Quality Report (Official Statistics of Finland, OSF): Access to Specialised Health Care
General description
Description of the statistics
The statistics on access to specialised health care contain information on the realisation of access to care in units providing specialised health care in the wellbeing services counties.
Statistics on access to specialised health care are available from December 2007 onwards. From 2021 onwards, the data of the access to specialised health care register have been collected and published in databases once a month. A statistical report is produced once a year.
Relevance
The statistics are intended for health care professionals, administrative authorities, planners and researchers who need information on access to specialised health care in their work.
The data are collected from units providing specialised health care once a month on the cross-sectional date, which is always the last day of the month. The provision of data to the Finnish Institute for Health and Welfare (THL) is mandatory and is based on the Act on the Finnish Institute for Health and Welfare (668/2008).
The supervisory authorities monitoring the realisation of access to care are the National Supervisory Authority for Welfare and Health (Valvira) and the Regional State Administrative Agencies (AVI). The Finnish Institute for Health and Welfare (THL) produces the data required for supervision for Valvira and the Regional State Administrative Agencies. The basis for reporting the data is the Health Care Act 2010/1326 Sections 51 c, 52 and 53.
Data content of the statistics
The statistics cover all persons in Finland who have received a referral to non-urgent specialised health care and are waiting for care. The data are collected once a month on the cross-sectional date, which is the last day of each month.
The statistics present number and percentage data on those waiting for assessment of need for care and those waiting for care. Those waiting are divided into those who have waited 1–90 days, 91–180 days and over 180 days. In addition, the processing of referrals is divided into those processed within less than three days, those processed within 4–21 days and those processed in over 21 days. Persons under 23 years of age waiting for mental health services are divided into those who have waited 1–90 days and those who have waited over 90 days. In addition, indicators adjusted to the population are presented. Data specific to queue groups are also collected on realised treatments cumulatively for the period between the beginning of the year and the cross-sectional date. Referral data are also collected cumulatively from the beginning of the year. Maximum waiting times are based on the Health Care Act 2010/1326 Sections 51 c, 52 and 53.
Access to care data are reported as electronic basic reports in condensed form and also more extensively in several database reports: Those waiting for care and assessment of need for care, Those waiting for care and waiting times by queue group, Children and young people waiting for psychiatric care and assessment of need for care, and referrals. The data content of the register has been developed together with field actors.
Database reports on access to care
In the textual section of the statistical report, the concepts used in the statistics are presented. The statistical report mainly uses established concepts.
Statistical process
Source data
Data on access to care are collected from the wellbeing services counties (excluding Åland). HUS reports the data for access to specialised health care for all wellbeing services counties in the Uusimaa region. Helsinki reports the specialised health care it produces itself. The organisations involved in data collection extract the data from their patient information systems and report them at aggregate level to THL. In access to specialised health care, a transition is underway to data provision at individual level by 1 January 2026.
Data collection method
The same data are collected from units providing specialised health care in all wellbeing services counties using the Hilmo – Specialties in Health Care classification-based division into medical specialties and, for those waiting for care, also a division by queue group. The data are submitted to THL either in Excel or CSV format.
A new data submission method, THL’s Data Submission Service (TTP), is being introduced for reporting data on access to specialised health care. According to THL’s administrative decision, wellbeing services counties must adopt the TTP by 1 January 2026. Until then, data can be submitted to THL using the currently used methods of data submission. At present, four wellbeing services counties already submit data via the TTP. During 2024–2025, data on access to care will accumulate in two different forms. The old data submission method is aggregate-level data, and the new data collection method will consist of individual-level data. This will result in reliable reporting of some indicators (e.g. median waiting days) not being possible during the transition period. Median waiting days can be reported once all regions have transitioned to the new data submission method.
Data validation
Access to specialised health care data are extracted from the patient information systems of wellbeing services counties. The correctness of the data depends on the data providers. If necessary, the correctness and quality of the access to care data are examined together with the wellbeing services counties and system suppliers. In addition, the data are also examined with supervisory authorities when necessary. There may be recording errors affecting figures in the data of all wellbeing services counties.
The access to care data of wellbeing services counties consist of specialised health care hospitals operating in the regions and primary health care units providing specialised health care. System changes and version updates, as well as changes in data content, have caused temporary deterioration in data quality from time to time and missing data for certain periods. For primary health care units providing specialised health care, the situation varies because units have been removed from data collection and have been transferred under the wellbeing services counties.
The data are checked at aggregate level in THL and contact is made with data providers when necessary. In the new data submission method, data checking will be possible more systematically.
Data processing
Aggregate-level data submitted to THL are uploaded into databases. The uploaded data are compared with data from previous months, and if major deviations occur, the wellbeing services county is contacted to ensure the correctness of the data. The wellbeing services county then re-submits the data if necessary.
Data revision
Data for previous statistical months are updated retrospectively when necessary in connection with the statistical release of the following month. The impact of corrections made afterwards on the figures has generally been assessed as small.
Quality assessment of the statistics
Accuracy and reliability
At the beginning of 2023, 23 wellbeing services counties started operating in Finland. Data on access to specialised health care are obtained directly from 18 wellbeing services counties, and HUS reports those waiting for access to specialised health care in the wellbeing services counties of Uusimaa. Helsinki also has some of its own specialised health care activity. After the introduction of the new data submission method, the data can also be presented by wellbeing services county in Uusimaa.
The data in the register on access to non-urgent specialised health care are based on notifications by data providers, and the correctness of the data depends mainly on the data received from them.
Data submitted by wellbeing services counties and HUS to THL are checked at aggregate level, and their correctness is verified when necessary. Missing data and data suspected to be erroneous are checked with the wellbeing services counties, and corrected data are requested to be submitted to the database.
In 2021, the instructions for the register were updated to improve reliability and to update the data content, including the addition of new specialties, among other things. Previous data collection instructions have been archived in electronic form.
The detailed data content of the register and variable-specific quality notes are available in the Data Catalogue.
Timeliness and punctuality
The statistical report on access to specialised health care is produced annually by THL. Data on access to specialised health care are published monthly in databases, and the statistical report at the annual level for the previous year is published in spring.
The data in the statistical report are based on access to care data reported during the previous calendar year. Wellbeing services counties submit data on access to specialised health care once a month on the agreed cross-sectional date, which is always the last day of the month. Those waiting for care per 10,000 inhabitants are obtained by combining data from the Digital and Population Data Services Agency (DVV) on the number of inhabitants in the area with access to care data.
Coherence and comparability
Data on access to specialised health care have been collected since 2007, when provisions on access to non-urgent care entered into force. The current form of data collection began in hospital districts in November 2007, when the situation at the end of October 2007 was requested. Primary health care units providing specialised health care have gradually been included in data collection since 2008.
Since 2013, data have been collected according to the same instructions by hospital district and are therefore comparable with each other until 2023. At the beginning of 2023, wellbeing services counties started operating, which began a new comparable statistical series. Instructions were slightly updated in 2021, including the addition of new specialties.
From 2023 onwards, data have been collected by wellbeing services county. In some areas, several hospital districts or primary health care units providing specialised health care were transferred under one wellbeing services county. The access to care data of wellbeing services counties consist of specialised health care hospitals and primary health care units providing specialised health care operating in the areas. System changes and version updates in patient information systems, as well as changes in data content, have caused temporary deterioration in data quality and missing data for certain periods. For primary health care units providing specialised health care, the situation varies because units have been removed from data collection and transferred under wellbeing services counties, and the figures are reflected in the figures of the wellbeing services counties.
Data concerning assessment of need for care are partly incomplete, because not all information systems and extraction programs include the waiting reason code: assessment of need for care. There are also problems in recording, because assessment of need for care is interpreted differently in different hospitals and is not an unambiguous concept. For the above reasons, data on assessment of need for care are not comparable.
Mandate
The collection of data is based on the Act on the Finnish Institute for Health and Welfare (688/2008). THL’s statutory task includes monitoring the health and welfare of the population. The Act also grants THL the right to utilise, among other things, the Population Information System in its duties.
The statistics on access to non-urgent specialised health care are part of the Official Statistics of Finland (OSF) series, and the production of statistics follows the European Statistics Code of Practice and OSF guidelines.
Data dissemination and publication
The statistical report and monthly updates of database reports are published on the statistics website. The publication date of the statistical report is indicated in the statistics release calendar. The data are released simultaneously to all users. Data are also published by wellbeing services county in the Sotkanet statistics and indicator bank.
Database reports on access to non-urgent specialised health care are published monthly on THL’s website. The database reports, i.e. tables and cubes, enable users to make their own selections and retrieve data from the register. In cubes and tables, it is possible to examine data by region, specialty, queue group and different waiting times at the monthly level.
Statistical products published by THL are public. However, register data containing personal data are confidential. The Social and Health Data Permit Authority Findata grants permits for the use of data based on the Act on the Secondary Use of Health and Social Data (552/2019).
Statistical data protection
The Finnish Institute for Health and Welfare, as an authority, has an obligation to report aggregated information related to health and welfare. The data used for compiling THL statistics are mainly confidential, and personal data must not be published. The protection of processed data is based on the Act on the Finnish Institute for Health and Welfare (688/2008), the Statistics Act (280/2004), the Act on the Openness of Government Activities (621/1999), the EU General Data Protection Regulation (EU) 2016/679, and the Data Protection Act (1050/2018).
THL’s data materials are protected at all stages of processing. Only those with a clearly defined right to use specific data for specific purposes have access to the data and information systems. Others do not have the possibility to view, process, modify or delete data. Written instructions have been prepared to ensure data protection of the final statistics. All THL staff have signed a confidentiality agreement.
The data on access to non-urgent specialised health care are at aggregate level, from which no individual-level data can be obtained. When data are submitted via the new data submission service, they will be at individual level, after which the register’s data protection notice will be available on the thl.fi online service.
Special issues in the 2025 statistics
In this report, regions are examined by wellbeing services county. HUS provides data on access to non-urgent specialised health care for the wellbeing services counties of Uusimaa, excluding specialised health care organised by Helsinki itself. However, HUS provides most of the specialised health care services in Helsinki as well. Helsinki has long had technical challenges in data submission, and its data have been completely missing since May 2021. Helsinki resumed submitting data on access to specialised health care at the beginning of 2025. In addition, data for the Ostrobothnia wellbeing services county are missing for the period between April and September due to issues in the patient information system. Data for Kanta-Häme are missing for January and February due to patient information system issues. In addition, the Central Ostrobothnia wellbeing services county does not use the waiting reason “assessment of need for care A” at all.
Various challenges in data submission and production continued during 2025. The challenges are related to the start-up of wellbeing services counties and the updating and integration of different systems. The number of primary health care units providing specialised health care has decreased during 2023–2025. Units have been reduced and their functions have been integrated into the specialised health care activities of wellbeing services counties. The access to care data produced by these units are reported as part of the data of the wellbeing services county.
A new data submission method, THL’s Data Submission Service, is being introduced for reporting data on access to specialised health care. The THL Data Submission Service (TTP) is a REST API-based service that can be used to submit datasets with different contents to THL. From the perspective of the data content, the service is generic, but the structural quality of the data is ensured by dataset-specific schemas. Certificates are used in the service both for user identification and connection encryption, and for encryption and signing of the transmitted data. The technical instructions of the TTP describe the use of the service from a technical perspective. According to THL’s administrative decision, wellbeing services counties must adopt it by 1 January 2028. Until then, data can be submitted using the currently used methods. During 2025–2027, access to care data will accumulate in two different forms. The old method has been aggregate-level data, and the new method consists of individual-level data. This means that reliable reporting of some indicators (e.g. median waiting days) will not be possible during the transition period. Median waiting days can be reported once all regions have transitioned to the new data submission method.
THL Data Submission Service – Technical instructions (in Finnish)
Submission of data from source system to THL (in Finnish)
THL Data Submission Service client application (in Finnish)