Enacting multisectoral service chains and packages in the health and social care regions in Finland

Several studies have concluded that about 10% of the users of the health care and social services use most services and produce about 80% of the costs of care. However, this client group and their needs for services, which are often complex and multisectoral, are poorly characterized. The new Act on Organizing Health and Social Care Services in Finland obliges the health and social care regions to identify the client groups who need integrated services and to define the multisectoral service chains and packages for these clients. The assumption is that an individual client's personal service path can be planned and enacted by utilizing the pre-defined service chains and packages. This study aimed at studying the definition, development and enactment of the service chains and packages. The study was based on a survey which was carried out in the 22 health and social care regions in spring 2023 for analyzing 1) to which client groups the service chains and packages are defined, 2) what needs there are in the background of defining service chains and packages, 3) what kind of goals are defined for the service chains and packages, 4) what the current developmental state of the service chains and packages is and how they manage to cross the sectoral and disciplinary boundaries, and 5) what successes and challenges there are in defining, developing and enacting the service chains and packages. The survey was the first part of a study which focuses on the development and enactment of service chains and packages in the health and social care regions. The survey results showed that most of the development activities were in the definition phase. The survey gives perspective and background knowledge to the second part of the study which focuses on one specific client group, the children with neuropsychiatric symptoms, and on the definition and enactment of their service chains and packages within three regions.