Local population responsibility in Finnish health centres in 1989-1993

Background: Since 1991, the working patterns in Finnish primary care health centres have been changing from traditional group practices towards local population responsibility (LPR) with personal patient lists, As a result, i t was expected the services would change notably, Methods: A controlled int ervention study included 30 health centres changing their working pattern t o LPR and 30 control health centres, We studied the use of health services in both primary and secondary care in the areas served by these health cent res during the transition phase from 1989 to 1993. Data were collected from national statistics. Results: The application of LPR was associated with a n initial increase in physician consultations, Consultations for preventive care decreased in both LPR and control health centres, The use of speciali zed care and consultations with private physicians particularly decreased i n large LPR municipalities, Conclusions: The most significant changes occur red in the working patterns of large health centres that had introduced LPR , A wide range of variations between the health centres was observed for al l activities in both groups.