says Jarmo Vakkuri.
The health kiosk in Lahti in a nutshell
- The health kiosk, established in March 2010 at the Trio shopping centre in Lahti, offers customer-oriented low threshold healthcare services.
- The health kiosk in Lahti is the second in Finland; the first health kiosk was established in Ylöjärvi in summer 2009.
- The staff at the health kiosk includes both registered nurses and public health nurses.
- It is possible to gain quick access to nurse-level services at the health kiosk without a prior appointment in the evenings and on Saturdays, as well as during normal working hours.
- The services available focus on various tests, the treatment of minor health problems, service consultation and preventative consultation. • Free of charge and open to all, the health kiosk services form part of basic public healthcare.
- The two-year health care pilot and research project involves the City of Lahti, the University of Tampere and Sitra’s Municipal Programme.
Antti Kivelä, Director, Sitra’s Municipal Programme, tel. +358 40 482 7435
Jarmo Vakkuri, Professor of Local Government Accounting and Finance, University of Tampere School of Management, tel. +358 3 3551 6356, +358 40 516 2479
Helena Launiemi, Coordinator of the health kiosk in Lahti, City of Lahti, tel. +358 44 7161139
Pirjo Asikainen, Acting Chief Nursing Officer, City of Lahti, tel. +358 50-398 7662
Terveyskioski palveluinnovaationa (‘Health kiosk as a service innovation’) PDF, in Finnish »
The interim evaluation of the health kiosk in Lahti project (Stage II) Sitra Reports 55 ISBN 1978-951-563-777-2 (paperback) ISBN 1978-951-563-772-7 (http://www.sitra.fi) ISSN 1796-7104 (paperback) ISSN 1796-7112 (URL:http://www.sitra.fi)