Is there a relation between waiting-list length and surgery rate?

The aim of this study was to investigate whether the differences in waiting-list lengths between hospitals can result from differences in demand for surgery. We compared waiting-list lengths for seven surgical procedures to the rates of these procedures. The numbers of procedures were obtained from the 1987 Finnish Hospital Discharge Register, and the numbers of patients on the waiting lists were obtained from an inquiry made to Finnish hospitals in 1987.

Who uses Norplant. A study from Finland.

Objective: Although Norplant implantable contraceptives were introduced first in Finland, their use has been infrequent. The objective of this study was to investigate what kind of women use Norplant in Finland, who suggested its use, and from what source women get their information on Norplant.

Methods: A questionnaire was mailed to all women having had Norplant inserted one to two years before the study initiation (June 1992) in seven family-planning clinics in the Helsinki city area (n = 262).

Amount of antenatal care and infant outcome.

The connection between the amount of antenatal care and pregnancy outcome was studied using the 1987 Finnish Medical Birth Registry. A total of 57,108 women were included in the analysis. The timing of initiation of antenatal care and the relative number of antenatal visits (adjusted by gestation length), were used as measures of amount of antenatal care.

A review of postmenopausal hormone therapy recommendations: potential for selection bias.

Objective: To survey the advice given to physicians in regard to postmenopausal hormone therapy, and thus to find out indirectly whether selective prescribing may have contributed to the findings of health effects.

Data Sources: Surveys on the health benefits of postmenopausal therapy were identified from previous reviews. Experts in various fields were consulted regarding relevant textbooks, and recommended booklists were used.

Reporting of malformations in routine health registers.

The utility of three national registers--the malformation, birth, and hospital in-patient discharge registers--in identification of malformations among 60,255 children born in 1987 in Finland was compared. Information in the malformation register is collected by specific reporting of physicians; information on the malformed children in the other two registers in 1987 through 1990 was routinely collected and identified by ICD 9-codes (740-759, 7886A). From October 1990 on, the ICD-9 codes were omitted from the birth register and malformation data were asked only in a yes-no question.

Women's satisfaction with maternity health care services in Finland.

The purpose of this study was to describe the Finnish maternity health care system and to determine the level of satisfaction in general with maternity health care services and specifically with hospital clinic visits in Helsinki, Finland. Information was collected using both interviews (N = 63) and questionnaires (N = 408). Care during pregnancy takes place in maternity centers, and risk pregnancies are referred to hospital clinics for consultation.

Physicians' views on hormone therapy around and after menopause.

Estrogens and progestins are commonly and increasingly used during and after menopause. We studied Finnish physicians' views of this hormone therapy based on their specialty. A questionnaire was sent to a stratified random sample of gynecologists, internists, general practitioners and nonspecialists (n = 500; response rate 74%).

Selection to postmenopausal therapy by women's characteristics.

Many surveys have shown that women using postmenopausal hormone therapy have a lower incidence of cardiovascular diseases and lower overall mortality. The purpose of this study was to compare past and non-users with current users of hormone therapy in regard to characteristics known to, or assumed to, predict poor subsequent health (indicators). The main data source was a survey in 1989 of a random sample (n = 2000, 86% response rate) of 45-64 year-old Finnish women.

Patterns of use of obstetrical interventions in 12 countries.

Recent obstetrical practice trends in 12 countries were surveyed. There was a 3-fold difference in caesarean section rates and a 10-fold difference in instrumental vaginal delivery rates among countries. There was a net increase in the caesarean section rate of all countries over the study period and a net decrease in the instrumental vaginal delivery rate of some countries.

Quantity and targetting of antenatal care in Finland.

The paper describes the timing of starting antenatal care and the number of visits and their variation measured against women's background characteristics in Finland. The main data source was the 1987 nationwide Medical Birth Registry, while some data were from published statistics and the 1988-90 Medical Birth Registries. These registries cover all antenatal visits, over 80% of which were to special out-patient maternity centers.

Careprovider and obstetrical interventions--a comparative study of four European countries.

The purpose of this study was to compare the treatment recommendations of obstetricians and midwives in four European countries: the Czech Republic, Finland, Hungary, and Slovenia. Intervention orientation was examined with six hypothetical patient cases. We wanted to learn whether midwives differ from obstetricians in their choices, and whether there is any variation among countries regarding the willingness of staff to intervene.

Hysterectomy among Finnish women: prevalence and women's own opinions.

This article describes the prevalence of hysterectomy, women's own opinions of it, and socioeconomic characteristics of hysterectomized women compared to non-hysterectomized ones. The questionnaire was sent in spring 1989 to 2000 45 to 64-year-old Finnish women picked randomly from the Population Census. After two reminders, 1713 (86%) had responded.

Is users' knowledge about contraceptives adequate? A case study of Finnish IUD users.

Intrauterine contraceptive devices (IUDs) are popular: in Finland, in 1987, about 25% of women of childbearing age used them. We studied Finnish women's knowledge about contraindications for and side-effects of IUD use, with emphasis on current users. In December 1987-January 1988, a postal questionnaire was sent to a random sample of 1000 women of childbearing age, in Uusimaa province, which includes the capital, Helsinki.

Mother's education and perinatal problems in Finland.

This study using nationwide data expands a previous study from one area in Finland. The purpose was to study how perinatal problems (mortality, short gestation, low birthweight and low Apgar scores) vary by mother's social class, which is measured by level of education. Outcomes of all births in the 1987 Medical Birth Register were linked to the 1988 National Education Register with gives the estimated number of years of completed education.

Need for and influence of feedback from the Finnish birth register to data providers.

Data for the Finnish medical birth register (established 1987) are collected by local hospital personnel as a part of their routine work. The purpose of this study was to study the need of personnel for feedback and the impact of feedback on later data quality. Furthermore, we studied whether such feedback tends to modify extreme cesarean section rates.

Midwives as providers of prenatal care in Finland--past and present.

This study analyzes the role of the midwife in prenatal care by exploring the history of the midwifery profession in Finland and by interviewing midwives. Midwifery education started in Finland in the beginning of the 19th century due to the utilitarian population policy aiming to reduce the high infant mortality rate. Because of a shortage of physicians professional midwives attained an important status in the care of births.

Variation in obstetric interventions by midwife.

This paper reports variation in birth interventions by 25 midwives among 2,135 births in a Finnish hospital. The rate of cesarean sections varied from 0 to 18%, and that of instrumental deliveries from 0 to 8%. Mother's and infant's characteristics and rates of vaginal breeches suggest that a low rate of cesarean sections was not explained only by selection to easy births.

Use of hormone replacement therapy in 1976-89 by 45-64 year old Finnish women.

Study Objective: The aim was to describe changes in the use of hormone replacement therapy (HRT) in Finland during the period 1976-1989.

Design: The study involved four separate cross sectional population surveys in the years 1976, 1978-1980, 1987, and 1989. Three of them involved interviews and one a questionnaire.

A survey on the use of alternative drugs during pregnancy.

Objective: To describe the use of alternative drugs during pregnancy.

Design: A trial including 3 surveys on drug use during pregnancy in maternity centers in one area of Finland in 1985-86 (study 1), and a retrospective survey in 2 maternity hospitals in Finland in 1988 (study 2).

Patients And Methods: Study 1: 2912 pregnant women (about 94% of pregnant women in the area during the study period); 97-88% returned questionnaires.