The reduction in the coverage of the health centre network is a recurring topic of discussion. If health centres are shut down, where would it have the least harmful consequences? Or where should we move health centres to ensure that they are accessible to as many people as possible?
A key to solving this is geographical data, which makes it possible to calculate the accessibility of practically any site. The SOLOGS project of the University of Oulu researches the most reasonable way to organise social and health care services in Northern Ostrobothnia from the viewpoint of accessibility.
“In accessibility analysis, we can comprehensively take into account different variables, such as the kilometres travelled, speed limits, costs, junctions that slow you down...” says Ossi Kotavaara, research director from Kerttu Saalasti Institute at the University of Oulu. “We focus on the ease of travelling and travel time, but we also pay attention to low carbon levels.”
The aim to reduce carbon dioxide emissions does not clash with the accessibility of services, says Timo Pohjosenperä, SOLOGS Project Manager at the Oulu Business School at the University of Oulu.
“If health services are easily accessible and goods can be transported on site with reasonable effort, it will result in low carbon levels quite automatically.”
The other key theme of SOLOGS is the movement of goods, or material transport logistics related to health services. The research results of both themes are not complete yet, but some preliminary findings are already available.
Services on the road?
First of all, accessibility in rural areas is mainly based on car traffic. “Public transport in rural areas is not in such great shape that we could build services reliant on it”, says Pohjosenperä.
On this basis, the health service network in Northern Ostrobothnia looks surprisingly good, Kotavaara states. “Accessibility in the northern parts of Yli-Ii and Kuusamo, mostly, could be improved by adding more health centres. And when we look at accessibility as a whole, small health centres in the south of the region have the least significance.”
The next topic of clarification is whether some health centres are so easily accessible that they could incorporate more services, such as specialised health care. This would reduce the number of visits to the Oulu University Hospital, which currently provides specialised health care in Northern Ostrobothnia.
The question is related to SOLOGS’s third key theme, mobile services. If, for example, an orthopaedist would make the rounds in the region and see twenty patients a day, how would they reach out to the biggest number of potential customers?
The results are not yet ready, but there is a non-exhaustive calculation concerning the region Koillismaa: 15 service vehicle routes would halve the number of kilometres travelled, travel times and carbon dioxide emissions. However, this applies to primary health care, and customer numbers would be small.
The profitability of mobility is, of course, also impacted by other factors, such as the equipment needed in different services and service costs. Experts of health care should reflect on this in more detail, as they can also take into account the content requirements of the services.
Unlike in rural areas, public transport in Oulu has a key position in terms of accessibility. “80 per cent of the region’s population is able to access health services in half an hour with a bus or light traffic”, Kotavaara says.
Still, there is room for improvement. “By no means are all health centres located on public transport routes. For example, in the districts of Tuira and Haukipudas, bus stops are not very close to health centres.”
Researchers also point out that accessibility as a whole would improve in Oulu if there were two or three additional health centres. The district of Maikkula would be great from the viewpoint of drivers, and when public transport users are included in the calculations, Korvensuora and Jääli emerge as possible locations.
Towards integrated transports
With regard to the theme of material logistics, researchers calculated two extreme examples: in the first one, dedicated transport vehicles of health centres go pick up supplies from the central warehouse in Oulu; in the second, a distribution vehicle makes the rounds and visits different health centres once a week.
The first example is not imaginary. “Many health centres organise their transport themselves”, Pohjosenperä says. “I don’t know the reason. Could it be that basic health care is not the responsibility of the hospital district, but the municipalities’?”
In any case, in this example, the total savings in kilometres and travel time incurred by a touring transport vehicle would amount to approximately 70 per cent. Carbon dioxide emissions would be reduced by just under 40 per cent.
“An algorithm helps make the distribution routes as efficient as possible. Five routes would be enough for Northern Ostrobothnia.”
Such activity would require that all the actors operate more systematically and predict what kind of needs will arise. This could impact other activities as well because a more streamlined delivery of goods would give health care personnel more time to focus on their own duties.
“I argue that development based on location data could help increase cost-effectiveness and improve services”, Pohjosenperä says in conclusion. He believes that the results, which will be ready soon, will be impactful.
“It looks like joint municipal authorities, hospital districts and companies belonging to SOLOGS interest groups are craving information. There are lots of questions coming in.”
Text: Jarno Mällinen
Photos: Juha Sarkkinen. Main photo: Timo Pohjosenperä (on the left) and Ossi Kotavaara.
Funding partners of SOLOGS-project are Council of Oulu Region, European Regional Development Fund (ERDF), Coronaria Hoitoketju Oy, Northern Ostrobothnia Hospital District, City of Oulu, Oulunkaaren kuntayhtymä, Kallion peruspalvelukuntayhtymä, Peruspalvelukuntayhtymä Selänne, Sosiaali- ja terveyspiiri Helmi and NordLab.
Last updated: 11.12.2019