| 21. |
- Einberg, Afrodite Psaros, et al.
(författare)
-
Prevalence of chronic hepatitis C virus infection among childhood cancer survivors in Stockholm, Sweden
- 2019
-
Ingår i: Acta Oncologica. - : TAYLOR & FRANCIS LTD. - 0284-186X .- 1651-226X. ; 58:7, s. 997-1002
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Childhood cancer survivors treated before 1992, when blood donor screening for hepatitis C virus (HCV) infection was introduced, are at risk of transfusion-transmitted HCV infection. A national HCV screening campaign targeting blood transfusion recipients was launched in Sweden in 2007-2010. The aims of this study were to, among adult childhood cancer survivors in Stockholm County, investigate the prevalence of HCV infection, the natural course of infection, treatment outcome and anti-HCV testing frequency before, during and after the screening campaign and finally to actively screen the untested ones.Material and Methods: This was a combined retrospective register based and prospective screening study of adult childhood cancer survivors (n=686) treated for malignancy in Stockholm before 1992. In the first part, we investigated the prevalence of HCV infection and previous anti-HCV testing, and in the second part, we actively traced and HCV-screened the remaining untested cohort living in Stockholm. Analysis of previous documented anti-HCV tests in medical records, laboratory records, and the national communicable disease registry was performed. In the second part, 231 presumably untested individuals were contacted by mail and offered an anti-HCV test. The natural course of HCV infection and treatment outcome was analyzed for those found to be chronically infected.Results: In total, 235 patients were tested and 11 were HCV-RNA positive. The overall prevalence of chronic HCV infection among the tested childhood cancer survivors was thus 4.7% (95% CI = 2.6-8.2%), which is almost 10 times higher than the national prevalence of 0.5%. Only 12% of the Stockholm cohort were tested during the screening campaign in 2007-2010, while the test uptake using active tracing screening within this study was 40% (p<.001).Conclusion: With today's effective treatment options, active tracing and HCV screening of childhood cancer survivors are recommended.
|
|
| 22. |
|
|
| 23. |
|
|
| 24. |
- Ekbrand, Hans, et al.
(författare)
-
Injury events in residential areas – risk groups and etiological factors for falling, cutting and poisoning
- 2016
-
Ingår i: Injury Prevention. - : BMJ Publishing Group Ltd. - 1353-8047 .- 1475-5785.
-
Konferensbidrag (refereegranskat)abstract
- Background: Injury events in homes constitute a major social problem. Falling, cutting and poisoning make up 85 per cent of all injury events in residential areas.This study is based on a unique data set that includes several million cases of falling, cutting and poisoning in Sweden during the period 1990-2013 which lead to either to death, hospitalisation or to a visit to a health care provider, and a control group randomly selected from the population.Three riskgroups are given special attention in the analysis: (1) old people, (2) children, (3) persons with disabilities and or long term illnesses.Methods: Multilevel regression analysis and geographical information systems, GIS.Results: The results show the probability for each riskgroup to be exposed to each type of injury event, and how this probability varies with place (GIS), previous exposure, type of household, socioeconomic status and type of housing.Conclusions: The project is ongoing. Our cross-sectorial group has demonstrated the importance of injury epidemiology as a guiding principle in architectural design, particularly for high-risk groups.
|
|
| 25. |
- Ekbrand, Hans, 1972, et al.
(författare)
-
The rise and fall of injury prevention programs in Sweden.
- 2016
-
Ingår i: Oral presentation at the 2ned Nordic Meeting, Society for Risk Analysis Europe, in Gothenburg 14-15 november, 2016..
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- This paper is a spin‐off from a project about injury events ‐ falling, cutting and poisoning ‐ in residental settings.
|
|
| 26. |
- Ekman, Björn, et al.
(författare)
-
A literature review of the regional implementation of the central Swedish government's health care reforms on choice and privatization.
- 2015
-
Ingår i: Health Economics Review. - : Springer Science and Business Media LLC. - 2191-1991. ; 5
-
Forskningsöversikt (refereegranskat)abstract
- The introduction in 2010 of the Freedom of Choice Act represents one of the most far-reaching reforms of the Swedish health system. While it is mandatory for the regional counties to introduce choice plans for primary care it is voluntary for ambulatory specialist services. The voluntary nature of the regulations for the latter types of care generates a potential gap between the central government's reform attempts and the regional implementation of the plans. We review the regional implementation of this reform with respect to specialist services from a political economy perspective. Data on the scope of implementation show that counties of the same political ideology as the central government have introduced the most choice plans for specialist care. In particular, counties ruled by right-wing majorities have introduced the Choice Act to a considerably larger extent than left-wing counties. This creates a highly uneven situation across the various parts of the country, possibly at odds with the basic premises of the country's health law of equal access to care. The introduction of choice plans forms part of a decidedly contentious set of issues that are high on the political agenda of Sweden. The nature and impacts of these reforms are also a concern to the general public and the broader industry. Considerably more rigorous analyses will be needed to assess the impact on key policy parameters such as overall system efficiency and equitable access to services as a result of these changes to the health care markets.
|
|
| 27. |
- Ekman, Björn
(författare)
-
Catastrophic health payments and health insurance: Some counterintuitive evidence from one low-income country.
- 2007
-
Ingår i: Health Policy. - : Elsevier BV. - 1872-6054 .- 0168-8510. ; 83:2-3, s. 304-313
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives: The purpose of the study is to quantitatively analyze the role of health insurance in the determinants of catastrophic health payments in a low-income country setting. Methods: The study uses the most recent publicly available household level data from Zambia collected in 1998 containing detailed information on health care utilization and spending and on other key individual, household, and community factors. An econometric model is estimated by means of multivariate regression. Results: The main results are counterintuitive in that health insurance is not found to provide financial protection against the risk of catastrophic payments; indeed, insurance is found to increase this risk. Conclusions: Reasons for the findings are discussed using additional available information focusing on the amount of care per illness episode and the type of care provided. The key conclusion is that the true impact of health insurance is an empirical issue depending on several key context factors, including quality assurance and service provision oversight.
|
|
| 28. |
|
|
| 29. |
- Ekman, Björn
(författare)
-
Cost Analysis of a Digital Health Care Model in Sweden
- 2018
-
Ingår i: PharmacoEconomics Open. - : Springer Science and Business Media LLC. - 2509-4254 .- 2509-4262. ; 2:3, s. 347-354
-
Tidskriftsartikel (refereegranskat)abstract
- Digital technologies in health care areexpected to increase in scope and to affect ever more partsof the health care system. It is important to enhance theknowledge of whether new digital methods and innovationsprovide value for money compared with traditional modelsof care.Objective The objective of the study was to evaluatewhether a digital health care model for primary care is aless costly alternative compared with traditional in-officeprimary care in Sweden.Methods Cost data for the two care models were collectedand analyzed to obtain a measure in local currency per carecontact.Results The comparison showed that the total economiccost of a digital consultation is 1960 Swedish krona (SEK)(SEK100 = US$11.29; February 2017) compared withSEK3348 for a traditional consultation at a health careclinic. Cost differences arose on both the provider side andon the user side.Conclusion The digital health care model may be a lesscostly alternative to the traditional health care model.Depending on the rate of digital substitution, gross economiccost savings of between SEK1 billion and SEK10billion per year could be realized if more digital consultationswere made. Further studies are needed to validatethe findings, assess the types of care most suitable fordigital care, and also to obtain various quality-adjustedoutcome measures.
|
|
| 30. |
- Ekman, Björn, et al.
(författare)
-
Cost analysis of informal care : estimates from a national cross-sectional survey in Sweden
- 2021
-
Ingår i: BMC Health Services Research. - : BioMed Central. - 1472-6963. ; 21:1
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundOver the past decades, informal care has increased in most OECD-countries. Informal care is costly to caregivers and to society in the form of lost income and direct costs of providing care. Existing evidence suggests that providing informal care affects caregivers' overall health. However, estimates of the social costs of informal care based on national data on individuals are currently scarce.ObjectiveThis study contributes to the existing evidence on the costs of informal care by estimating the direct and indirect costs to caregivers using a purposive national household survey from Sweden.MethodsAdopting a bottom-up, prevalence approach, the direct and indirect costs are estimated using the survey data and the value of working time and leisure time from existing sources.ResultsThe results suggest that around 15% of the adult population of Sweden provide informal care and that such care costs around SEK 152 billion per year (around 3% of GDP; USD 16,3 billion; EUR 14,5 billion), or SEK 128000 per caregiver. Around 55% of costs are in the form of income loss to caregivers. The largest cost items are reduced work hours and direct costs of providing informal care. Replacing informal caregivers with professional care providers would be costly at around SEK 193,6 billion per year.ConclusionsFindings indicate that, even in a country with a relatively generous welfare system, significant resources are allocated toward providing informal care. The costing analysis suggests that effective support initiatives to ease the burden of informal caregivers may be cost-effective.
|
|
