Palliative care at home expands as hospital beds shrink in North Savo

Bertta Marin, 77, remains at her home in Kiuruvesi because North Savo’s mobile hospital unit delivers the palliative care she needs.

The mobile hospital, run by the North Savo wellbeing services county, now treats more patients nearing the end of life in their own homes, avoiding long ward stays.

Kiuruvesi resident Marin, who has heart, liver and kidney disease, says the twice-weekly visits from nurse Hanna Hujanen allow her to stay at home rather than in a ward in Iisalmi.

“I feel secure when the nurse comes,” Marin said. Her husband lives with her and their daughters live nearby, contributing to daily support.

Hujanen, who has worked in home-hospital care since 2019, visits Marin at least once a week and more often if symptoms flare. Most treatments are intravenous—hydration, antibiotics or pain-pump adjustments—delivered alone but backed by a supportive team.

North Savo’s mobile hospital began as a home-hospital service in 2012 and has since added overnight emergency calls via regional paramedics. Yet the wellbeing services county has simultaneously cut more than 130 hospital beds and ended overnight emergency care in Iisalmi and Varkaus.

Tehy union representative Nea Ruhanen said the mobile unit complements existing services but cannot replace lost beds or overnight emergency care. Long travel distances and limited equipment mean care quality varies, she said.

Mobile-hospital chief physician Marko Hoikka said tight budgets and ongoing restructuring talks rule out expansion to Suonenjoki, Rautalampi, Tervo, Vesanto or Karttula, home to about 15,000 people. For now, patients there receive care via the Pielavesi and Kuopio mobile units and regional paramedics.