Funding and costs of occupational health care

Occupational health care for employees is funded with obligatory earned income insurance contributions collected from employers and employees as well as with employer client fees (Figure 1). In 2022, occupational health care costs amounted to approximately EUR 992 million, or 3.6% of total health care costs of nearly EUR 28 billion (THL). Average costs per employee covered by occupational health care amounted to EUR 487 and Kela compensations to EUR 208 (Kela). In addition, entrepreneurs’ occupational health care costs were approximately EUR 5.8 million, of which the state’s share was roughly EUR 2.1 million, or 36.2% (Kela).

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Figure 1. Distribution of occupational health care costs among different payers (KELA 2020) (HIA, Health Insurance Act = funding through earned income insurance)

In 2022, Kela’s compensation details showed that 2,035,000 employees were covered by occupational health care arranged by the employer, which was 89% of the wage earners and over one third of the entire population (see Figure 2 below).

Total occupational health care costs have tripled since 2000. When calculated per wage earner, they have doubled (Figure 2). Factors explaining the increase in total costs include, for instance, the rise in the cost level, the increase in the number of people covered by occupational health care from 1.60 million to 2.03 million (coverage), the ageing of the employed population as well as tasks associated with supporting work ability and return to work that have been defined for occupational health care in legislation. The increase in coverage is reflected in the growth of total costs, but the cost per employee has not increased at the same pace. However, the share of occupational health care costs of all health care costs has been decreasing in recent years (Figure 2).

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Figure 2. Occupational health care costs and coverage

The share of preventive occupational health care activities of total costs has increased in relation to medical care costs in 2010–2022 (Figure 2). In 2010, the costs of preventive activities was approximately 38% whereas in 2022, it was roughly 48%. The costs of preventive activities increased by more than 85% during the same period (Kela). Medical care costs also increased from 2010 to 2022. Particularly strong growth occurred between 2021 and 2022.

Nowadays, the operations of occupational health care can be reliably examined through Avohilmo (Satokangas et al., 2024). Approximately 40% of the working-age population in Finland utilized occupational health care services in 2021 and 2022. In 2022, around 160,000 referrals for the working-age population were made from occupational health care to public specialized medical care. In 2022, approximately 17,000 professionals provided occupational health care services, including individual visits.