How is a large-scale reform perceived by citizens in Finnish primary health care

Dados Bibliográficos

ID5658246
AutoresLaura Kihlström (0000-0002-0619-6572, Finnish Institute for Health and Welfare), Ilmo Keskimäki (0000-0002-4614-7062, Finnish Institute for Health and Welfare), Henna Paananen (0000-0003-1140-7730, Tampere University), Satu Paatela (0000-0003-3548-7827, Finnish Institute for Health and Welfare), Markku Satokangas (0000-0003-1085-8687, Finnish Institute for Health and Welfare), Liina-Kaisa Tynkkynen (0000-0003-0729-1595), Liina‐kaisa Tynkkynen (Finnish Institute for Health and Welfare)
Ano2025
Volume387
Páginas118688
Data de publicação2025-12-01
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoSocial Science & Medicine (JOURNAL)
Identificadores do periódicoISSN: 0277-9536 • E-ISSN: 1873-5347
EditoraElsevier BV (PUBLISHER)
DOI10.1016/j.socscimed.2025.118688
PMID41110247
OpenAlexW4415214586
IdiomaEN
Citações recebidas2
Referências citadas45

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 fear to distrust and from indifference to cautious acceptance. Older citizens, in particular, view the reform as a turning point which alters the relationship between them and public healthcare services, and more broadly between citizens and the state. This perception has been amplified by austerity politics and measures taken during reform implementation, mainly closing of local health care centers, swift transition to remote care, and lack of citizen engagement during the implementation process. We introduce the concept of exceptionalism complacency to critique the assumption that universal health care in Nordic countries is inherently stable. In Finland, this complacency manifests itself as the tendency of politicians, policymakers, administrators, and sometimes researchers to take citizens' trust for granted, as system-focused analyses of the reform, and as a disregard of local needs in policy implementation. There is a risk that this might fuel resentment towards public institutions and the reform by leaving more vulnerable citizens behind. Citizens' experiences regarding changes in health care should therefore be carefully monitored

Geriatric Care and Nursing Homes · Healthcare Policy and Management · Primary Care and Health Outcomes