Evidence map›Paper›PMID 40148965›Full record

ArticleBMC health services research2025

Change of primary health care service provider model in Vantaa: the impact on mortality and causes of death among older adults - a register-based follow-up study.

Aina Enckell, Hanna-Maria Roitto, Hannu Kautiainen, Mika T Lehto, Kaisu H Pitkälä, Timo Kauppila, Merja K Laine

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Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Aina EnckellDepartment of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. aina.enckell@helsinki.fi.ORCID http://orcid.org/0000-0001-9845-3152
Hanna-Maria RoittoDepartment of Medicine, Clinicum, University of Helsinki, Helsinki, Finland.ORCID http://orcid.org/0000-0002-5466-2873
Hannu KautiainenDepartment of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.ORCID http://orcid.org/0000-0003-0786-0858
Mika T LehtoDepartment of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.ORCID http://orcid.org/0000-0001-7315-2118
Kaisu H PitkäläDepartment of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.ORCID http://orcid.org/0000-0001-9659-6985
Timo KauppilaDepartment of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.ORCID http://orcid.org/0000-0002-6155-0300
Merja K LaineDepartment of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.ORCID http://orcid.org/0000-0002-1848-1514

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAccess to primary health care (PHC) has declined in Finland in recent years. To address this, the city of Vantaa, Finland, transitioned from a named general practitioner (GP) model to a restricted-list GP model in 2011 to increase access to named GPs for the most vulnerable population. This study evaluates the impact of this model change on mortality rates and causes of death among older adults.

methodsThis register-based follow-up study was conducted in Vantaa, Finland, using data from the electronic health records. The study included all patient contacts aged 75 and older between 1 September 2004 and 31 August 2018. The primary outcome was the Standardised Mortality Ratio (SMR). We calculated excess deaths and examined cause-specific mortality trends before and after the restricted-list GP model implementation.

resultsDuring the study period, 32,034 PHC contacts were recorded. The SMR remained stable during the named GP model years but began to decrease during the restricted-list GP model, falling below expected levels from 2016 onward. Excess deaths decreased from 615 in 2004 in the named GP model to -29 by 2018, when the restricted-list GP model was in operation. Leading causes of death were circulatory diseases (41.1%), cancers (20.4%) and neurological conditions (17.8%), with a decrease in circulatory disease deaths and an increase in cancer and dementia-related deaths over time.

conclusionsThe transition to the restricted-list GP model was associated with a lower SMR and fewer excess deaths in older adults. These findings highlight the importance of ongoing assessment of PHC models to ensure they meet evolving healthcare demands.

Indexed as

Health Services AccessibilityMortalityPrimary Health CareAgedAged, 80 and overCause of DeathFemaleFinlandFollow-Up StudiesGeneral PractitionersHumansMaleRegistriesAccess to careCause of deathFollow-up studyGeneral practitionerMortalityNamed general practitionerPrimary health care

Identifiers

PMID40148965
PMCPMC11951805

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.