A1 Journal article (refereed)
Not Free at All : Home Care User Fees in a Nordic Care System (2022)

Ilmarinen, K., Van Aerschot, L., & Kröger, T. (2022). Not Free at All : Home Care User Fees in a Nordic Care System. Social Policy and Society, FirstView. https://doi.org/10.1017/S1474746422000240

JYU authors or editors

Publication details

All authors or editors: Ilmarinen, Katja; Van Aerschot, Lina; Kröger, Teppo

Journal or series: Social Policy and Society

ISSN: 1474-7464

eISSN: 1475-3073

Publication year: 2022

Publication date: 20/05/2022

Volume: FirstView

Publisher: Cambridge University Press (CUP)

Publication country: United Kingdom

Publication language: English

DOI: https://doi.org/10.1017/S1474746422000240

Publication open access: Not open

Publication channel open access: 

Abstract

In Finland, older persons are entitled to needs-tested public home care services. Home care mainly assists with personal care, activities of daily living and medical needs. It is complemented with auxiliary services that offer help with instrumental activities of daily living. In Finland, municipalities are responsible for organising public home care services. These services are mainly tax-funded, but user fees are also charged. In this article, we examine the levels of user fees of home care and auxiliary services in Finnish municipalities in 2018. The data analysis consists of descriptive statistics and exemplary cases of costs to the service users. The results show that user fees may represent a significant share of older persons’ monthly incomes. Consequently, home care users, especially those with low incomes, are at risk of economic deprivation and non-take-up of the services. We also found substantial variation in user fees across municipalities, causing regional inequality.

Keywords: care for the elderly; public services; home help services; service fees; regional differences; universalism; welfare state

Free keywords: care of older people; user fees; universalism; Nordic welfare state; Finland

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Ministry reporting: Yes

Reporting Year: 2022

JUFO rating: 1