Perceived health and cause-specific mortality among Finnish men and women aged 30 and over

Perceived health is strongly associated with subsequent mortality, but the causes of this association are not known. The purpose of the paper is to analyze the association between perceived health and mortality after controlling for sociodemographic characteristics, and to estimate whether the association varies by cause ofdeath. The study analyzed data from the Mini-Finland Health Survey, a nationally representative sample of 7,217 adults aged 30 and over in 1978-1980. A 12-year mortality follow-up was established by record linkage to death certificates at Statistics Finland. The study showed that perceived health was very strongly associated with mortality after sociodemographic adjustments; men reporting fairly poor or poor health had a 2.41 (95% confidence interval 1.96-2.96) times higher adjusted mortality than men reporting fairly good or good health. Among women, the corresponding relative risk was 1.71 (95% confidence interval 1.37-2.15). The strength of the association varied by cause of death. Future attempts to better understand the association between perceived health and mortality should begin at the cause-specific level. The explanations for the association are likely to vary for different diseases and causes of death

Sickness absence trends during and after long-term psychotherapy and antidepressant medication among depressive employees

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The Finnish experience to save asthma costs by improving care in 1987-2013

The Finnish National Asthma Program 1994-2004 markedly improved asthma care in the 1990s. We evaluated the changes in costs during 26 years from 1987 to 2013. Direct and indirect costs were calculated by using data from national registries. Costs from both the societal and patient perspectives were included. The costs were based on patients with persistent, physician-diagnosed asthma verified by lung function measurements. We constructed minimum and maximum scenarios to assess the effect of improved asthma care on total costs. The number of patients with persistent asthma in the national drug reimbursement register increased from 83,000 to 247,583. Improved asthma control reduced health care use and disability, resulting in major cost savings. Despite a 3-fold increase in patients, the total costs decreased by 14%, from (SIC)222 million to (SIC)191 million. Costs for medication and primary care visits increased, but overall annual costs per patient decreased by 72%, from (SIC)2656 to (SIC)749. The theoretical total cost savings for 2013, comparing actual with predicted costs, were between (SIC)120 and (SIC)475 million, depending on the scenario used. The Finnish Asthma Program resulted in significant cost savings at both the societal and patient levels during a 26-year period.Peer reviewe