Summary of the 2017 annual report

The Finnish Patient Insurance Centre (PVK) is the central body handling all personal injuries that occur in connection with healthcare activities in accordance with the Patient Injuries Act. PVK promotes patient safety by carrying out research, making calculations and compiling statistics. Its members are all the insurance companies granting patient insurance policies in Finland.

Operating environment

By its decision issued in 2015, the Ministry of Social Affairs and Health set up a working group to revise the legislation on patient insurance and prepare a proposal for its amendment in the form of a government proposal. The disability and survivors' pensions under the Patient Injuries Act were converted into primary pensions in relation to earnings-related pensions as of the beginning of 2017.

The legislation working group set up by the Ministry of Social Affairs and Health completed its report by the end of 2016, and the drafting of the act was continued in 2017 by state officials at the Ministry of Social Affairs and Health in consultation with the stakeholders.

The number of notices of injury filed has been on the rise since 2009. The growth has been estimated to be primarily due to the increased awareness and activeness of the claimants and the increased number of procedures carried out in health care. In 2017, the rising trend levelled off, and the number of new notices of injury was 4% less (8,655) than in 2016 (8,993). Potential reasons underlying the decrease in the number of notices are the improvement of patient safety in health care units and the Centre's active communications to increase the claimants' awareness of the patient insurance and the cases where compensation can be paid.

Claims

Transition to electronic case handling was the most important objective of the Patient Insurance Unit. Additionally, efforts were made to make to claims handling process more effective and to eliminate the backlog in claims handling.

The claims handling process became entirely electronic during the year. A total of 8,632 claims decisions (7,539 in 2016) were made at the statement of grounds stage, more than ever before.

Process changes slowed down the claims handling process at the beginning of the year, as a result of which the total processing time at the statement of grounds stage increased to a certain extent. The median processing time was 8.4 (6.8) months, the average being 8.8 (7.5) months. A total of 8,993 (8,755) injuries were registered for pre-processing. At the compensation stage, the average processing time was 44 (41) days, while at the pension processing stage, the average processing time was 83 (92) days.

A total of EUR 39.5 (40.4) million was paid out in compensation for patient injuries that occurred in different years, including the management expenses of compensation operations.

A total of 1,157 (1,134) requests for a recommended decision were made to the Patient Injuries Board, 972 (888) of which were made by patients. The Patient Injuries Board issued 1,065 (934) recommendations, of which 83 (108) recommended that compensation be paid to the injured party (grounds decision) and 99 (91) considered that additional compensation should be paid to the injured party.

The number of actions on patient injuries brought to court was 4 (9).

Patient safety

A new patient safety physician started in her position in August. An action plan was prepared to promote patient safety, the key areas of which are research, communications and stakeholder cooperation.

A patient safety section was prepared on our website. Safety themes were addressed in our own communications channels, and they also gained visibility in the media.

The patient safety physician visited three central hospitals during the autumn. In the Doctor 2017 event, the Centre arranged an 'Injury Clinic' session under the heading 'New times, new mistakes' in collaboration with the Ministry of Social Affairs and Health and the Finnish Patient Safety Association. The Centre also had an exhibition stand at the event. Furthermore, the Patient Insurance Centre had an exhibition stand at the training days of the Finnish Society of Perinatology and at the Patient's Rights Day, where the Centre's experts gave a brief presentation. Additionally, lectures were given at the Patient Ombudsman Days.

Cooperation with the National Supervisory Authority for Welfare and Health (Valvira) and the National Institute for Health and Welfare (THL) was intensified. Close cooperation with the Finnish Patient Safety Association continued in the form of Board memberships and training events.

In the Nordic executive management meeting, a decision was made to initiate the first research project as a comparison between two countries (Finland and Denmark) that will be later expanded to also cover all the other Nordic countries. The subject matter is back surgery injuries.

Four new studies were initiated out of the patient injury data.

The Patient Injury Report service was launched for hospital districts. An intuitive user interface makes it easy to view patient injury statistics on a more detailed level. The service increased the dialogue with hospital districts and interest towards patient injuries.

Communications and stakeholder activities

The past year was the 30th anniversary year for the Patient Insurance Centre. The theme was widely utilised in communications and, among other things, we arranged an anniversary seminar that attracted around 150 opinion leaders from the health care and finance sectors.

An easy-to-read brochure was prepared for customers in collaboration with the Finnish Centre for Easy to Read. Our website was made more customer-friendly by developing customer paths and content. The number of customer calls was significantly reduced towards the end of the year.

The test offered on the website was taken more than 11,000 times during the year. The purpose of the test is to identify cases where the Patient Injuries Act cannot be applied. These notices were reduced by 22%. The number of visitors on our website increased by 15% on the previous year. The Centre's visibility on the media increased by 56%.

An internal change and project communications model was prepared. Our social media guidelines were revised to meet the demands of the current situation. Experts also took more responsibility for social media content as well.

Insurance affairs

During the reporting period, there were 16,995 (16,950) insurance schemes issued by our member companies in force, of which 9 (7) were group insurance schemes taken out by trade unions in the health care sector.

The number of public sector insurance schemes in force issued by the Patient Insurance Centre was 29 (29). These insurance schemes cover the entire country with regard to public health and medical care, so that the policyholders are the joint municipal authorities for all hospital districts except one and Ålands hälso- och sjukvård (Åland Islands healthcare services).

Additionally, the policyholders include nine central government organisations with health and medical care operations. There were a total of 9 (9) insurance policies in force issued by the Patient Insurance Centre under the obligation to issue insurance policies (Section 7 of the Patient Injuries Act).

Actuarial and statistics affairs

The Patient Insurance risk premium study for 2018 was carried out. Additionally, investigations required by the tasks laid down in the Patient Injuries Act and needed to promote patient safety were made. From the point of view of utilisation of the data, the deployment of the SAS Visual Analytics reporting software at the beginning of the year was an important reform, as it was used for implementing the aforementioned Patient Injury Report service.

The calculations required for the pay-as-you-go system were prepared, based on which the final adjustment for 2016 and the advance adjustment for 2017 were made and the pay-as-you-go payment for 2018 was determined. The Centre participated in the development work pertaining to injury allocation that was underway in the compensation system.

The Centre contributed to the reform of the Patient Injuries Act by drawing up analyses and scenario calculations. Cash flow forecasts for technical provisions estimated by the Centre required by Solvency II reporting were sent to the member companies.

Financial and personnel administration

The public-sector insurance premium income from patient insurance operations totalled EUR 46 (53) million, and private-sector premium income EUR 17 (20) million. The Patient Injuries Board's expenses during the reporting period were EUR 1.5 (1.6) million.

Administrative cooperation with the Finnish Workers' Compensation Centre was intensified.

Personnel

A total of around 95 person-years were used in the Centre's operations (excluding medical experts). In addition to its own staff, PVK also had joint staff shared with other organisations within the Insurance Centre.

Personnel strategy was implemented in accordance with the annual plan, concerning which a separate personnel report has been prepared.

Assessment of likely future development

No phenomena with material impact on future development can be seen in the operating environment after the end of the financial year, so operations are expected to remain at their current extent. No special research and development investments were made.

Bodies in 2017

Board

  • Marku Munter, LocalTapiola, Chair
  • Christina Branders, Folksam
  • Mikko Kokko, Fennia
  • Hannu Leskinen, Northern Ostrobothnia Hospital District
  • Tiina Schaarschmidt-Pernaa, If
  • Tuomas Seppänen, OP, Vice-Chair
  • Tiina Schaarschmidt-Pernaa, If P&C Insurance Ltd (publ), branch in Finland, until 25 September 2017, after which the company was represented by Tapio Valtonen in an expert capacity.

Executive management of PVK in the Insurance Centre Group

  • Ulla Niku-Koskinen, Managing Director
  • Jari-Matti Lifländer, Director of Administration
  • Minna Plit-Turunen, Unit Manager
  • Simo Sarvamaa, Director of Actuarial Affairs until 29 September 2017
  • Ville Lilja, Director of Actuarial Affairs as of 20 November 2017
  • Leena-Mari Tanskanen, Head of Communications
  • Asko Nio, Director of Legislative Affairs
  • Debt Collection, Janne Jumppanen, Director of Motor Insurance Unit

Auditors

Oy Tuokko Ltd

  • Jari Miikkulainen, APA (controlling auditor)
  • Janne Elo, APA

The official annual accounts are available for viewing at the PVK office, Itämerenkatu 11–13, Helsinki.

 

07.05.2018