"Effectiveness'' in Finnish healthcare studies

Abstract

Aims: Evaluation of effectiveness is connected with prevailing paradigms, and the breadth and perspective applied therein exhibit differences. Effectiveness refers to the extent to which a given intervention or service produces health outcomes in individuals to whom it is offered. The aim of this paper is to clarify the concept of effectiveness evaluation in health care and present the ways in which Finnish healthcare studies use the concept of effectiveness.

Methods: Through a systematic review of Finnish scientific journals in the healthcare research field, 25 original studies, 35 review articles, and 20 discussion papers were acquired. The inclusion criterion was that the word ;;effectiveness'' was presented in the title or abstract.

Results: In this study the effects of actions were evaluated through the process (outputs) or through the outcomes (harms and benefits). The word ;;effectiveness'' is widely used in healthcare research in Finland; mostly in studies of orthopaedics, health services research, physiotherapy, rehabilitation, and psychiatry, yet the concept was explicitly defined in only three papers. Most studies used both process and outcome measures. The outcome indicators were usually disease-specific. Papers presenting only process outputs clearly showed a health service producer's perspective. Health-related quality of life as an outcome indicator was rarely used.

Conclusions: In Finnish healthcare studies, the concept of effectiveness was rarely defined and effectiveness measures were often vague or even nonexistent. The meaning of the term had to be interpreted from the study methodology, measures, and indicators.