BACKGROUNDS AND OBJECTIVES: In the last decade many challenges have appeared against the modern health care system. The society is aging, the elderly people have growing need for long-term, the number of chronic illnesses is increasing continuously, the pharmaceutical, surgical and diagnostic technologies are developing rapidly. The effective management of these problems will require structural changes in the health care system. METHODS: At macro level the study focuses on the dimensions of capacity N of patients, activities, financing, technology content and HR of care. At regional-county level it examines the procedures of competence and task distribution among hospitals and other health provider institutions and level of integration. At the level of institutions further dimensions are examined as the institutional physical infrastructure, such as the number of sites and pavilons, block-structure. RESULTS: The capacity of acute and chronic care has decreased (has been reduced by ca. 28% from 2004 – to 2014). The number of one-day surgical procedures is increasing (from 5 % to 20% of all surgical interventions from 2005- to 2015). Prevention plays an important role in the goverments communication and measure like smoking sessacion. Also the group praxis model has been launched in the primary care GP services. The regional profile change is part of the concentration of active capacities in the county and the integration of hospitals. At institutional level block structure of hospitals and new profession have been created (emergency care units) CONCLUSIONS: The structural change is in progress, but it is still there are potential efficiency gain in the better organization and management of the health services. We are lagging in the development of outpatient care, home care and ICT based services. Strategic, well-planned health policy professional programs (like cancer control program), restructuring and integration of the delivery system based on efficiency and quality are highly needed.