In the SoteDataLab project, we examined how many people—and what kinds of populations—live near health centres slated for closure. We identified 133 health centres that are either being closed or are planned for closure. These centres are the nearest health centre for about 860,000 Finns. The health centres to be closed serve, on average, smaller populations and are more often located in rural areas. The average population served by a closing health centre does not appear sicker or more disadvantaged than the population served by centres that will remain open—if anything, the opposite. The differences, however, are small. Therefore, we assess that, from the standpoint of digital-clinic use, the readiness and willingness to use digital services among the average population of a closing health centre is quite similar to that of the average population of a continuing health centre. 

Why are health centres closed?

Due to cost pressures, wellbeing services counties have decided to reform their primary healthcare service networks—that is, where and what kinds of services they provide to residents. A key factor in the background is that it has been harder to recruit healthcare staff to certain areas outside city centres than to the centres themselves. Likewise, maintaining and servicing facilities can create cost pressures, while centralized services are pursued for cost-efficiency and better quality of care. The services of health centres slated for closure are to be replaced with local service points of varying levels, mobile services, and digital services. Many wellbeing services counties have already decided to close several health centres, and in some areas—especially those that previously operated as joint municipal authorities—the service network had already been consolidated before the reform. By contrast, some wellbeing services counties are still planning changes, or their assessments describe a long-term target state for the service network.

Where are the health centers closed?

Figure 1 shows health centres in Finland and in the capital region on a map, grouping them by whether a closure is planned or not. Based on data collected in January, a total of 138 health centres were under threat of closure, while no closure plans were found for 357 centres. The health centres at risk are mainly in the southern and western parts of the country—west of the Treaty of Nöteborg border (Pähkinäsaari)—where the network of health centres has historically been denser than in Eastern and Northern Finland. 

It’s worth noting that classifying health centres by their risk of closure doesn’t tell the whole story. There have already been significant differences in opening hours and in the services offered at health centres, and these gaps may widen. Some wellbeing services counties may choose to keep sites open but seek savings by narrowing hours or service offerings—for example, having a doctor on site only on certain days. It sounds dramatic that the nearest health centre for about 860,000 Finns is under threat of closure. However, that high number can be misleading if those centres already had shorter-than-average opening hours and a more limited service range before any closure decision. Likewise, it’s likely that for some people, the next-nearest health centre that remains open is not substantially farther away than the previous one.

Figure 1: Where are the health centers closed? Health stations in Finland and the Helsinki metropolitan area on the map

Explanation: The map illustrates which health centres have been closed, are in the process of being closed, or may be closed, compared with the health-centre network as of September 2023. The information on centres to be closed was compiled in January 2025 by Visa Väisänen, with the primary source being the wellbeing services counties’ service network plans.

How do closed health centres differ from non-closed ones in terms of population base?

In Table 1 we find that:

• 133 health centres are being closed or possibly closed (hereafter we’ll refer simply to “closures”), while for 362 health centres we found no closure plans. The closures will directly affect at least about 860,000 Finns whose nearest health centre is slated for closure—16% of the population.

• The health centres slated for closure serve smaller-than-average populations: the average catchment population at centres to be closed was 6,400, whereas it was nearly double (12,200) at centres not facing closure. Note that “catchment population” was defined by each resident’s nearest health centre as the crow flies (i.e., not necessarily the nearest centre within their own wellbeing services county).

• The average health centre to be closed was more often located in rural areas than the average continuing health centre. The population base of the average health centre to be closed was in urban areas 31 %, while the population base of the average continuing health centre lived in an urban area 40 %.

• In terms of sociodemographic and socioeconomic background characteristics, the differences were small. Near the average health centre slated for closure, there were slightly fewer women, somewhat fewer people who had been unemployed during the year (8.0% vs. 9.0%), and slightly fewer people over age 80 than near the average health centre that will remain open. In the catchment of the average closing centre, median incomes were higher (€30,900 vs. €30,000), the share of the lowest income quintile was slightly smaller, and the proportion with a tertiary degree was slightly lower.

• Regarding morbidity, the differences were small—but in the direction that the shares of people with common chronic diseases and those with multiple conditions were, on average, lower at health centres under threat of closure compared with those that will remain open.

• Regarding use of health services, the findings are interesting—though the differences are small, as with morbidity. The population of the average health centre slated for closure uses fewer public primary-care services and less remote care in specialized healthcare, but has more in-person visits in private outpatient care and more both in-person and remote visits in occupational healthcare.

Table 1: How do closed health stations differ from non-closing ones in terms of background characteristics of the population base?

In light of the results, it appears that the health centres to be closed are smaller than average and more often located in rural areas according to the urban–rural classification. From an equity perspective, it is reassuring that the population of the average closing health centre does not appear sicker or more disadvantaged than that of centres that will remain open—if anything, the opposite. As a general observation, the differences seem quite small aside from the urban–rural dimension. Thus, from the standpoint of digital-clinic use, we assess that the readiness and propensity to use digital services among the average population of a closing health centre is fairly similar to that of the average population of a continuing health centre. However, we suspect there is considerable variation between individual health centres—both among those closing and those remaining open—and we will investigate this next.

On the follow-up study

In the SoteDataLab project, we will continue examining what kinds of people live near health centres slated for closure and whether their background characteristics predict high or low use of digital-clinic services. A preliminary finding is that there is considerable variation between health centres in the share of residents predicted to use a digital clinic, if one is available. What kinds of people live near those health centres where only a small share of residents are expected to use a digital clinic? That is what we aim to answer next.

In addition, THL is running a project to study the effects of the closures of health centres in the 2010s on the service use and health outcomes of people living near closed health centres (contact information: Konsta Lavaste, konsta.lavaste@thl.fi).

NB! Number of health stations to be closed corrected afterwards (1.4.2025). Map and table updated. The number of health stations to be closed had previously been reported to be 138.

What is a digital clinic? Read our blog: https://sotedatalab.fi/uutinen/digiklinikka-muuttamassa-julkista-perusterveydenhuoltoa/

What are the differences between digital clinic solutions in wellbeing services counties? Read our blog: https://sotedatalab.fi/uutinen/tuoko-digiklinikka-tuottavuuskasvua/

Who uses digital clinics? Read our blog: https://sotedatalab.fi/uutinen/julkisen-avosairaanhoidon-digiklinikka-asioinnin-osuus-on-ollut-suurin-pienilla-lapsilla-nuorilla-aikuisilla-naisilla-ja-tulojakauman-ylapaassa/

Category: Bloggers

Tapio Haaga, Aurora Morén, Visa Väisänen (THL), Alex Kivimäki, Vivi Mauno and other SoteDataLab team (lots. What is Kortelainen, Oskari Nokso-Koivisto, Tanja Saxell and Lauri Sääksvuori).

We thank our THL colleagues who commented on our work (Konsta Lavaste, Markku Satokangas and Tiina Hetemaa).