Major flaws found in Finland’s social and welfare service funding data collection
A government-commissioned report reveals serious inconsistencies in how Finland’s wellbeing services counties record and submit diagnostic data, directly affecting the allocation of billions in state funding, Yle reports.
The findings, published by the Ministry of Finance on Wednesday, show that variations in how long-term diagnoses are documented across counties risk distorting the distribution of funds. Four-fifths of financing for social, healthcare, and rescue services is determined by assessed service needs, with diagnostic records playing a key role in these calculations.
Some counties may receive less funding than their populations’ health conditions warrant, while others could gain disproportionate allocations due to differences in recording practices. Several counties, including Central Finland, have already appealed funding decisions, citing diagnostic data issues. The Administrative Court is currently reviewing these cases.
Last summer, the Finnish Institute for Health and Welfare (THL) identified significant errors in long-term illness diagnoses recorded by at least ten wellbeing services counties.
Recording practices vary widely
The report, authored by professors Ulla-Mari Kinnunen (health data management) and Tomi Voutilainen (public law), highlights that diagnostic documentation varies because legal requirements are interpreted differently. While the Client Data Act mandates recording each service event, it leaves flexibility in how diagnoses are specified—only requiring details “to the necessary extent.”
With no strict legal obligation to log diagnoses, practices rely heavily on lower-level regulations and THL guidelines. However, interviews revealed that these guidelines do not always directly inform county procedures. Instead, recording habits are often passed informally from senior to junior medical staff—a “master-apprentice” approach.
Data is submitted to THL through various IT systems, but the report finds that regulations governing these transfers are inadequate. THL also lacks the authority to enforce uniform processes. Outdated systems further compound the problem, as updates to guidelines fail to reach frontline users promptly.
Calls for complete overhaul
The professors conclude that the most critical issues involve the recording of permanent diagnoses (long-term conditions) in patient records and their transfer to THL’s treatment notifications. They propose immediate clarification of what constitutes a “long-term diagnosis” and how it should be documented.
More fundamentally, the report urges a full reassessment of the entire notification-based funding model. It also criticises THL for underutilising existing national data systems, which could provide more accurate counts of long-term diagnoses—despite legal reforms enabling this since 2023. The transition period for these changes ends in late 2029, but the report stresses that ministerial intervention is needed to ensure compliance.
The authors call for a complete revision of data collection and processing regulations, warning that current reliance on non-binding guidelines is insufficient. Clear legal distinctions must be drawn between mandatory requirements and advisory recommendations.