Finland: #14 in the 2024 World Index of Healthcare Innovation

Introduction

In the 2024 World Index of Healthcare Innovation, Finland climbed to 14th place overall, improving from 16th in 2022. The country’s highest achievement was in Quality, where it ranked 3rd, largely thanks to enhancements across various aspects of patient-centered care. However, Finland’s performance was notably weak in the category of Choice, where it placed 31st due to strict limitations on patient access to healthcare providers. As a result, long waiting times and significant cost-sharing are prevalent features of the Finnish health system.

Background

Finland’s healthcare system is socialized yet decentralized, financed through a multifaceted mix of sources. In 2023, out-of-pocket payments accounted for 22 percent of the total health expenditures, a slight increase from the previous year. The main areas of healthcare spending were outpatient care (34 percent), inpatient care (22 percent), long-term care (16 percent), and pharmaceuticals (13 percent). Collectively, outpatient care, long-term care, and pharmaceutical costs constitute nearly two-thirds of all out-of-pocket expenses.

The Finnish healthcare infrastructure mainly consists of publicly owned facilities, with only a small percentage being privately or jointly owned. The public hospital network comprises 15 central hospitals and five university hospitals, which are organized into 19 hospital districts—each serving as a federation of municipalities. This network has seen a reduction in facilities, down from 20 hospital districts, as part of an ongoing trend toward mergers and closures that began in the early 2000s.

Significant health metrics have shown improvement; life expectancy at birth has reached 82.4 years, marking a one-year increase over the past four years. This improvement is attributed to better management of chronic diseases and effective public health initiatives focusing on prevention and treatment. However, public health challenges persist with alcohol consumption rates at 9.4 liters per adult per year, a smoking prevalence of 16 percent, and a 23 percent obesity rate among adults.

Despite spending about nine percent of its GDP on healthcare—lower than the Scandinavian average of 11 percent—Finland continues to grapple with controlling the growth of health expenditures. The healthcare system utilizes a tiered service model in which primary care is provided by municipal health centers and private practitioners, while specialized care is delivered through central and university hospitals. This structure promotes efficient resource use and accessibility, prioritizing preventative care to manage long-term costs.

Finland has increasingly embraced technological innovations in healthcare, with significant investments directed towards digital health solutions. These include expanding telemedicine capabilities, which now cater to 30 percent of outpatient consultations, and integrating artificial intelligence in administrative and diagnostic processes to enhance efficiency and patient outcomes.

Dimension Performance

Quality

Finland’s healthcare system achieved an overall Quality ranking of 3rd. Its standout performance is in patient-centered care and pandemic preparedness and response. In patient-centered care, Finland dramatically improved to 3rd place from 28th in 2021. We attribute this significant rise to reduced waiting times for doctor appointments, enhanced transparency between patients and providers, and improved patient safety standards. However, Finland scored lower in other aspects, ranking 18th in preventable disease measures, and faces ongoing struggles with overcrowding at hospitals.

Choice

Despite Finland’s successes in other measures, it ranked near the bottom of the Index in Choice (30th). Under its socialized healthcare system, the freedom to choose healthcare services was nearly nonexistent and resulted in a 32nd ranking in that metric. Furthermore, Finland ranked 10th and 20th, respectively, in the elements affordability of health insurance and access to new treatments.

Science and Technology

Finland ranked 13th overall in Science and Technology. Notably, Finland’s national implementation of electronic health records (EHR) was commendable, securing an 8th place ranking in health digitization. Its Scandinavian neighbors, Sweden and Denmark, also demonstrated strong performance in EHR adoption. Additionally, Finland’s innovation in medical technology was notable, securing the 11th spot in medical advances, although it placed 17th in scientific discoveries.

Fiscal Sustainability

Fiscal Sustainability remained a difficult dimension for Finland’s healthcare system, ranking 21st. While its debt-to-GDP ratio ranked slightly above the median—coming in at 19th in national solvency—its public healthcare spending was near the bottom third of countries (24th). However, Finland’s growth of public health spending improved and ranked among the top third of countries at 11th.