Subsidized employment as an intervention and its impact on the use of primary health care services

Authors

• Pia Hakamäki Tampereen yliopisto, Terveyden ja hyvinvoinnin laitos
• Vesa Saaristo Terveyden ja hyvinvoinnin laitos https://orcid.org/0000-0002-7953-1888
• Pirjo Lindfors Tampereen yliopisto https://orcid.org/0000-0002-9316-7955
• Timo Ståhl Terveyden ja hyvinvoinnin laitos https://orcid.org/0000-0002-6677-4792

DOI:

https://doi.org/10.23990/sa.103415

Keywords:

subsidized employment, health, well-being, primary health care services, municipality

Abstract

Prolonged unemployment can be interrupted by short-term subsidized employment, which can have an impact on well-being, health, and ability. Employment can affect the use of primary health care services, for example by highlighting the latent need for services. The article examines the use of services during a five-year period in a sparsely populated municipality. The aim was to investigate the use of primary health care services among people in subsidized employment and those who were excluded from intervention. The study population consisted of persons unemployed for more than 500 days. Individual-level data were extracted from the registers as a total sample (age: 17–63 years, gender: 61% men, 39% women, N = 152). The data were extracted from three different registers: Kela’s unemployment insurance data, the customer data of the City of Pudasjärvi’s employment services, and the Oulunkaari joint municipal authority’s patient register. Two groups were formed: the intervention group (subsidized employment, n = 67) and the control group (n = 85). The data were analyzed by quantile regression. The study showed that there were differences in the use of health services between the intervention and control groups and that the use of services was unevenly distributed in both research groups. In the intervention group, visits increased until the end of the year after the intervention but decreased in the following year, 2016. The visits in the control group increased until 2016. The use of services was not evenly distributed, with 17 percent using half of all services. The use of services among those who used a lot of services in the intervention group was statistically significantly lower than in the control group (p = 0.000–0.002). Evaluation of employment measures needs information on the use of primary health care services. The relevant register data are not commonly used.