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The purpose of this paper is to analyze the dynamics of budgetary biasing in the context of public hospitals.

The study applies theories of accounting and budgeting behaviors in the specific institutional context of health care systems. Based on the theoretical framework, data from interviews with hospital budget officers were analyzed using qualitative content analysis.

A typology of biases is provided. It proved to be useful and highlighted the central empirical assumptions and preliminary results of biasing dynamics.

Understanding the logic of budgeting actors and the drivers of bias may help explain why bias so often appears in health care budgeting. It further contributes to understanding whether the bias is functional or dysfunctional.

The concepts of budgetary bias are rarely used in the context of health care budgeting, so the study fills a gap in research knowledge.

This paper describes factors influencing doctor‐managers' decision making in specialised health care, health centres and at different levels of management.

Data were collected as part of a survey on physicians graduating in 1977‐1991 as drawn from the register of the Finnish Medical Association. The study sample was formed by selecting all physicians born on odd days (n=4,144) from the baseline group (n=8,232). The category of doctor‐managers comprised physicians reporting as their main occupation: principal or assistant principal physician of hospital, medical director or principal physician of health centre, senior ward physician of hospital, and health centre physician in charge of a population area.

Independent of gender, all doctor‐managers responding to the survey reported that the most important base for decision making was personal professional experience. Position in organisation (first‐line manager, principal physician) had no impact on the base of decision making. Doctor‐managers in primary health care utilised knowledge on norms and knowledge available from their organisation in support of their decision making to a greater degree compared with doctor‐managers in specialised health care.

Evolution discourse from public administration is not yet receiving much response in Finnish doctor‐managers' activities, instead, they still act as clinicians.

Facing the growing challenges of the future, the paper shows that doctor‐managers should reconstruct their orientation and to act more like managers.

The aim of this study is to analyse the position and role of mental health in health promotion policy. Policy documents from Finland, Sweden, Denmark, the Netherlands, England and Portugal indicate that, although mental health is considered a serious issue, it is problematic in policy terms. A range of arguments are put forward, making the case for the importance of mental health within the health promotion agenda, including the classification of mental illness as a public health problem, socio‐economic and individual costs of mental health problems and the view that mental well‐being is a crucial element of overall health. However problems of definition, measurement and a traditional focus on treatment and care continue to make mental health promotion problematic for policy makers.

This case study aims to introduce a novel home care service integrator model called “Kotitori”. In the model the City contracts with a private provider, which, in turn, works with public, private, and third sector providers in order to meet the customer needs in a personalised way.

The case study draws from key policy documents and stakeholder interviews.

The study introduces a unique form of public‐private partnership in Finland, and describes the basic elements of Kotitori, the development process of the model, and the model's distinctive features compared to more traditional ways of home care service delivery.

The Kotitori model is still in its early stages of implementation and reliable data on performance are limited.

The transferability potential of the Kotitori model is good both nationally and internationally. The model is potentially beneficial for countries with an interest in developing integrated care in general, as it reflects a form of “accountable care organisation”.

This is the first study describing the Kotitori model for an international audience.

Suicide as a stigmatising issue presents a huge challenge for prevention policy. Also, policy itself is often difficult to turn into action. This research describes the interpretative repertoires found in the suicide prevention strategies of England and Finland, and explores their potential functions and audiences. It was found that the political repertoire was formed from four sub‐repertoires: the public health epidemiology, the everyday, the preventive action and the reflective repertoires. This paper discusses the polyphonic and multilayered nature of these policy documents and how different repertoires may be used for various functions. The polyphonic nature of policy documents is necessary to reach a wide readership and to capture suicide as a controversial phenomenon. However, the downside is that the argumentative style may also undermine some of the measures and actions recommended.

The purpose of this paper is to investigate how managers in social and health care evaluate the knowledge sources affecting their decision‐making, and how the evaluations were associated with the managers' professional background, activity sector, gender, age and management experience.

The study data are gathered from a questionnaire survey to the middle‐line doctor, nurse and social managers (n=404) within the responsibility area of a Finnish university hospital. Assessed the proportions of individual knowledge sources in the complete data set and their associations with the subjects' background data. In addition, grouping of individual knowledge sources variables are made using factor analysis.

The findings indicate that social and health care managers attempt to utilize diverse knowledge sources. Overall, professional experience and education, organization budget, and action plans of one's own unit are estimated as knowledge sources with the greatest impact. Manager's professional background and activity sector are associated with the kind of knowledge affecting their decision‐making. Some differences are noted between genders, but differences with respect to age or management experience are non‐significant.

Social and health care organizations represent expert organizations where decision‐making is steered by professions and management tasks.

This paper suggests that the future decision‐makers will be required to identify versatile knowledge areas across cultural barriers, and to be capable of making comprehensive decisions affecting the entire organization.