Social Insurance Institution of Finland (Kela): Statistics on reimbursement entitlements in respect of medicines
entitlement to special refunds
Municipality, sub-region, region, area for the regional state administrative agency, major region, Mainland Finland/Åland, hospital district, university hospital special responsibility area, whole country
Classification by sex
male, female, combined
The indicator gives the percentage of people entitled to special refunds on medicines in the 40-64 age group at the end of the calendar year. An individual person may have one or more special refund entitlements in one or more refund categories. An entitlement to special refunds means that the person has a severe disease that requires long-term medication. Entitlement can be granted based on uniform criteria specific to each disease. A statement from a specialist usually needs to be attached when claiming the entitlement.
An entitlement to special refunds (75% or 100%) can be granted if the disease is chronic and severe and requires long-term medication. Some fifty diseases fulfil these criteria. To be eligible to receive special refunds, the patient must claim the entitlement from the Social Insurance Institution. A statement from a specialist usually needs to be attached for consideration by the Social Insurance Institution. All insured persons entitled to special refunds are registered by the Social Insurance Institution by disease. They account for just over a fifth of the total population.
An entitlement to special refunds fairly adequately describes the prevalence of chronic morbidity in the population. However, the indicator excludes allergies and a few musculoskeletal diseases, for instance. Allergies are especially prevalent among children, whilst musculoskeletal diseases become more prevalent in late working age and among older people.
The variable is based on register data, and it describes prevalence. It shows relatively little variation between years, and even smaller municipalities usually have a sufficient number of cases, provided that the analysis is not limited to very small age- or sex-based population groups.
Individual level data are confidential. For the sake of privacy protection, no municipality level data with less than 4 cases are published.
Sickness Insurance Act
The indicator can be used to monitor the attainment of the targets set in the Health 2015 public health programme.