Effectiveness and Cost-Effectiveness of Service Pathways for High and Multiple Service Users (PALVA) – Research Project

The aim of the research is to produce data on the effectiveness and cost-effectiveness of services for high and multiple service users, in order to improve continuity and timeliness of care, and to support service management in the Eastern Finland Wellbeing Services Cooperation Area (YTA). The research consortium includes the wellbeing services counties of North Savo, South Savo, Central Finland, and North Karelia. Experts from Diak (Diaconia University of Applied Sciences) and the regional centres of excellence in social welfare, Koske and ISO as well as University of Eastern Finland. The project is funded by the Ministry of Social Affairs and Health through the Sustainable Growth Program (Next Generation EU) for Finland during 2024–2025.

The objectives of the research project are to:

1. Identify underlying causes of the situation of these client groups.
2. Examine the quality of care, adherence to care guidelines, and the effectiveness and cost-effectiveness of services for these groups.
3. Study the impact of multidisciplinary collaboration models on these client groups.
4. Test and develop improved effectiveness indicators for evaluating social and healthcare services targeted at these client groups.

The research project consists of four sub-studies

Sub-study I investigates the reasons behind uncoordinated overuse of social and healthcare services and identifies service bottlenecks using a mixed-methods approach based on both register data and interviews.

Sub-study II examines the quality, effectiveness, and cost-effectiveness of care for multimorbid and high service user client groups. The analysis of complex service processes is based on electronic client records.

Sub-study III evaluates the effectiveness of multidisciplinary and multi-professional care and support models for high service user groups, with a focus on the perspective of social services. The study looks at subgroups of high service users, service chains, usage volumes of social and healthcare services, referral to operational models, and cost-efficiency of services.

Sub-study IV tests and develops effectiveness and cost-effectiveness indicators for social services currently in use in the Eastern Cooperation Area.

Further Information

• Tomi Mäki-Opas, Principal Investigator, Research Professor, North Savo Wellbeing Services County, Centre for Social, Welfare, and Rescue Services Research +358 50 323 402,  tomi.maki-opas@pshyvinvointialue.fi
• Minna Rytkönen, Project Coordination, North Savo Wellbeing Services County, Hankevoimala, minna.rytkonen@pshyvinvointialue.fi
• Sub-study I: Pekka Mäntyselkä, Chief Physician, North Savo Wellbeing Services County; Professor, University of Eastern Finland, pekka.mantyselka@pshyvinvointialue.fi
• Sub-study II: Tiina Laatikainen, Professor, Wellbeing Services County of North Karelia ; Professor, University of Eastern Finland, tiina.laatikainen@uef.fi
• Sub-study III: Aini Pehkonen, Research Professor, North Savo Wellbeing Services County; Professor, University of Eastern Finland, aini.pehkonen@pshyvinvointialue.fi
• Sub-study IV: Tomi Mäki-Opas, Research Professor, North Savo Wellbeing Services County; Professor, University of Eastern Finland,  tomi.maki-opas@pshyvinvointialue.fi

The Sustainable Growth Program for Finland is funded by the Ministry of Social Affairs and Health. The program has received funding from the European Union´s Next Generation EU recovery instrument. The Ministry has granted 1,509,000 euros in project funding to the North Savo Wellbeing Services County for the implementation of the PALVA research project.

Research articles

Lamidi etc. (2025): The effect of a team-based service model on treatment processes and outcomes and healthcare usage among people with type 2 diabetes in North Karelia, Finland.