2.M. Workshop: Fostering integrated care through a large-scale structural health system reform in Finland Open Access

Several countries have introduced health system reforms to foster integrated care within their health systems and in some case also between health and other welfare services such as social care. These integrated care initiatives have included reorganization of the work of professionals, developing patient pathways and removing barriers for organisations to work together. Comprehensive structural reforms to foster integrated care have not been that common. In health systems, like in public policy in general, small, micro-level reforms are common but only seldom large-scale structural reforms are enacted. Also integrated care is often fostered through small-scale reforms which are not always even scaled up from the local or regional level to national level policies. In Finland a large-scale structural reform was introduced in 2023 which can be marked as one of the most comprehensive health system reform in Europe over the past decades. As a result of the reform the responsibility for organizing health care, social services and rescue services was transferred from over 300 municipalities to 22 health and social care authorities which all get funding from the state. A key tool in pursuing the reform has been to implement administrative and financial integration both in terms of vertical integration within health system and horizontal integration between health care and social services. The workshop uses the Finnish health system reform as a case study to present how integrated care can shape the health reform agendas and implementation of the reform. We discuss how structural reformation can foster integrated care at patient level and how the rather radical restructuration of the Finnish health system looks from the wider European perspective.

• One of the most comprehensive health-system reforms in Europe over the past decades was introduced in Finland in 2023.

• The radical structural health-system reformation can foster integrated care at patient level and offers a learning opportunity to other European health systems.