Summary
Background:
It has been nearly a decade since the Finnish national asthma programme (1994–2004) and chronic obstructive pulmonary disease (COPD) programme (1998–2007) finished. During these past ten years the treatment of these illnesses has improved remarkably due to intensive research. There has also been a tendency to shift the responsibility of care from hospital-based outpatient services to primary health care. The aim of this report is to present data on the current state of hospital-based and health centre-based outpatient services for adults with asthma and/or COPD in Finland.
Methods:
The data for this report was collected by an email survey. The questionnaire was sent to all the chief physicians of the departments of pulmonary diseases in the university hospitals (n = 5) and district hospitals (n = 21), as well as to the physicians and nurses responsible for the services for asthma and COPD patients in 242 health centres. The response rate from hospitals was 69.2% (18/26) and from health centres 21.1% (51/242).
Results:
The quality of care of patients with obstructive pulmonary diseases seemed to vary significantly depending on the municipal service system and resources. The availability and quality of care were affected by labour shortage, employee turnover and limited opportunities to attend continuing education. The greatest shortcomings in the care of asthma and COPD patients were reported in access to follow-up visits in health centres and availability of pulmonary rehabilitation. Guidance for self-management also showed noticeable regional variation.
Conclusions:
The shortcomings reported by the respondents reveal inequalities in the outpatient services for asthma and COPD patients depending on the municipality. In order to improve the situation, it would be necessary to reevaluate the current service system for asthma and COPD patients. Regional features and variation should be taken into account in the process.
