Effects of a doctors' strike on primary care utilization in Varkaus, Finland

Changes in out-patient medical care utilization at the health centre of Varkaus were studied during the Finnish doctors' strike in spring, 1984. In this urban and semi-urban area, about 80% of the out-patient medical services to the population are provided by the municipal health centre. Visits to the physicians decreased by 70% during the strike, and for urgent visits the decrease was 55%. The private sector compensated only a very small share of this "deficit". Of the common urgent illnesses the relative decrease was greatest for "cold" and ill-defined "abdominal pains". Open wounds were treated normally although there was some indication that the wounds treated were more serious than normally. The post-strike increase in visits suggests an increase in unmet needs. For all face-to-face encounters the increase was eight per cent, but for low back pain, urinary infection and hypertension the observed post-strike rates were more than 40% higher than expected by pre-strike rates. A marked reduction in various other activities of the health centre, such as telephone calls and home visits, was observed. The present study gave no evidence of harmful effects of the strike. This was the impression of the health care personnel, too. There were no public claims of reduced access to care or its delay. The distress among patients or other experiences of the population were, however, not measured. The strike was fairly short and any conclusions concerning the effects of a more prolonged or extensive strike on health care are unwarranted.