Medical deserts in Finland: measuring the accessibility and availability of primary health care services.

Publisher: BioMed Central Country of Publication: England NLM ID: 101088677 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6963 (Electronic) Linking ISSN: 14726963 NLM ISO Abbreviation: BMC Health Serv Res Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Health Services Accessibility*/statistics & numerical data ; Primary Health Care*/statistics & numerical data ; Medically Underserved Area*; Finland ; Humans ; Telemedicine/statistics & numerical data ; Male ; Female ; Aged ; Middle Aged ; Adult

Competing Interests: Declarations. Ethics approval and consent to participate: The study utilized publicly available routinely collected aggregated (and thus anonymous) municipality-level data, and as such, ethical approval by an ethics committee was not needed. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.
Background: Well-functioning primary health care (PHC) systems are needed to meet the challenges of aging populations and increasing care needs. However, "medical deserts", areas with poor accessibility and availability of PHC services, remain a significant issue throughout Europe, contributing to regional inequalities. Identifying the location of these areas is crucial for effective policymaking and for improving health outcomes. Our aim was to locate underserved areas in Finland by developing a medical desert index. In addition, we examined the impact of telehealth, care needs, and multiple funding sources on the index and analyzed its association with key quality indicators.
Methods: The index was calculated using routinely collected municipality-level PHC consultation data from 2022 adjusted for population care needs (availability) and the average travel time to the nearest PHC center (accessibility). Telehealth and occupational healthcare consultations were included separately. Standardized index values were mapped and categorized using descriptive analysis, and compared with indicators of healthcare utilization, care accessibility and availability, care satisfaction, and continuity of care using correlation analysis.
Results: The index displayed clear patterns of medical deserts, primarily in the rural areas of northern and eastern Finland. Approximately 13% of the Finnish population resided in medical deserts, defined as a standard score of -0.5 or lower. The inclusion of telehealth consultations appeared to improve the index values especially in some rural areas. Better accessibility and availability of PHC services, as indicated through the index, was significantly correlated with lower proportion of acute care consultations, fewer hospital care days, and lower continuity of care among clients aged 65 years and older.
Conclusions: We were able to identify medical deserts in Finland utilizing novel methodology distinct from previous indicators, and thus providing important considerations for future research on regional inequalities in accessibility and availability of PHC services. Our findings demonstrated the potential of telehealth services in mitigating medical deserts, though its appropriateness for some population groups and care needs remains unclear. We call for health policy addressing PHC service provision especially in rural areas.
(© 2025. The Author(s).)

Eur J Public Health. 2023 Oct 10;33(5):785-788. (PMID: 37421651)
Digit Health. 2022 Jan 28;8:20552076221074485. (PMID: 35111333)
Pediatr Res. 2016 Jan;79(1-2):169-76. (PMID: 26466080)
Br J Gen Pract. 2016 Aug;66(649):e531-9. (PMID: 27324627)
Int J Circumpolar Health. 2011;70(5):460-72. (PMID: 22030009)
J Med Internet Res. 2022 Aug 26;24(8):e37100. (PMID: 36018711)
BMJ. 2017 Feb 1;356:j84. (PMID: 28148478)
Lancet. 2018 Jun 2;391(10136):2236-2271. (PMID: 29893224)
Int J Qual Health Care. 2000 Apr;12(2):105-13. (PMID: 10830667)
Int J Health Policy Manag. 2024;13:8309. (PMID: 39099482)
Health Place. 2010 Nov;16(6):1077-83. (PMID: 20655795)
Health Policy. 2016 Feb;120(2):205-12. (PMID: 26831039)
Int J Integr Care. 2016 Oct 26;16(4):4. (PMID: 28316544)
PLoS One. 2020 Apr 23;15(4):e0232032. (PMID: 32324786)
J Health Econ. 2020 May;71:102254. (PMID: 32120332)
Eur J Public Health. 2017 Oct 1;27(suppl_4):18-21. (PMID: 29028245)
Health Place. 2016 Mar;38:70-81. (PMID: 26798964)
BMC Health Serv Res. 2018 Jun 4;18(1):403. (PMID: 29866201)
Health Policy. 2024 Jan;139:104950. (PMID: 38061175)
BMC Health Serv Res. 2008 Jul 28;8:160. (PMID: 18662391)
Perspect Public Health. 2017 Mar;137(2):89-101. (PMID: 27004489)
Int J Health Geogr. 2017 Dec 11;16(1):46. (PMID: 29228961)
Health Policy. 2019 Aug;123(8):737-746. (PMID: 31300174)
Int J Integr Care. 2022 Sep 14;22(3):18. (PMID: 36186511)
Soc Sci Med. 2009 Feb;68(4):654-63. (PMID: 19108940)
BMC Health Serv Res. 2024 Sep 13;24(1):1065. (PMID: 39272124)
Br J Gen Pract. 2023 Apr 27;73(730):e374-e383. (PMID: 37105731)
Health Policy. 2014 Jan;114(1):5-14. (PMID: 24054709)
Eur J Public Health. 2015 Jun;25(3):364-5. (PMID: 25999461)
Eur J Ageing. 2022 Apr 15;19(2):221-232. (PMID: 35465210)
Fam Pract. 2014 Oct;31(5):502-16. (PMID: 25216664)
Eur J Health Econ. 2024 Sep;25(7):1117-1131. (PMID: 38170332)
Med Care. 1977 Apr;15(4):347-9. (PMID: 859364)
Eur J Public Health. 2013 Jun;23(3):356-60. (PMID: 22645236)
J Gen Intern Med. 2019 Nov;34(11):2610-2619. (PMID: 31428988)
BJGP Open. 2021 Jun 30;5(3):. (PMID: 33712502)
Int J Public Health. 2024 Jan 05;68:1606184. (PMID: 38250321)
Health Serv Res. 2020 Dec;55(6):1003-1012. (PMID: 33258126)
Int J Equity Health. 2023 Jan 5;22(1):3. (PMID: 36604705)
Health Syst Transit. 2019 Aug;21(2):1-166. (PMID: 31596240)
Med Care. 1981 Feb;19(2):127-40. (PMID: 7206846)
BMC Health Serv Res. 2009 Dec 04;9:222. (PMID: 19961588)
J Gen Intern Med. 2017 Oct;32(10):1136-1140. (PMID: 28653233)
Perspect Health Inf Manag. 2022 Jan 01;19(1):1n. (PMID: 35440933)
Nurse Educ Today. 2016 Apr;39:50-62. (PMID: 27006033)
Int J Health Geogr. 2020 Nov 9;19(1):46. (PMID: 33298076)
Int J Health Plann Manage. 2024 May;39(3):708-721. (PMID: 38358842)
Health Place. 2014 Jul;28:92-8. (PMID: 24793139)
BMC Health Serv Res. 2019 Sep 4;19(1):629. (PMID: 31484530)
PLoS One. 2012;7(5):e35903. (PMID: 22567118)
Int J Equity Health. 2013 Mar 11;12:18. (PMID: 23496984)
Health Aff (Millwood). 2014 Feb;33(2):258-64. (PMID: 24493769)
Int J Health Geogr. 2024 Feb 28;23(1):5. (PMID: 38419022)
Healthc Policy. 2021 Aug;17(1):73-90. (PMID: 34543178)
Int J Health Policy Manag. 2023;12:7454. (PMID: 38618823)
J Med Internet Res. 2021 Aug 26;23(8):e29575. (PMID: 34435965)
BMC Health Serv Res. 2010 Mar 13;10:65. (PMID: 20226084)
Int J Health Policy Manag. 2022 Dec 6;11(11):2440-2450. (PMID: 35021611)
BMC Health Serv Res. 2006 Mar 03;6:25. (PMID: 16512923)
Lancet. 2013 Apr 13;381(9874):1312-22. (PMID: 23541057)

101018341 Third Health Funds

Keywords: Accessibility; Availability; Index; Medical desert; Primary healthcare; Regional inequalities; Telehealth

Date Created: 20250219 Date Completed: 20250508 Latest Revision: 20250508

20250509

PMC11841193

10.1186/s12913-025-12409-1

39972338