The purpose of this study was to compare the incidence of and treatment methods for Achilles tendon ruptures (ATRs) in public and private healthcare in Finland between 1997 and 2019.

The Finnish National Hospital Discharge Register and the Finnish Register of Primary Health Care Visits were searched to identify all adults diagnosed with ATR in 1997–2019.

In the study period, 91% of patients with ATR were treated in the public sector. In public healthcare, the majority of patients were treated nonoperatively (10,997; 40% operative vs 16,303; 60% nonoperative), whereas in the private sector, the majority of the patients were treated operatively (2088; 80% operative vs 514; 20% nonoperative) (P < 0.001).

The distribution of public and private treatment for ATRs remained consistent during the follow-up period from 1997 to 2019. In the public sector, treatment methods became significantly more nonoperative during the study period, while no such change was observed in the private sector.