in content lists or on the content page.The most commonly cited problems with public health care are long waiting times, difficulty accessing services and making appointments. In the Finnish municipalities of Ylöjärvi and Lahti, a low-threshold service model, health kiosks, has been piloted as part of primary health care provision. According to evaluation reports issued by the University of Tampere, the easy-access services of health kiosks are a way of increasing customer-orientedness in and improving access to health care services while providing these services cost-effectively and with real impact.
“The success of health kiosks shows that customer-oriented and cost-effective new operating models can be simple solutions. It is possible to create new service models that involve a preventive dimension at the customer interface, which can then be deployed more widely to benefit the public and municipal economies,” says Antti Kivelä, Director of Sitra’s Municipal Programme.
The evaluation study carried out by the University of Tampere discusses the significance and impact of the health kiosk model as an innovation in primary health care provision. The evaluation emphasises the elements of customer-orientedness, cost-effectiveness and impact. The study focuses particularly on user experiences on the service as well as its financial impact and demand and supply of services. A first-stage basic survey report on the health kiosk in Lahti has been completed, while the Ylöjärvi health kiosk evaluation has reached its second, interim report stage.
Prevention as a tool to curb health care expenditure
In Lahti, the operations of the health kiosk focused on health promotion and the prevention of illnesses. According to the evaluation report by the University of Tampere, the most common reasons for visiting health kiosks were patient assessments and examinations, such as blood pressure monitoring and health and exercise counselling, which support health promotion and illness prevention, and which are the selected focus areas. Active co-operation with organisations, NGOs and the businesses in the shopping centre has been carried out with a view to illness prevention and risk group assessment, and it has brought new customers to the services.
“The potential advantages of the preventive approach may include reduced pressure on the increase in health care costs. According to the evaluation report, it would appear at this point that the health kiosk may have helped respond to the demand of health services which suffer from a shortage of resources,” says Jarmo Vakkuri, Professor of Local Government Accounting and Finance from the University of Tampere.
Service that proved more popular than expected
The popularity of the health kiosk in Lahti exceeded all expectations. Based on the six months it has been open, the annual number of visitors is expected to reach as many as 12,000. This means approximately 45 visits per day. Respondents to the customer survey supporting the evaluation report graded the service as very good. Dissatisfaction with the inaccessibility of health care services may have been reflected in the positive feedback received by the health kiosk. The users of the health kiosk considered the range of services good and believe they will return as customers later. The typical customer is a female from Lahti over the age of 60, either near retirement or already retired. One quarter of the health kiosk customers are male.
Underlying illnesses were detected during consultations and customers were referred to receive further treatment. The health kiosk also managed to reach people who would not have in other circumstances sought consultation.
“Here in Lahti, the health kiosk has introduced a whole new approach to municipal services. These so-called low-threshold services are more accessible to the public and create health benefits. We will be developing health kiosks further to attract, for example, younger customers and to optimise personnel resourcing. As part of our productivity scheme, we are also considering opening another health kiosk in Lahti during 2011,” says Risto Raivio, Director of Health Services in the City of Lahti.
Customers in Ylöjärvi have opted for the health kiosk instead of the health care centre
Whereas the focus of the health kiosk in Lahti has been on preventive health services, in Ylöjärvi the main goal has been to improve access to health services in a customer-oriented manner and to reduce the number of visits to and shorten waiting times at health care centres.
The interim report compiled by the University of Tampere would suggest that the customer flow of the main health care centre in Ylöjärvi has partly gone through the health kiosk in cases of more simple procedures and examinations. In that case, one of the initial objectives of the health kiosk has been achieved. The development of customer flows will be systematically followed up on in the future, to provide an indication of what the impact of the health kiosk is on the entire public health care provision in Ylöjärvi.
The aim of the Ylöjärvi health kiosk has also been the early detection of diseases. Most of the findings have been made in conjunction with blood pressure measurements. According to the evaluation report, underlying health problems which might have otherwise gone unnoticed, had been detected during consultations at the health kiosk.
Based on the evaluation report, customer satisfaction with the health kiosk has remained at a high level and its services continue to be in demand in Ylöjärvi. More than half of the respondents had visited the health kiosk four times or more, so it has managed to establish a regular clientele over a period of 18 months. The unit costs of a health kiosk visit are small compared to the overall costs incurred by the outpatient services in Ylöjärvi.
“The health kiosk could be a viable solution in many municipalities when responding to the demands on the access to health services and its cost-effectiveness. In the light of the evaluation reports, I am positive that the health kiosk is one new service provision model in the more wide-reaching structural reform of health care,” says Professor Jarmo Vakkuri.
Facts about health kiosks
- The health kiosks in Ylöjärvi and Lahti offer customer-oriented low-threshold health services in shopping centres.
- Free of charge and open to all, the services form part of the public primary health care provision.
- The customer-oriented approach and accessibility of services has been promoted through health kiosks, which offer nursing-level treatment without a prior appointment.
- Health kiosks have longer opening hours than health care centres, including evenings and Saturdays.
- The services available focus on various measurements, the treatment of minor health problems, service consultation and preventive consultation. The two-year health care pilot and research project involves local authorities, the University of Tampere and Sitra’s Municipal Programme.
Further information
Risto Raivio, Director of Health Services, City of Lahti, tel. +358 3 818 2001 Pekka Mattila, Chief Physician, Outpatient Care, City of Lahti, tel. +358 3 818 4401
Kari Virta, Director of Health and Social Services, City of Ylöjärvi, tel. 050 337 5168
Seija Ritala, Nursing Director, Ylöjärvi, tel. +358 3 349 5952
Milla Järvinen, nurse, Ylöjärvi health kiosk, terveyskioski@ylojarvi.fi
Jarmo Vakkuri, Professor of Local Government Accounting and Finance, Department of Economics and Accounting, University of Tampere, tel. +358 3 3551 6356, +358 40 516 2479
Riikka Kivimäki, researcher, Department of Economics and Accounting, University of Tampere, tel. +358 3 3551 6822
Jarmo Vakkuri, Professor of Local Government Accounting and Finance, Department of Economics and Accounting, University of Tampere, tel. +358 50 569 8285
Antti Kivelä, Director, Sitra’s Municipal Programme, tel. +358 40 482 7435
Publication details
Terveyskioski palveluinnovaationa Lahden terveyskioski -hankkeen peruskartoitus (Vaihe I) (in Finnish)
Selvityksiä 35
ISBN 978-951-563-734-5
(URL:http://www.sitra.fi)
ISSN 1796-7112 (URL:http://www.sitra.fi)
Terveyskioski palveluinnovaationa Ylöjärven terveyskioski -hankkeen väliarviointi (Vaihe II) (in Finnish)
Selvityksiä 36
ISBN 978-951-563-735-2 (URL:http://www.sitra.fi)
ISSN 1796-7112 (URL:http://www.sitra.fi)