Voices behind indicators for welfare and healthcare in Finland

The voices of different kinds (i.e., stated or unstated expectations of the entities) affect the functioning of the systems. Voices of authorities (VoA), processes (VoP) and shareholders (VoS) are seen in controls interacting with an environment. Therefore, control-related indicators are prescriptive, and they provide expectations for the functioning of the systems. In the study, the entity-related approach of the voices (VoA, VoP, and VoS) adapted to formalize rules for the evaluation metadata of the KUVA and SOTKANET indicators the meaning of which is to control welfare and health in Finland. The KUVA indicators are meant to control especially cost-effectiveness. The region classifications of the KUVA and SOTKANET indicators used to figure out whether responsible information providers (VoP) and information consumers (VoA and VoS) can be established. When 15 region classifications mapped within the voices by the nine rules the result of which was that nine region classifications mapped within VoA, three within VoS, and two within VoP. The main information providers are municipalities and hospital districts and municipalities. Despite our metadata-based KUVA and SOTKANET content research, without the deployment instructions of the indicators, the municipalities and other service providers do not get a complete picture of how the authorities and shareholders see them and what is expected of them, i.e., control-related cost-effectiveness will not be transparent.The voices of different kinds (i.e., stated or unstated expectations of the entities) affect the functioning of the systems. Voices of authorities (VoA), processes (VoP) and shareholders (VoS) are seen in controls interacting with an environment. Therefore, control-related indicators are prescriptive, and they provide expectations for the functioning of the systems. In the study, the entity-related approach of the voices (VoA, VoP, and VoS) adapted to formalize rules for the evaluation metadata of the KUVA and SOTKANET indicators the meaning of which is to control welfare and health in Finland. The KUVA indicators are meant to control especially cost-effectiveness. The region classifications of the KUVA and SOTKANET indicators used to figure out whether responsible information providers (VoP) and information consumers (VoA and VoS) can be established. When 15 region classifications mapped within the voices by the nine rules the result of which was that nine region classifications mapped within VoA, three within VoS, and two within VoP. The main information providers are municipalities and hospital districts and municipalities. Despite our metadata-based KUVA and SOTKANET content research, without the deployment instructions of the indicators, the municipalities and other service providers do not get a complete picture of how the authorities and shareholders see them and what is expected of them, i.e., control-related cost-effectiveness will not be transparent

Common controls driven conceptual leadership framework

The forthcoming social welfare and healthcare reform in Finland with its organizational, financing and steering changes challenges the leadership. All service systems levels of the social welfare and healthcare have to achieve performance objectives whilst at the same time also meeting conformance requirements. However, there are hundreds authority documents (e.g., best practices, guidelines, regulations and standards) the common controls of which are adapted partly manually and partly by leveraging automation in organizations. Leaders review and develop their practices around performance and conformity (i.e., conformance or compliance) within frameworks that are mainly the sets of principles. However, the common controls affect into the main tasks of the governance (i.e., direct, evaluate and monitor). Therefore, we construct a conceptual leadership framework to highlight the meaning of the common controls and the meaning of criteria for performance and conformity. The constructed framework contains the terms (e.g., a control objective, decision criteria, event, insight, and transaction) that are mainly defined in the glossaries of the authority documents. The terms are used to find out terms and definitions for the leadership framework to figure out cognitive meanings for the concepts of the common controls driven leadership

Variations in the length of stay of intensive care unit nonsurvivors in three scandinavian countries

Introduction: The length of stay (LOS) in intensive care unit (ICU) nonsurvivors is not often reported, but represents an important indicator of the use of resources. LOS in ICU nonsurvivors may also be a marker of cultural and organizational differences between units. In this study based on the national intensive care registries in Finland, Sweden, and Norway, we aimed to report intensive care mortality and to document resource use as measured by LOS in ICU nonsurvivors. Methods: Registry data from 53,305 ICU patients in 2006 were merged into a single database. ICU nonsurvivors were analyzed with regard to LOS within subgroups by univariate and multivariate analysis (Cox proportional hazards regression). Results: Vital status at ICU discharge was available for 52,255 patients. Overall ICU mortality was 9.1%. Median LOS of the nonsurvivors was 1.3 days in Finland and Sweden, and 1.9 days in Norway. The shortest LOS of the nonsurvivors was found in patients older than 80 years, emergency medical admissions, and the patients with the highest severity of illness. Multivariate analysis confirmed the longer LOS in Norway when corrected for age group, admission category, sex, and type of hospital. LOS in nonsurvivors was found to be inversely related to the severity of illness, as measured by APACHE II and SAPS II. Conclusions: Despite cultural, religious, and educational similarities, significant variations occur in the LOS of ICU nonsurvivors among Finland, Norway, and Sweden. Overall, ICU mortality is low in the Scandinavian countries