Ilmo Keskimäki
Biographic Data
| ID | 1731710 |
|---|---|
| NAME | Ilmo Keskimäki |
| GIVEN NAMES | Ilmo |
| FAMILY NAME | Keskimäki |
| SIGNATURE | KESKIMÄKI I |
| AFFILIATIONS | Finnish Institute for Health and Welfare |
| ORCID | 0000-0002-4614-7062 |
| VERIFIED | Yes |
| TOTAL WORKS | 30 |
| TOTAL CITATIONS | 48 |
| AUTHOR COUNT | 30 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 1995 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 3 |
How health workers experience health system reform
BACKGROUND: Health system reforms have been ubiquitous in high-income countries during the past decades, yet research on how reform implementation is experienced by the health and care workforce (HCWF) remains scant. This is a critical omission, given that the recruitment and retention of the HCWF is recognized as one of the key challenges of health systems globally, and one which health system reforms often set out to solve. OBJECTIVE: To study …
What are the policy options for regulating private equity involvement in health care? A review of policies implemented or considered in seven high-income countries
Over the past two decades, private equity investment in health care has increased substantially. Proponents argue that private equity can optimize and improve health services, while critics warn that the business model of these firms is not aligned with the social values of care delivery and has harmful consequences for health systems and patients. It remains unclear to what extent - and how - subnational, national and supranational governments h…
Assessment of service integration in Finland – using SCIROCCO-tool in organizationally integrated health and social services
Background: In 2023, Finland initiaded a significant reformin health and social care, transferring the responsibility for all services from municipalities to Wellbeing Services Counties. While a major practical goal of the reform was to underline economy of scale and to form larger authorities for organising health and social services, a broad integration of health and social sevices has been considered to enhance efficiency. In addition service …
How is a large-scale reform perceived by citizens in Finnish primary health care
We build on the anthropology of health systems and policy to study how Finland's 2023 health and social services reform has been perceived and experienced by citizens, and how these perceptions reflect broader societal shifts. We draw on interviews (n = 65) and 11 months of ethnographic fieldwork completed from January to November 2024 in Finnish primary health care in three regions. Citizen reactions towards the reform were mixed, ranging from f…
Is the EU steering national social and health policy making? A case-study on Finland's national reform
As part of the European Semester, Finland received country-specific recommendations (CSRs) in 2013-2020 that encouraged the reform of national social and health services. These recommendations were part of efforts to balance public finances and implement public-sector structural reforms. Finland has been struggling to reform the national social and health care system since 2005. Only on 1 January 2023 did the new wellbeing services counties becom…
Work like a Doc
BACKGROUND: Medical residents work long, continuous hours. Working in conditions of extreme fatigue has adverse effects on the quality and safety of care, and on residents' quality of life. Many countries have attempted to regulate residents' work hours. OBJECTIVES: We aimed to review residents' work hours regulations in different countries with an emphasis on night shifts. METHODS: Standardized qualitative data on residents' working hours were c…
Pandemic preparedness and response regulations in Finland
The COVID-19 pandemic has plagued health systems in an unprecedented way and challenged the traditional ways to respond to epidemics. It has also revealed several vulnerabilities in countries' health systems and preparedness. In this paper we take the Finnish health system as an example to analyse how pre-COVID-19 preparedness plans, regulations, and health system governance were challenged by the pandemic and what lessons can be learned for the …
Power and politics in a pandemic
Power and politics are both critical concepts to engage with in health systems and policy research, as they impact actions, processes, and outcomes at all levels in health systems. Building on the conceptualization of health systems as social systems, we investigate how power and politics manifested in the Finnish health system during COVID-19, posing the following research question: in what ways did health system leaders and experts experience i…
Nordic responses to Covid-19
This paper explores and compares health system responses to the COVID-19 pandemic in Denmark, Finland, Iceland, Norway and Sweden, in the context of existing governance features. Content compiled in the Covid-19 Health System Response Monitor combined with other publicly available country information serve as the foundation for this analysis. The analysis mainly covers early response until August 2020, but includes some key policy and epidemiolog…
Balancing financial incentives during Covid-19
Integrating Health and Social Services in Finland
Various models for cooperation between regional health and social care authorities have emerged in the regions to identify good integrated care practices. The study suggests that the applied theoretical framework and presented elements of integrated care governance can be used to monitor development of care integration
Regional approaches for integrating health and social services in Finland
Introduction Government policies in Finland have supported administrative and operative coordination of health and social care to create larger authorities for organising services and to strengthen integration of social services, and primary and specialised care. While nationally the policies have led to attempts to reform and consolidate the service system, in several areas, regional joint health and social care authorities have been established…
Individual and Area-level Factors Contributing to the Geographic Variation in Ambulatory Care Sensitive Conditions in Finland
BACKGROUND: Measuring primary health care (PHC) performance through hospitalizations for ambulatory care sensitive conditions (ACSCs) remains controversial-recent cross-sectional research claims that its geographic variation associates more with individual socioeconomic position (SEP) and health status than PHC supply. OBJECTIVES: To clarify the usage of ACSCs as a PHC performance indicator by quantifying how disease burden, both PHC and hospital…
The Road to the Alcohol Act 2018 in Finland
Finnish alcohol policy has aimed for decades years to mitigate alcohol-related harm by using high taxation and restrictions on the physical availability of alcohol. The state monopoly on the retail of alcohol has played a central role in reducing the availability of alcohol. In 2011, preparations began for a comprehensive reform of the Alcohol Act 1994. Over time, the issue became highly politicised, lobbied and divisive. It took intense work of …
Regional integrated care in Finland
The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 5.120 (2020 JCR, received in June 2021)
Integration in home care, effects on worker stress
The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 5.120 (2020 JCR, received in June 2021)
Trends of relative and absolute socioeconomic equity in access to coronary revascularisations in 1995–2010 in Finland
Despite large increase in supply of revascularisations and decrease in IHD mortality, there is still marked socioeconomic inequity in revascularisations in Finland. However, since changes in absolute distributions of both supply and need for coronary care have favoured low-income groups, absolute inequity can be claimed to have decreased although it cannot be quantified numerically
Comparative observational study of mortality amenable by health policy and care between rural and urban Finland
No geographical or income-related differences in the distribution of mortality existed between Helsinki and other urban or rural areas of Finland. This suggests that the effect of increasing residential differentiation in the capital may have been mitigated by the policies of positive discrimination and social mixing. One of the main reasons for the increase in health inequalities was growth of alcohol-related mortality, especially among those wi…
The contribution of health policy and care to income differences in life expectancy – a register based cohort study
The results underline the importance of active health policy and health care measures in tackling socioeconomic health inequalities
Socioeconomic equity in amenable mortality in Finland 1992-2008
P1-233 Assessing the effect of individual and area level sociodemographic factors on regional differences in mortality amenable to healthcare
Introduction Mortality from many causes varies geographically. We examine trends in regional differences in amenable mortality in Finland and explore the role of socioeconomic factors. Methods We analysed deaths amenable to primary and specialist healthcare in the Finnish population aged 25–74 in 1992–2003. Sociodemographic variables were individually linked from annual employment statistics. Three area-level scores were created using factor anal…
Equity in the use of antithrombotic drugs, beta-blockers and statins among Finnish coronary patients
The use of antithrombotic drugs and beta-blockers among Finnish coronary patients seemed to be rather appropriate and, to some extent, prescription practices of preventive medication varied according to patients' risk of coronary events. However, statin use was remarkably low among men with low socio-economic status, and there is need to improve preventive drug treatment among diabetic coronary patients
Multilevel Modeling of Regional Variation in Equity in Health Care
BACKGROUND: The use of a concentration index is recommended to estimate socioeconomic equity in health and health services. Methods for the analysis of concentration indices have been developed in several studies. However, these methods do not take into consideration clustering within areas, which is necessary in a comprehensive study of regional variations in equity. OBJECTIVES: The study aims to develop a statistical method to assess variations…
Sociodemographic Differences in Myocardial Infarction Risk Perceptions among People with Coronary Heart Disease
This study examines sociodemographic differences in myocardial infarction (MI) risk perceptions among people with coronary heart disease (CHD) ( N = 3130). Two variables for comparative risk perceptions were computed: (1) own risk compared to that of an average person; and (2) own risk compared to that of an average person with CHD. Comparative optimism in MI risk perceptions was common, particularly among men and those with higher education. CHD…
Are there socioeconomic differences in myocardial infarction event rates and fatality among patients with angina pectoris
Background: Systematic socioeconomic differences in mortality have been reported among myocardial infarction (MI) patients in many countries, including Finland. The findings have been similar irrespective of country, study period, age group, or length of follow up, but few studies have examined the disparities among other groups of coronary patients. This study examined whether similar socioeconomic differences in outcomes exist among patients wi…
Socioeconomic equity in finnish hospital care in relation to need
Socioeconomic variations in hysterectomy
STUDY OBJECTIVE: To explore variations in rates for hysterectomy in relation to social class, education, and family income. DESIGN: Retrospective analysis of the 1988 Finnish hospital discharge register linked individually to the 1987 population census. SETTING: Finland. PARTICIPANTS: All women living in Finland aged 35 and over were the denominator population. The numerators were the 8663 women who underwent hysterectomy in 1988. MAIN RESULTS: T…
How did Finland's economic recession in the early 1990s affect socio-economic equity in the use of hospital care
Socioeconomic equity in amenable mortality in Finland 1992-2008
Sociodemographic Differences in Myocardial Infarction Risk Perceptions among People with Coronary Heart Disease
This study examines sociodemographic differences in myocardial infarction (MI) risk perceptions among people with coronary heart disease (CHD) ( N = 3130). Two variables for comparative risk perceptions were computed: (1) own risk compared to that of an average person; and (2) own risk compared to that of an average person with CHD. Comparative optimism in MI risk perceptions was common, particularly among men and those with higher education. CHD…
Power and politics in a pandemic
Power and politics are both critical concepts to engage with in health systems and policy research, as they impact actions, processes, and outcomes at all levels in health systems. Building on the conceptualization of health systems as social systems, we investigate how power and politics manifested in the Finnish health system during COVID-19, posing the following research question: in what ways did health system leaders and experts experience i…
Are there socioeconomic differences in myocardial infarction event rates and fatality among patients with angina pectoris
Background: Systematic socioeconomic differences in mortality have been reported among myocardial infarction (MI) patients in many countries, including Finland. The findings have been similar irrespective of country, study period, age group, or length of follow up, but few studies have examined the disparities among other groups of coronary patients. This study examined whether similar socioeconomic differences in outcomes exist among patients wi…
How is a large-scale reform perceived by citizens in Finnish primary health care
We build on the anthropology of health systems and policy to study how Finland's 2023 health and social services reform has been perceived and experienced by citizens, and how these perceptions reflect broader societal shifts. We draw on interviews (n = 65) and 11 months of ethnographic fieldwork completed from January to November 2024 in Finnish primary health care in three regions. Citizen reactions towards the reform were mixed, ranging from f…
Integrating Health and Social Services in Finland
Various models for cooperation between regional health and social care authorities have emerged in the regions to identify good integrated care practices. The study suggests that the applied theoretical framework and presented elements of integrated care governance can be used to monitor development of care integration
Socioeconomic equity in finnish hospital care in relation to need
Socioeconomic variations in hysterectomy
STUDY OBJECTIVE: To explore variations in rates for hysterectomy in relation to social class, education, and family income. DESIGN: Retrospective analysis of the 1988 Finnish hospital discharge register linked individually to the 1987 population census. SETTING: Finland. PARTICIPANTS: All women living in Finland aged 35 and over were the denominator population. The numerators were the 8663 women who underwent hysterectomy in 1988. MAIN RESULTS: T…
Does a policy matter? Assessing the Finnish health policy in relation to its equity goals
Health differences in Finland, in terms of mortality, are the second largest among Western European countries. This is the case in spite of egalitarian social policy efforts and other health policy responses by the government. In addition, the Finnish Health for All (HFA) policy programmes pay attention to inequality in health. The two main aims of the Finnish HFA policy have been the best possible level of health for the population (the level ta…
Regional equity in childhood health — register-based follow-up of the Finnish 1987 birth cohort
How did Finland's economic recession in the early 1990s affect socio-economic equity in the use of hospital care
Are there socioeconomic differences in myocardial infarction event rates and fatality among patients with angina pectoris
Background: Systematic socioeconomic differences in mortality have been reported among myocardial infarction (MI) patients in many countries, including Finland. The findings have been similar irrespective of country, study period, age group, or length of follow up, but few studies have examined the disparities among other groups of coronary patients. This study examined whether similar socioeconomic differences in outcomes exist among patients wi…
Sociodemographic Differences in Myocardial Infarction Risk Perceptions among People with Coronary Heart Disease
This study examines sociodemographic differences in myocardial infarction (MI) risk perceptions among people with coronary heart disease (CHD) ( N = 3130). Two variables for comparative risk perceptions were computed: (1) own risk compared to that of an average person; and (2) own risk compared to that of an average person with CHD. Comparative optimism in MI risk perceptions was common, particularly among men and those with higher education. CHD…
Equity in the use of antithrombotic drugs, beta-blockers and statins among Finnish coronary patients
The use of antithrombotic drugs and beta-blockers among Finnish coronary patients seemed to be rather appropriate and, to some extent, prescription practices of preventive medication varied according to patients' risk of coronary events. However, statin use was remarkably low among men with low socio-economic status, and there is need to improve preventive drug treatment among diabetic coronary patients
Multilevel Modeling of Regional Variation in Equity in Health Care
BACKGROUND: The use of a concentration index is recommended to estimate socioeconomic equity in health and health services. Methods for the analysis of concentration indices have been developed in several studies. However, these methods do not take into consideration clustering within areas, which is necessary in a comprehensive study of regional variations in equity. OBJECTIVES: The study aims to develop a statistical method to assess variations…
P1-233 Assessing the effect of individual and area level sociodemographic factors on regional differences in mortality amenable to healthcare
Introduction Mortality from many causes varies geographically. We examine trends in regional differences in amenable mortality in Finland and explore the role of socioeconomic factors. Methods We analysed deaths amenable to primary and specialist healthcare in the Finnish population aged 25–74 in 1992–2003. Sociodemographic variables were individually linked from annual employment statistics. Three area-level scores were created using factor anal…
Socioeconomic equity in amenable mortality in Finland 1992-2008
The contribution of health policy and care to income differences in life expectancy – a register based cohort study
The results underline the importance of active health policy and health care measures in tackling socioeconomic health inequalities
Comparative observational study of mortality amenable by health policy and care between rural and urban Finland
No geographical or income-related differences in the distribution of mortality existed between Helsinki and other urban or rural areas of Finland. This suggests that the effect of increasing residential differentiation in the capital may have been mitigated by the policies of positive discrimination and social mixing. One of the main reasons for the increase in health inequalities was growth of alcohol-related mortality, especially among those wi…
Trends of relative and absolute socioeconomic equity in access to coronary revascularisations in 1995–2010 in Finland
Despite large increase in supply of revascularisations and decrease in IHD mortality, there is still marked socioeconomic inequity in revascularisations in Finland. However, since changes in absolute distributions of both supply and need for coronary care have favoured low-income groups, absolute inequity can be claimed to have decreased although it cannot be quantified numerically
Regional integrated care in Finland
The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 5.120 (2020 JCR, received in June 2021)
Integration in home care, effects on worker stress
The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 5.120 (2020 JCR, received in June 2021)
The Road to the Alcohol Act 2018 in Finland
Finnish alcohol policy has aimed for decades years to mitigate alcohol-related harm by using high taxation and restrictions on the physical availability of alcohol. The state monopoly on the retail of alcohol has played a central role in reducing the availability of alcohol. In 2011, preparations began for a comprehensive reform of the Alcohol Act 1994. Over time, the issue became highly politicised, lobbied and divisive. It took intense work of …
Regional approaches for integrating health and social services in Finland
Introduction Government policies in Finland have supported administrative and operative coordination of health and social care to create larger authorities for organising services and to strengthen integration of social services, and primary and specialised care. While nationally the policies have led to attempts to reform and consolidate the service system, in several areas, regional joint health and social care authorities have been established…
Individual and Area-level Factors Contributing to the Geographic Variation in Ambulatory Care Sensitive Conditions in Finland
BACKGROUND: Measuring primary health care (PHC) performance through hospitalizations for ambulatory care sensitive conditions (ACSCs) remains controversial-recent cross-sectional research claims that its geographic variation associates more with individual socioeconomic position (SEP) and health status than PHC supply. OBJECTIVES: To clarify the usage of ACSCs as a PHC performance indicator by quantifying how disease burden, both PHC and hospital…
Nordic responses to Covid-19
This paper explores and compares health system responses to the COVID-19 pandemic in Denmark, Finland, Iceland, Norway and Sweden, in the context of existing governance features. Content compiled in the Covid-19 Health System Response Monitor combined with other publicly available country information serve as the foundation for this analysis. The analysis mainly covers early response until August 2020, but includes some key policy and epidemiolog…
Balancing financial incentives during Covid-19
Integrating Health and Social Services in Finland
Various models for cooperation between regional health and social care authorities have emerged in the regions to identify good integrated care practices. The study suggests that the applied theoretical framework and presented elements of integrated care governance can be used to monitor development of care integration
Work like a Doc
BACKGROUND: Medical residents work long, continuous hours. Working in conditions of extreme fatigue has adverse effects on the quality and safety of care, and on residents' quality of life. Many countries have attempted to regulate residents' work hours. OBJECTIVES: We aimed to review residents' work hours regulations in different countries with an emphasis on night shifts. METHODS: Standardized qualitative data on residents' working hours were c…
Pandemic preparedness and response regulations in Finland
The COVID-19 pandemic has plagued health systems in an unprecedented way and challenged the traditional ways to respond to epidemics. It has also revealed several vulnerabilities in countries' health systems and preparedness. In this paper we take the Finnish health system as an example to analyse how pre-COVID-19 preparedness plans, regulations, and health system governance were challenged by the pandemic and what lessons can be learned for the …
Power and politics in a pandemic
Power and politics are both critical concepts to engage with in health systems and policy research, as they impact actions, processes, and outcomes at all levels in health systems. Building on the conceptualization of health systems as social systems, we investigate how power and politics manifested in the Finnish health system during COVID-19, posing the following research question: in what ways did health system leaders and experts experience i…
Medicine (23 works) · Political science (17 works) · Environmental health (16 works) · Health care (16 works) · Economics (12 works) · Population (12 works) · Nursing (10 works) · Business (9 works) · Economic growth (9 works) · Public health (9 works)