Current research

Kela carries out research on the benefit systems it operates, Kela’s internal operations, general health security and rehabilitation. Brief summaries of our key current research projects follow, arranged by subject area.

Family benefits

Labour markets and income security

Pensions

Private medical and dental services

Medicines

Sickness allowances

Rehabilitation and work ability

Kela's services and operations and the implementation of social security

Social security system:

Health insurance

Income security

FAMILY BENEFITS
Families with children

The focus of the research project is on mothers who have given birth in or after the year 2000 and on their families. The bulk of the data consists of a 60% sample of mothers who gave birth in 1999–2009. Included in the data is information about the benefits available from Kela and spells of benefit receipt as well as background information derived from the Statistics Finland labour force survey. Corresponding data are available for spouses. The data are representative and are used both for cross-sectional and longitudinal analyses. The longest follow-up period allowed by the data is 10–11 years.

The project seeks 1) to shed light on the connections between family leave reforms and the sharing of family leaves between the spouses and the labour market status of mothers and fathers; 2) to produce more detailed information on families with children who have thus far not been received much research attention or who form such a small sub-group as to make them impracticable to study; and 3) to assess to what extent various features of employer companies can explain the use of family leaves and and the distribution of paid leaves.

Project publications.

Working papers::

Publications and blogs related to the project:

  • Jussi Tervola: Maahanmuuttajien kotihoidon tuen käyttö 2000-luvulla. (Take-up of home care allowance among immigrant mothers in the 2000s.) Yhteiskuntapolitiikka 2015 80:2, 121–133. Permanent address of the publication: http://urn.fi/URN:NBN:fi-fe201504162727
  • Anita Haataja: Kotihoidon tuki kehittyy omaan tahtiinsa Pohjoismaissa. Sosiaalivakuutus 17.03.2016. (Home care allowance develops at its own pace in the Nordic countries.)
  • Anita Haataja and Miia Saarikallio-Torp: Korvamerkityt rahat kannustavat isiä vapaille. (Earmarked approriations encourage fathers to take parental leaves.) Sosiaalivakuutus 17.03.2016.
  • For issues related to the informal care of a sick child, see also the article by Johanna Hytönen: Hoivan ja tasa-arvon vaikea yhtälö. Sosiaalivakuutus, 17.03.2016. (The difficult equation between caring and equality.)
  • Jussi Tervola: Kotihoidon tuki vai kotouttaminen? Sosiaalivakuutus, 19.05.2016. (Home care allowance or integration?)
  • Jussi Tervola, Ann-Zofie Duvander, Eleonora Mussino: Promoting parental leave for immigrant fathers – what role does policy play?  Stockholm Research Reports in Demography 14, 2016.
  • Tapio Räsänen: Uusien äitien paluu työuralle – syitä pitkiin perhevapaajaksoihin. (Return to work among mothers with infants: about the reasons behind long periods of parental leaves.  Research blog, posted 29.02.2016. http://blogi.kansanelakelaitos.fi/arkisto/3382.

Cooperation partners: Statistics Finland, Kela Actuarial & Statistical Department and IT Department, National Institute for Health and Welfare (THL) and the VATT Institute for Economic Research.

Additional information: Miia Saarikallio-Torp, tel. +358 20 634 1968, firstname.surname@kela.fi

Family leaves 2013 – a population survey

The project aims to explore the use of family leaves among parents of small children. The purpose is to examine the experiences and opinions of parents concerning parental leaves and child home care leaves, the use of family leaves by fathers and the reconciliation of family and working life in families with children.

The study material was collected by means of an online questionnaire survey targeting mothers and fathers of children born in 2011. For the survey, the respondents were sampled from Kela’s registers and the material collection took place in autumn 2013.  The data obtained from Kela’s registers are used to supplement the questionnaire data.

The study is the continuation of a questionnaire study conducted in 2006 and is implemented jointly with the National Institute for Health and Welfare (THL). At Kela Research, the questionnaire has been utilised in the abovementioned ‘Families with children’ project and related publications.

In addition to the population survey, two specifically targeted surveys were carried out.  The ‘Multiple-birth families’ survey was targeted to mothers who had given birth to twins or triplets in 2011, and the ‘Young mothers’ survey, correspondingly, to mothers aged under 22 who had given birth in 2011.   Separate reports will be published on the Multiple-birth families and Young mothers surveys.

Family leave study on the THL website: Family leaves, financial crisis and gender equality (Perhevapaat, talouskriisi ja sukupuolten tasa-arvo)

The following persons from Kela Research were involved in the project: Anita Haataja, Ulla Hämäläinen, Vesa-Pekka Juutilainen, Miia Saarikallio-Torp (on leave of absence).

Publication:

Additional information: Miia Saarikallio-Torp (on leave of absence), tel. +358 (0)20 634 1968,  firstname.lastname@kela.fi

Child care arrangements in families with children in Helsinki in the 2010s (HELA)

Information concerning child care arrangements in families is readily available for those parents and children that are receiving family leave benefits from Kela. In contrast, there are no individual or family level statistics on the use of early childhood education services. How many families are using early childhood education services and how does the family structure affect the choices? What kind of child care paths do children have before they start school? How does a long-term illness of either the child or parents affect the choices? What kind of child care arrangements are made in families when the number of children in the family increases, or when one or both parents are unemployed or work part-time, either voluntarily or due to the lack of full-time work?

The research project HELA aims to find answers to the aforementioned questions. The first task is to compile research material which, for the first time, utilises longitudinal data both on the use of early childhood education services and on other child care solutions made by families.

The research material is constructed by combining data on children in day care in the years 2008–2015, as obtained from the Department of Early Education and Care of the City of Helsinki, and data on all families with children in Helsinki. The material will be updated during the project until the year 2017. In addition, the combined research material will include data on the families’ incomes, including the family leave benefits paid by Kela, other income and income transfers, as well as unemployment periods.

Project publications.

The project is conducted in cooperation by Kela Research, City of Helsinki Urban Facts and City of Helsinki Early Education and Care. The research is a part of the consortium projects ‘Tackling Inequalities in Time of Austerity (TITA)’ and ‘Work, Inequality and Public Policy (WIP)’, which are funded by the Strategic Research Council at the Academy of Finland.

The following persons from the various parties are involved in the HELA project: Anita Haataja, Karoliina Koskenvuo, Maria Valaste and Miia Saarikallio-Torp from Kela Research and Sanna Ranto and Hanna Ahlgren-Leinvuo from City of Helsinki Urban Facts.

Contact information firstname.lastname@kela.fi for Kela and firstname.lastname@hel.fi for City of Helsinki Urban Facts.

Survey on family leaves and the maternity package

Since 1999, Kela has conducted a variety of surveys to analyse clients’ experiences of the maternity package. Carried out in 2017, the survey on family leaves and the maternity package is the 10th study on the topic. 

It looks at the experiences and opinions of families that received a maternity package in 2015 or 2016 concerning the quality of the items in the package and how essential they are, and invites parents to say what changes they would like to see in the package. The survey also explores mothers’ views on the alternative family leave models that have been proposed in recent years.

The survey is based on questionnaire data collected electronically in April 2017. A total of 855 mothers completed the questionnaire, which was 36% of those who were sent it. Findings concerning the maternity package have been reported directly to Kela’s Family Benefits Section, which will use them to develop the maternity package further. 

Findings concerning a possible family leaves reform have been reported in Kela’s Research blog. More detailed results will be reported later.

Survey results:

Earlier publications:

Additional information: Hanna-Mari Heinonen, tel. +358 20 634 0372, firstname.lastname@kela.fi

LABOUR MARKETS AND INCOME SECURITY

Social assistance and housing costs

The purpose of the study is to offer new information in support of decision-making about recipients of social assistance, particularly their housing and employment situation. We also assess how up-to-date the social assistance scheme is and how well it serves its purpose. The project is divided into four subprojects, which focus respectively on: 1) Recipients of social assistance, 2) Housing costs, 3) Combining social assistance and employment, and 4) Evaluation of the social assistance scheme. The project is part of the Government’s analysis, assessment and research activities.

Cooperation partners: VATT Institute for Economic Research; University of Helsinki, Discipline of Social and Public Policy

Project schedule: February 2018–February 2019

Additional information: Signe Jauhiainen, firstname.lastname@kela.fi

Study on housing benefit recipients and the impact of changes made in the benefit system

The purpose of the study is to offer new research-based information on housing benefits to support decision-making. The projects looks at recipients of housing benefits, their income and housing costs, trends in housing benefit expenditures, and the impact of changes made in the housing benefits system. Particular attention is given to the duration of housing benefit spells and to persons with a long history of receiving housing benefits.

The study includes a literature survey that compares the findings on the housing benefits system with the systems in other countries. The benefit systems should also be considered in the context of the housing market and social security system in a country. Interviews with a number of major landlords are conducted as part of the project. They are designed to discover what the landlords think of the housing benefits system.

The study also investigates whether the transition of students from a separate student housing benefits scheme to the general housing allowances scheme has brought changes to students’ housing situation. Following this transition, which took place on 1 August 2017, some students received a higher rate of benefit while others were left without benefit. The changes studied are choice of housing, housing costs and change of residence.

The study draws on individual-level register data on households that were paid housing benefits in 2013–2016. The data covers factors that are relevant to housing benefits such as housing costs, income and household size. Data on types of housing and various background factors describing households are used as well. The data are analysed by statistical means.

Project schedule: May 2017–May 2019

Contact person: Signe Jauhiainen, firstname.lastname@kela.fi

Wellbeing of recipients of Kela-provided unemployment benefits in 2017: A phone survey

Kela Research will conduct a phone survey in January 2017 in cooperation with Taloustutkimus Oy. Recipients of Kela-provided unemployment benefits are interviewed in the survey, which gathers information on their wellbeing in 2017.

The project is headed by professor Olli Kangas, director of government and community relations at Kela. Also involved in the study are research professor Annamari Tuulio-Henriksson and principal researcher Minna Ylikännö of Kela Research. The study is carried out with the participation of the Finnish Association for Mental Health.

A random sample of 1,000 persons who in November 2016 received unemployment benefit payments from Kela were selected for the study. Participation is voluntary and declining the interview has no negative consequences for the persons’ other interactions with Kela.

The phone interviews are the sole source of data used in the study. The researchers have no prior information on the participants concerning their identity or their prior benefit history with Kela.  The researchers are only provided with the participants’ answers to the survey, without names or other identifying details. The numerical data created cannot be used to identify individuals, nor can information about them be combined with individual-level register data held by Kela.

The participants are asked about their wellbeing, health, finances and satisfaction with various areas of life. Findings will be reported extensively and can be used in labour market policy decision-making or in planning changes to the unemployment benefits system. 

Cooperation partners: The Finnish Association for Mental Health

Additional information: Minna Ylikännö, firstname.lastname@kela.fi

PENSIONS

The direction of pension security

The project entitled ‘The direction of pension security’ aims to provide updated and new information about the realisation, sufficiency and development of pension security in various groups, such as women and men, different age groups, or the recipients of minimum pension security, survivors’ pension and disability pensions. Another area of interest is the citizens’ opinions concerning a good and fair pension system and the pension reform in 2017.

As part of the project, a population survey will be conducted that utilises the ISEA (International Survey of Economic Attitudes) survey questions concerning opinions and attitudes related to pension security. This facilitates the comparison of changes that have taken place in opinions and attitudes in Finland over the course of two decades. The study concerning the pension reform 2017 is conducted in cooperation with the Finnish Centre for Pensions (ETK).

Project period: 1 September 2015–31 December 2018.

Additional information: Ilpo Airio, tel. +358 20 634 1954 and Karoliina Koskenvuo, tel. +358 20 634 1355, firstname.surname@kela.fi

The impacts of survivors’ pension on welfare

The project aims to analyse the role of survivors’ pensions in terms of subsistence and health, thereby facilitating the evaluation of the risks possibly included in the suggested plans to renew the survivors’ pension system. Moreover, the project aims to explore citizens’ opinions about the survivors’ pension security, by utilising the questions about widow(er)’s pension security from the survey material completed in early 2016 (the material was collected jointly with the ‘Direction of pension security’ project).

Project period: 25 March 2014–31 December 2017.

Additional information: Karoliina Koskenvuo, tel. +358 20 634 1355, firstname.surname@kela.fi

Time and processes before disability pension

The study is being undertaken jointly by the Finnish Centre for Pensions (ETK) and Kela for the purpose of investigating the factors contributing to retirement with disability pension. In order to understand the process that leads to disability pensioning and in terms of possible preventive measures, it is important to investigate the routes and mechanisms within the different social security systems through which individual persons end up becoming recipients of disability pension. The objective is, in particular, to identify those stages of the process before disability pensioning in which the process might take a different turn and enable one’s return to working life. The study will produce topical register-based data on those factors that help in recovering one’s work ability and return to work after a sickness leave. The subjects’ health status, unemployment periods, sickness leaves as well as earlier pension and rehabilitation decisions before the application for disability pension are examined for the study. The material is comprised of extensive register-based material on working-age population, including data sampled from different registers.

Cooperation partners: The Finnish Centre for Pensions

Additional information: Jenni Blomgren, tel. +358 20 634 1893, firstname.surname@kela.fi

PRIVATE MEDICAL AND DENTAL SERVICES

New operating models in dental care

The project is comprised of three studies, the first of which looks at results from a partnership project between private and municipal dental care providers. The study explores the use of dental services by patients in the private sector, the procedures performed and the cost of the procedures. The procedures and costs of the patients covered by the partnership project are compared against the procedures and visits of other private-sector patients.

The second study looks at the operations of different companies in the dental care market, and at how changes in the market impact the procedures performed on patients, the treatment practices, and the frequency of service use. The third study investigates the impact of a voucher trial on national health insurance reimbursements for dental costs and the pricing practices of service providers in Helsinki.

Data are obtained from Kela’s register on reimbursements for medical expenses covering the years 2008–2015. Suitable statistical methods are used to analyse the data.

Additional information: Hennamari Mikkola, tel. +358 20 634 1890 , firstname.lastname@kela.fi and Merja Komu, tel. +358 20 634 1959, firstname.surname@kela.fi

MEDICINES

Changes in the special reimbursement status of Type 2 diabetes medications on the use of the medication and the take-up of social assistance

At the beginning of 2017, medications for type 2 diabetes were transferred from the higher special reimbursement category with a reimbursement rate of 100% to the lower special reimbursement category, in which reimbursements are available at a rate of 65%.

The purpose of this study is to investigate the impact of changes in the special reimbursement status of Type 2 diabetes medications on the patients’ overall use of medication. A secondary objective is to look at trends in the share of costs for pharmaceutical treatment of patients with Type 2 diabetes that are covered out of social assistance funds following the 2017 change in the special reimbursement status, and to see whether they differ from trends seen in social assistance supported pharmaceutical treatments in suitable comparison populations.

Additional information: Hanna Rättö, tel. +358 20 634 1980, firstname.surname@kela.fi

Drug reimbursement system and social assistance

No comprehensive data is available on medicine costs covered out of social assistance payments prior to the transfer of administrative responsibility for basic social assistance to Kela at the beginning of 2017. This study looks at costs of pharmaceutical treatment covered out of basic social assistance and the types of treatment and pharmaceuticals most typically targeted by the assistance. The study also examines how medicine expenses affect the need for social assistance and how the transfer of administrative responsibility to Kela has impacted the amount and selection of pharmaceuticals covered out of social assistance. The project will be carried out in 2018–2021.

Additional information: Heini Kari, firstname.lastname@kela.fi

Family care and use of medicines

The project explores medicine use by family care providers based on data from Kela’s register of reimbursements for prescription medicines. Substudy 1 looks at purchases of psychoactive medications by family care providers and care recipients in the city of Oulu in 2013. Substudy 2 focuses on prescription drug purchases by family care providers across Finland.

Additional information: Päivi Tillman, tel. +358 20 634 1927

Medicine reimbursement system: assessing the development and savings measures

According to the Government Programme, the expenditure for medicine reimbursements shall be reduced by a total of 134 million euro in 2017 on top of the already realised savings. This development project involves an assessment of the proposed savings measures, which will serve as background support for the decision-making process. Other aims of the project are to further develop the simulation tool in use and to produce data that can be utilised in the development of the medicine reimbursement system. The study covers the years 2016-2018.

Additional information: Jaana Martikainen, firstname.lastname@kela.fi

Follow-up of changes to medicine reimbursements in 2016

As of the start of 2016, several changes were made to the system of medicine reimbursements for the purpose of reducing the expenditure from medicine reimbursements (Government proposals 330/2014, 106/2015 and 128/2015). Changes with a direct effect on the patient’s out-of-pocket payments included the introduction of an annual initial deductible (non-reimbursable sum), the increase of the compensation percentage in the basic refund category and the increase of fixed deductibles. The aim of the study is to evaluate the influence of these changes, which became valid in 2016, on the deductibles paid by the patients, their purchasing behaviours and the medicine reimbursements within the sickness insurance system. The changes are analysed at a general level from the perspectives of both the sickness insurance system and patients, and also at a more detailed level specifically for different patient and population groups on the basis of data on special refund entitlements as well as on socioeconomic and demographic factors. Another objective of the study is to produce data for comparison with the results obtained by advance simulations in order to further develop and validate the simulation method.

The study is a sub-study (WP3.4) in the TITA consortium project coordinated by the University of Turku and funded by the Strategic Research Council at the Academy of Finland. The project aims, among other things, to evaluate the impacts of the initial deductible, which was introduced in 2016, analysed by patient groups and socio-demographic factors.

Additional information: Katri Aaltonen, firstname.lastname@kela.fi.

Factors underlying the increase in the expenditures for prescription medications

The expenditures for prescription medications have increased continuously in Finland over the last few decades. The project analyses the factors behind this increase in selected drug categories between 1998-2005. The analysis is planned to encompass antidepressants, antipsychotics, anti-infectives and non-steroidal anti-infective painkillers. The range of drugs may be expanded or changed as necessary. The research data will be collected from the prescription register maintained by Kela and the register of medical specialisations.

The study began in 2006. Articles will be published as the study proceeds.

Cooperation partners: Kela IT Department.

Additional information: Hanna Koskinen, firstname.lastname@kela.fi

The impact of a reference pricing system and stepwise discounted prices on the prices of generic medicines

Promotion of generic substitution and increased price competition are widely used methods for the purpose of containing the rise in medicinal costs. In Finland, like many other European countries, attempts have been made to indirectly reduce the prices of generic medicines by means of generic substitution and reference pricing. Austria is an example of a country where the government directly influences the prices of generic medicines. In Austria, the price of the first generic product must be at least 48% lower than the price of the original medicinal product, and the price of the second generic product 15% lower than the price of the first generic product.

The study aims to compare the volume of generic products and the prices of generic vs. original products in Finland and Austria. The study is jointly carried out in cooperation with the WHO Collaborating Centre for Pharmaceutical Pricing and Reimbursement Policies unit in Vienna, Austria.

Additional information: Jaana Martikainen, firstname.lastname@kela.fi

Use of ADHD medication in the Nordic countries

In 2007, the frequency of the use of ADHD medicines varied considerably across the Nordic countries. In Finland, the use was the least. According to preliminary information, it appears that the use of ADHD medicines has rapidly expanded in countries where they were previously used to a limited extent. The purpose of the study is to compare the frequency and forms of use of ADHD medicines in the Nordic countries in 2007–2012. The study is a collaborative project involving Kela in Finland, the Norwegian Institute of Public Health, the Southern University of Denmark, the University of Iceland, and the Karolinska Institute in Sweden.

Additional information: Jaana Martikainen, firstname.lastname@kela.fi

Medicine costs in integrated social and health services – Case EKSOTE

The study aims to evaluate, within the South Karelia Social and Health Care District (Eksote), how the integration of social and health services and the transfer of the responsibility for the provision of the services from municipalities to a larger region would affect the medicinal and health care expenditure within the region. The study also analyses the medicinal costs of different population groups using social and health services. Additionally, the analysis concerns the transfer of the responsibility for medicinal costs to a wider social and health service region and the subsequent effects on the medicinal costs across the different service user groups.

The study is related to the work of a taskforce appointed by the Ministry of Social Affairs and Health to investigate the multi-channel funding of health care services.

Additional information: Leena K. Saastamoinen, tel. +358 20 634 1972, firstname.lastname@kela.fi

Long-term use of sedatives and hypnotics in Finland

Sedatives (tranquilisers) and hypnotics (sleeping pills) are among the most commonly used medicines in Finland. According to the treatment recommendations, these medicines should only be prescribed for short-term use of no more than a few weeks because of their harmful effects. Nevertheless, their long-term use is common. This register-based study investigates the development of long-term use of sedatives and hypnotics in Finland and associated factors.

The study is being implemented as a joint research project by Turku University Hospital, Kela Research, the Universities of Turku and Helsinki, and the Niuvanniemi Hospital. The data sources include several of Kela’s benefit registers as well as data from other registers.

From Kela Research, Leena Saastamoinen, Annamari Tuulio-Henriksson and Terhi Kurko participate in the project.

Additional information: Terhi Kurko, tel. +358 20 634 0726, firstname.surname@kela.fi

Citizens’ experiences and attitudes concerning the prescription drug reimbursement system and cost-saving measures

The reimbursement rates for prescription medications have been reduced several times in recent years, and many of the cuts have raised the patients’ out-of-pocket costs. An annual initial deductible was introduced in 2016 for adults, and the reimbursement rates for type 2 diabetes medicines were reduced at the beginning of 2017. Along with the budget cuts, there has been debate on the structure of the reimbursement system, the prioritisation of pharmaceutical treatment and the targeting of the reimbursements to different demographic and patient groups. However, the popular opinion has not been studied sufficiently to support public policy decision-making. The purpose of this study is to investigate the citizens’ attitudes and experiences concerning prescription drug reimbursement system administered by Kela and the copayments and deductibles paid by patients. A second objective is to find out how those attitudes and experiences have changed between 2015 and 2017. Data are obtained from surveys carried out by the National Agency for Medicines in 2015 and 2017. 

Additional information: Katri Aaltonen, tel. +358 20 634 1941, firstname.surname@kela.fi

Microsimulation of the prescription drug reimbursement system

Microsimulation is widely used to plan changes to social security schemes and legislation. Kela has developed a microsimulation method to model the prescription drug reimbursement system, which has been used to evaluate how various planned legislative changes will impact the reimbursement system. The purpose of this project is to maintain, update and develop further this microsimulation method.

Additional information: Katri Aaltonen, tel. +358 20 634 1941, firstname.surname@kela.fi

SICKNESS BENEFITS

The role of the sickness allowance in health and social services

This study looks at the role of the sickness allowance as part of the totality of health and social service provision and expenditure in Finland. It explores regional differences in sickness allowance recipiency and examines the duration of recipiency and expenditure on sickness allowances within the overall health and social services. Further, the study will investigate the use of health and social services by sickness allowance recipients, comparing them to the general working-aged population, examines the type of services most commonly received, and looks at the distribution of overall costs of social and health provision in these groups. 

Additional information: Jenni Blomgren, tel. +358 20 634 1893, firstname.surname@kela.fi

REHABILITATION AND WORKING ABILITY

Denials of applications for Kela-arranged rehabilitation, 2005–2017

Statistics on disability application awards and denials are compiled both according to the statutory basis of the rehabilitation and the medical diagnosis, but not much detailed information is available about the trends in the number of awards and denials and their respective shares, or about persons whose application was denied. This study looks at developments in rehabilitation application awards and denials in 2005–2017, seeking to produce information on denied applications for Kela rehabilitation and the persons whose application was denied, as compared to those whose applications was granted.

Additional information: Hanna Rättö, tel. +358 20 6341980, firstname.lastname@kela.fi

Impacts of rehabilitation changes on the customer (Muutos project).

The project aims to investigate the impacts and consequences experienced by customers due to the changes in the rehabilitation services provided by Kela. The project is comprised of several sub-studies focusing on different forms of rehabilitation or benefits. The underlying factors include changes in legislation or reforms based on the results of development work. The study involves the investigation of the implementation of rehabilitation services in a situation where the contents, activities or conditions related to a particular service or benefit have changed or where a completely new service has been created. The research focuses on the customer perspective: Is the rehabilitation timely and appropriate for the person receiving it? The purpose is to produce knowledge that is applicable to the development, steering and advocacy work within the field of rehabilitation.

The project is being implemented over the period of 1 May 2015 - 31 December 2019, financed with development funds in accordance with the law (KKRL § 12) and coordinated by Kela Research.

Additional information: Riitta Seppänen-Järvelä, firstname.lastname@kela.fi.

Multimodal neuropsychiatric family rehabilitation evaluation study

Kela contributes, for its part, to the well-being of families with children by supplementing the public health care services. In terms of mental and behavioural disorders among children and adolescents (aged 5–15 years), Kela focuses on the development and research of multimodal family rehabilitation.

During 2010–2018, two development projects are underway in Kela, one concerning the multimodal family rehabilitation (family intervention program LAKU) and the other concerning a teleservice model for family rehabilitation. Multimodal rehabilitation services are intended for families with a 5–12-year-old child who has been diagnosed with a neuropsychiatric disorder and possible other concurrent mental or behavioural disturbances.

The purpose of family rehabilitation is to support the child’s growth and development and coping with everyday life at home, day care and school as well as among friends and peers. The methods are selected to suit the age and target groups. For each family, the target is to reinforce the resources of the child’s parents and to support the mutual interaction among family members through family psychotherapy methods. A family rehabilitation process lasts 1–2 years.

The aim of the study is to evaluate the acceptance and suitability of multimodal family rehabilitation for the target group and assess the impacts of family rehabilitation on the well-being of the child and parents. The study has been registered in a public research register. The final report on the study will be published in the Kela Research Publications series in autumn 2018. The results will also be reported in national and international peer reviewed publications in the fields of medicine, social medicine and nursing science.

Cooperation partners: Kela rehabilitation section, Hospital District of Southwest Finland/Turku University Hospital, University of Turku

Additional information: Miika Vuori, tel. +358 20 634 1500, firstname.surname@kela.fi

Disability and rehabilitation benefits for youth

The purpose of the project is to produce information about trends in the use of disability and rehabilitation benefits granted to young people, and about vocational rehabilitation benefits intended for youth and the related changes. In addition, the study maps the pathways leading to disability pensioning as well as the later situation and background factors for young people who have applied for or been granted various benefits based on illness.

Project period: 1 September 2013–31 December 2019.

Additional information: Karoliina Koskenvuo, tel. +358 20 6341355, firstname.lastname@kela.fi

Rehabilitation to support the study and working life abilities of young adults suffering from neuropsychiatric disorders (Oma Väylä project)

In 2015, Kela initiated a project entitled Oma Väylä (‘Own Path’) with an aim to develop a group and individual rehabilitation model for young adults with neuropsychiatric disorders. The target group is comprised of young adults (aged 18–38 years) who have been diagnosed with Asperger’s syndrome or Attention Deficit and Hyperactivity Disorder (ADHD).

The Oma Väylä rehabilitation aims to reinforce and develop the study abilities, working life skills and everyday life management skills of young adults with a neuropsychiatric disorder. Social skills are trained within everyday environments, such as home, school or the workplace. The 18-month-long rehabilitation process is implemented by a multiprofessional team, including a work coach who serves as a special worker, and also a working life specialist. The project supports, for its part, the realisation of the Youth Guarantee, which aims to advance young persons’ placement in education or the labour market and to prevent marginalisation or prolonged unemployment.

As part of the project, an evaluation study is being conducted by the National Institute for Health and Welfare (THL), jointly with Kela Research, to assess the aspects of development and impact. In terms of development, the study aims to collect data on the process of seeking rehabilitation, the implementation of group rehabilitation, the integration of rehabilitation into everyday life and the motivation of rehabilitees. Observation and other qualitative methods are used as research methods. Data concerning the efficacy of the rehabilitation model and the success of collaboration with stakeholders will be collected through questionnaires and interviews among rehabilitees, service providers and interest groups.

The research project covers the years 2015–2018 and its results will be reported in national and international publications.

Additional information: Annamari Tuulio-Henriksson, tel. +358 20 634 1877, firstname.surname@kela.fi

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Implementation of Kela’s rehabilitation psychotherapy after the legislative change in 2011

At the start of 2011, the provision of rehabilitation psychotherapy became a statutory responsibility of Kela, instead of being a discretionary service. The change means, in practice, that the number of rehabilitees shall no longer be limited by the appropriations tied to a particular budget year. The criteria for receiving rehabilitation psychotherapy are mostly the same as earlier. On the basis of register data, we examine if the increase in psychotherapies is reflected as changes in the distributions of the demographic factors, occupation, diagnoses, psychotropic medication and sickness allowances among the rehabilitees, as compared to the situation before the amendment of the law. Another aim of our research is to examine the labour market activity of the recipients of the statutory psychotherapy before the rehabilitation, at its start and end, as well as during a two-year follow-up. We also investigate the implementation of rehabilitation psychotherapies of varying duration and the refusal and granting decisions concerning rehabilitation psychotherapies.

The research project covers the years 2016–2017 and its results will be reported in national and international publications.

Additional information: Annamari Tuulio-Henriksson, firstname.lastname@kela.fi

KELA'S SERVICES AND OPERATIONS AND THE IMPLEMENTATION OF SOCIAL SECURITY

Citizens' views on Kela, Kela's benefits and their implementation

The study surveys citizens’ perceptions of Kela, Kela’s benefits and their implementation. Kela’s operations and the needs to develop them are assessed from the viewpoint of both Kela’s public image and customer satisfaction. The study is a sequel to the citizen surveys conducted in 2000, 2002–2005 and 2008-2014, and therefore it is also possible to observe the change over time.
The data are collected through phone interviews. The number of interviews will total 1,000. The persons interviewed represent the population that has reached the age of 15, excluding the Åland Islands.

Cooperation partner: TNS Gallup Oy.

Additional information: Hannu Mattila, tel. +358 20 634 1956, firstname.surname@kela.fi

A questionnaire survey on benefits and benefit administration

The study explores the experiences and ideas for improvement that customers have about the implementation of Kela's benefit programmes. Data are collected with questionnaire forms sent out to over 3,000 persons having immediately before the survey received a decision on a benefit claim from Kela.

The study will also investigate customers’ views about the benefits available from Kela, the existing customer services and new services they would like to see, and Kela’s overall public image.

Additional information: Markku Laatu, tel. +358 20 634 1945, firstname.surname@kela.fi

Staff barometer survey

The survey is conducted among Kela’s staff to learn more about their experiences of well-being, management practices, workplace functioning and Kela as an employer. The Barometer results tell about the development of well-being at work within Kela as a whole and in its various units. The information will be used for HR management, thereby contributing to the development of Kela’s operations.

Additional information: Piia Bogdanoff, firstname.lastname@kela.fi and Minna Ylikännö, firstname.lastname@kela.fi

Reasons provided for denied applications for benefit

The study looks at how comprehensible the language explaining the reasons for decisions on health insurance applications is from a legal point of view. The project takes a combined juridical-empirical approach. The data consists of decisions issued by Kela denying applications for sickness allowance, general housing allowance and disability allowance. The decisions are partly constructed from predefined phrases, whose content and impact on the reasons set out for the decision are analysed in the study.

Cooperation partners: University of Helsinki Faculty of Law and the Research Institute for the Languages of Finland.

Additional information: Vappu Verronen, firstname.lastname@kela.fi

SOCIAL SECURITY SYSTEM:

Changing Salo 2013–2023

The city of Salo has undergone a rapid transformation of its economic structure following the closing of the Nokia mobile phone assembly plant. This study looks at the effects that such extensive structural change has had on the wellbeing of the Salo residents and of the region as a whole. In a questionnaire, Salo residents are asked about their experiences with unemployment, economic security, wellbeing and health. The study also looks at the economic development of the region and the effectiveness of the government assistance provided to Salo, and follows trends in the kinds of public services offered over a ten-year period (2013–2023).

The first results will be reported in autumn 2013. The study is a cooperation between Kela Research and the University of Turku. Project website (University of Turku).

Additional information: Sari Kehusmaa, tel. +358 20 634 2866, firstname.lastname@kela.fi and Minna Ylikännö, tel. +358 2 333 8896, firstname.lastname@utu.fi

HEALTH INSURANCE SYSTEM

Use and costs of social and health services and social security benefits in Oulu, 2013–2018

The study seeks to produce information at the individual level about the use of social and health services and benefit recipiency among residents of the city of Oulu. Particular attention is paid to how specific individuals use and combine services and benefits from different sectors and systems. Having access to a set of register data spanning a period of several years, the study is able to investigate broadly the aggregate use and costs in different sectors of the healthcare system and of public social services and benefits. The project is divided into several sub-projects.

Cooperation partners: City of Oulu, occupational health service providers.

Additional information: Jenni Blomgren, tel. +358 20 634 1893, firstname.surname@kela.fi

Evaluation of savings achieved through taxi ride-sharing in the Pirkanmaa special responsibility area for specialised medical care

In 2010–2014, dispatch centres were established in hospital districts as a contact point for clients This step was due to the need to implement ride-sharing for trips made by taxi. At the same time, a system for claiming reimbursement electronically was introduced for these taxi trips. This collaborative project looks at the savings achieved through ride-sharing in the Pirkanmaa special responsibility area in 2015 and considers whether ride-sharing should be implemented not within single hospital districts but within special responsibility areas, which are made up of several hospital districts.  The project will conclude on 30 June 2017.

Cooperation partner:  University of Oulu

Additional information: Päivi Tillman, tel. +358 20 634 1927, firstname.surname@kela.fi

INCOME SECURITY SYSTEM

Sustainable well-being

Sustainable wellbeing” is a forward-looking research project analysing social policy thinking, models and practices that would correspond better to the demands of sustainable development. The project is based on the idea that well-being is multidimensional, that these dimensions are interdependent, and that all activity aimed at creating well-being must occur within ecologically sustainable boundaries. The project consists of several articles and a trilogy of books.

The following publications have come out this far:

  • Salonen, Arto O. & Helne, Tuula (2012) Vegetarian Diets: A Way Towards a Sustainable Society. Journal of Sustainable Development 5 (6).
  • Hirvilammi, Tuuli & Helne, Tuula (2014) Changing Paradigms: A Sketch for Sustainable Wellbeing and Ecosocial Policy. Sustainability 6 (4).
  • Helne, Tuula & Hirvilammi, Tuuli (2015) Wellbeing and Sustainability: A Relational Approach. Sustainable Development 23.  
  • Helne, Tuula & Salonen, Arto O. (2016) Ecosocial food policy: improving human, animal and planetary wellbeing. Sustainability: Science, Practice, & Policy 12 (2).
  • Helne, Tuula & Hirvilammi, Tuuli (2017) The relational conception of wellbeing as a catalyst for the ecosocial transition. In Aila-Leena Matthies and Kati Närhi (eds.)The Ecosocial Transition of Societies. The Contribution of Social Work and Social Policy. London: Routledge.
  • Helne, Tuula (2019) Being Matters: A Holistic Conception of Well-being in the Shift towards Strongly Sustainable Societies. In Karl Johan Bonnedahl and Pasi Heikkurinen (eds.) Strongly Sustainable Societies. London: Routledge.

Additional information: Tuula Helne, tel. +358 20 634 1582, firstname.lastname@kela.fi

Microsimulation

Microsimulation methods are used to analyse the effects of legislation on household transfers and taxes. Microsimulation is useful both in the drafting of legislation and as a tool of tax and social security research. For example, it allows the researcher to examine long-term trends in social security legislation and to test the impact of different hypothetical changes in legislation on household incomes.

The Research Department is involved in developing and updating the new SISU simulation model administered by Statistics Finland, and uses the model in research and reports as well as to develop further its own applications. Updating of the JUTTA model adopted earlier will continue to meet the needs of sample calculations.

Cooperation partners: Statistics Finland, Ministry of Finance, Ministry of Social Affairs and Health, VATT Institute for Economic Research, Labour Institute for Economic Research, Library of Parliament's Information Service.

Additional information: Karoliina Koskenvuo, firstname.lastname@kela.fi