Patient organizations in Finland: increasing numbers and great variation.

Objective: There is very little research on patient organizations (POs), even though their numbers and influence seem to be increasing. The purpose of this study was to describe the establishment, membership, size, organization, decision making and basic funding of national POs in Finland.

Setting And Participants: National POs (n = 130) were identified from their umbrella organizations and by Internet searches.

Change and persistence in healthcare inequities: access to elective surgery in Finland in 1992--2003.

Aims: Many countries experience persistent or increasing socioeconomic disparities in specialist care. This study examines the socioeconomic distribution of elective surgery from 1992 to 2003 in Finland.

Methods: Administrative registers were used to identify common elective procedures performed in all public and private hospitals in Finland in 1992-2003.

Effect of legislative changes in drug promotion on medical students: questionnaire survey.

Objective: The aim of this follow-up study was to examine whether the legislative changes that took place in Finland in 2004 had an impact on the interactions between pharmaceutical companies and medical students. According to a previous survey, information provided by pharmaceutical companies represented one of the most important sources of information on pharmaceutical products for medical students and students frequently attended promotional events.

Methods: The authors collected the survey data using questionnaires distributed to medical students in Finland's five medical departments in spring 2005.

The feasibility of European reproductive health indicators.

Objective: The elaboration of a European health monitoring system is an ongoing process. Our aim was to study the availability, feasibility and comparability of the reproductive health indicators and to illustrate whether cross-country comparisons are feasible for pinpointing areas of concern and future research.

Methods: We surveyed 18 reproductive health indicators from eight countries: Finland, France, Germany, Italy, Latvia, Poland, Romania and Spain.

Stillbirths and infant deaths among migrants in industrialized countries.

Introduction: The relation of migration to infant outcomes is unclear. There are studies which show that some migrant groups have similar or even better outcomes than those from the receiving country. Equally, raised risk of adverse outcomes for other migrant groups has been reported.

Antidepressant utilisation patterns and determinants of short-term and non-psychiatric use in the Finnish general adult population.

Background: The aim was to study utilisation patterns and determinants of antidepressant use in the general population >30 years, especially short-term use or use not related to known psychiatric morbidity.

Methods: Participants from a cross-sectional population-based Finnish Health 2000 Study (2000--2001) were linked with the National Prescription Register and National Care Register for Health Care. Within a representative sample (N=7112) of the adult population (>30 years), 12-month DSM-IV depressive, anxiety, and alcohol use disorders were assessed with the M-CIDI.

Sexual health among young adults in Finland: assessing risk and protective behaviour through a general health survey.

Objective: To describe the extent of sexual risk and protective behaviours and reproductive health outcomes comparing men and women of 18-29 and assess the demographic correlates of these indicators within genders.

Design: A module of questions on sexual behaviour and reproductive health outcomes was integrated into a population-based general health survey in Finland.

Methods: A representative sample of people over 17, including 1,894 individuals between 18 and 29 years, was drawn from the population registry in 2001.

Pregnancy-related deaths in four regions of Europe and the United States in 1999-2000: characterisation of unreported deaths.

Objective: We compared official maternal mortality statistics with those from a special study covering all pregnancy-associated deaths in two European countries (Finland and France) and in two US states (Massachusetts and North Carolina) in 1999-2000 to characterize pregnancy-related deaths that are not included in official statistics.

Study Design: We linked the official ICD-10-based maternal mortality data for 84 deaths with study data on 404 pregnancy-associated deaths.

Results: Of the pregnancy-associated deaths, 151 were pregnancy-related.

Sociodemographic, disease status, and illness perceptions predictors of global self-ratings of health and quality of life among those with coronary heart disease--one year follow-up study.

This one-year follow-up study (n = 130 at baseline, n =2745 at follow-up, aged 45-74 years) examined the relationship of patients' perceptions of coronary heart disease (CHD) and illness-related factors with global health status and global quality of life (QOL) ratings. The independent variables were CHD history (myocardial infarction, revascularisation), CHD severity (use of nitrates, CHD risk factors and co-morbidities) and illness perceptions. In multivariate regression analysis, CHD history and severity explained 13% of variance in global health status and 8% in global QOL ratings at the baseline.

Effectiveness of upper and lower limb casting and orthoses in children with cerebral palsy: an overview of review articles.

The objective of this overview is to summarize from systematic reviews the evidence on the effectiveness of using upper and lower limb casting or orthoses in children with cerebral palsy. We used computerized bibliographic databases to search for systematic reviews without any language restrictions. Identification, selection, quality assessment, and data extraction were performed independently by two investigators.

Reform, change, and continuity in Finnish health care.

This article describes some essential aspects of the Finnish political and governmental system and the evolution of the basic institutional elements of the health care system. We examine the developments that gave rise to a series of health care reforms and reform proposals in the late 1980s and early 1990s and relate them to changes in health care expenditure, structure, and performance. Finally, we discuss the relationship between policy changes, reforms, and health system changes and the strength of neo-institutional theory in explaining both continuity and change.

Physicians' opinions on patients' requests for specific treatments and examinations.

Objective: The number of technologies used in health care is growing, patients' educational level has risen, health and drug information is increasingly available and patients today are actively looking for information from different sources. The aim of the study was to investigate physicians' opinions on patients' requests for specific treatments and examinations.

Design: The data were gathered as part of an annual physician's survey sent to all Finnish physicians (n=16,698) by the Finnish Medical Association in March 2002.

Methods for identifying pregnancy-associated deaths: population-based data from Finland 1987-2000.

To find maternal and pregnancy-related deaths, it is important that all pregnancy-associated deaths are identified. This article examines the effect of data linkages between national health care registers and complete death certificate data on pregnancy-associated deaths. All deaths among women of reproductive age (15-49 years) in Finland during the period 1987-2000 (n = 15 823) were identified from the Cause-of-Death Register and linked to the Medical Birth Register (n = 865 988 births), the Register on Induced Abortions (n = 156 789 induced abortions), and the Hospital Discharge Register (n = 118 490 spontaneous abortions) to determine whether women had been pregnant within 1 year before death.

What is the most relevant standard of success in assisted reproduction?: The value of cryopreservation on cumulative pregnancy rates per single oocyte retrieval should not be forgotten.

The most relevant standard of success in IVF has been discussed widely. An optimal standard should reflect both the risk aspects and the effectiveness of the treatment. The most important parameter for the couple is the ultimate cumulative delivery rate per started cycle.

Monitoring of IVF birth outcomes in Finland: a data quality study.

Background: The collection of information on infertility treatments is important for the surveillance of potential health consequences and to monitor service provision.

Study Design: We compared the coverage and outcomes of IVF children reported in aggregated IVF statistics, the Medical Birth Register (subsequently: MBR) and research data based on reimbursements for IVF treatments in Finland in 1996-1998.

Results: The number of newborns were nearly equal in the three data sources (N = 4331-4384), but the linkage between the MBR and the research data revealed that almost 40% of the reported IVF children were not the same individuals.

Nursing documentation in nursing homes--state-of-the-art and implications for quality improvement.

This study was designed to gain information on the quality of nursing care based on the comments in nursing records. The specific aims of the study were to find out if the patients' (i) individual needs are assessed, the goals for nursing care are set, and the nursing interventions are determined; (ii) if the patients' needs are met and (iii) if goal achievement is regularly evaluated by including comments in nursing documents. In addition, the study aimed to describe the up-to-dateness of nursing care plans as well as the frequency of making daily notes.

IVF treatments and their outcomes in Finland in the 1990s.

Background: In vitro fertilization and its variants have become routine infertility treatments in industrialized countries. Our purpose is to summarize the procedures and treatment outcomes in Finland in the 1990s and to compare the results between public and private clinics.

Methods: The data came from the Finnish IVF statistics for 1992 to 1999.

Frequency of daily over-the-counter drug use and potential clinically significant over-the-counter-prescription drug interactions in the Finnish adult population.

Objective: To explore the frequency of continuous use of over-the-counter (OTC) drugs among the Finnish adult population and the potential for harmful interactions between OTC drugs and prescribed (Rx) drugs.

Methods: Data were extracted from a 1995-1996 population-based interview survey on health care (n = 10,477, response rate 86%). The drug interaction classification system from the Swedish Drug Compendium FASS 1997 was used to identify OTC drugs likely to have clinically significant interactions with prescription drugs.

Self-medication with vaginal antifungal drugs: physicians' experiences and women's utilization patterns.

Background: In many countries, vaginal antifungal drugs have been released on over-the-counter (OTC) markets, yet little is known about women's management of their symptoms.

Objectives: The aim of this study was to judge the appropriateness of self-medication with vaginal antifungal drugs by examining utilization patterns and physicians' experiences of women's self-medication.

Methods: An anonymous questionnaire survey was carried out in 20 pharmacies in Finland of women buying OTC vaginal antifungal drugs in 1997.

Self medication and health habits in the management of upper gastrointestinal symptoms.

Upper gastrointestinal symptoms are a common complaint among the general population but only a small proportion of sufferers seek medical advice. The aim of this study was to examine what kind of perceptions persons using self medication have about the causes of their gastrointestinal symptoms, whether they have made any health-related lifestyle changes, and whether visits to a physician are related to lifestyle changes. A pharmacy-based survey was done in 10 pharmacies in the Helsinki area in 1995.

Physicians' attitudes toward reclassifying drugs as over-the-counter.

Objectives: Releasing prescription drugs over-the-counter (OTC) has been a trend in many Western countries. The purpose of this study was to find out about Finnish physicians' attitudes towards OTC switches and to find out whether transfer of drugs that are used in a doctor's own area of specialty increases negative attitudes toward release. For the latter purpose, gynecologists' perceptions about the availability of vaginal antifungal OTC drugs was studied.

Accidental out-of-hospital births in Finland: incidence and geographical distribution 1963-1995.

Background: The study aims to describe the incidence and geographical distribution of accidental out-of-hospital births (accidental births) in Finland in relation to the changes in the hospital network, and to compare the perinatal outcomes of accidental births and all hospital births.

Methods: Data for the incidence and distribution analyses of accidental births were obtained from the official statistics between 1962 and 1973 and from the national Medical Birth Registry (MBR) in 1992-1993. The infant outcomes were analyzed for the MBR data in 1991-1995.

Contraceptive health risks--women's perceptions.

The aim was to study women's concerns about health risks associated with contraceptives, in particular oral contraceptives and intrauterine devices (IUDs), and to investigate what factors are related to these concerns. A questionnaire was sent to a random sample of 3000 women aged 18-44 years in Finland in 1994. After two reminders, the response rate was 74% (n = 2189).

Quality of care in abortion services in Finland.

Background: The aim of this study was to describe the quality of abortion services and women's experiences with the care they had received during their abortion.

Methods: A population-based postal survey of 3000 randomly selected 18-44-year old Finnish women in 1994. The response rate was 74% (n=2189).