1.
Fredriksson, Johan, et al.
(författare)
Effects of mobile video-mediated communication for health care professionals in advanced home care of children
2014
Ingår i: 27th IEEE International Symposium on Computer-Based Medical Systems. - Los Alamitos, California : IEEE Computer Society. - 9781479944354 ; , s. 363-368, s. 363-368
Konferensbidrag (refereegranskat) abstract
In this paper we explore the use of a mobile video-conferencing tool (MVCT) in advanced home care of children. We present the results from a qualitative study where we have evaluated mobile video communication between the patient's home and the hospital unit. Our results show that mobile video enhances communication between home care teams and medical staff at the unit, makes more effective use of practitioners' time and that the equipment have additional values for staff that extend beyond video communication. Challenges identified are related to technical problems, limitations in the MVCT's design and the concern that the inability to handle problems may affect health care professionals' role as an authority. The benefits of the MVCT rely to a great extent on individual users' creativity and the willingness of key actors in the organization's management to find ways of improving the present home care format.
2.
3.
Shutzberg, Mani
(författare)
Literal Tricks of the Trade : The Possibilities and Contradictions of Swedish Physicians’ Everyday Resistance in the Sickness Certification Process
2020
Ingår i: Journal of Resistance Studies. - : Irene Publishing. - 2001-9947. ; 6:1, s. 8-39
Tidskriftsartikel (refereegranskat) abstract
This article deals with the ways Swedish General practitioners (GPs) informally deal with the stricter standards of sickness certification and the implications of understanding these ways in terms of ‘resistance.’ In recent decades, procedural and bureaucratic changes within the Swedish sickness benefit system have curtailed physicians’ clinical discretion with regards to the sickness benefit approval for patients. By both formal and informal means, the Swedish Social Insurance Agency (SSIA) has consolidated its power over the decision-making process. Despite widespread dissatisfaction among physicians with the current system, acts of open defiance do not seem to occur. However, as shown in a recent qualitative study, Swedish General practitioners have developed informal ‘techniques’ (ranging from simple exaggerations in the certificates to complex constructions of apparent objectivity) for intentionally circumventing the stricter sickness certification standards. Taking that study as a point of departure, this article will consider the use of techniques as a form of everyday resistance. Three dimensions of ambiguity arise which require further attention, namely: (1) the multiple motives and shifting target of resistance; (2) the complex blend of power and powerlessness which defines the situation of GPs and their resistance, and (3) the fundamental ambiguity of the resistant act of issuing sickness certificates tactically, as a particular mix of compliance and resistance.
4.
Svärd, Veronica, et al.
(författare)
Coordinators in the return-to-work process : Mapping their work models
2023
Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 18:8
Tidskriftsartikel (refereegranskat) abstract
PurposeIn recent decades, many countries have implemented return-to-work coordinators to combat high rates of sickness absence and insufficient collaboration in the return-to-work process. The coordinators should improve communication and collaboration between stakeholders in the return-to-work process for people on sickness absence. How they perform their daily work remains unexplored, and we know little about to what extent they collaborate and perform other work tasks to support people on sickness absence. This study examines which work models return-to-work coordinators use in primary healthcare, psychiatry and orthopaedics in Sweden.MethodsA questionnaire was sent to all 82 coordinators in one region (89% response rate) with questions about the selection of patients, individual patient support, healthcare collaboration, and external collaboration. Random forest classification analysis was used to identify the models.ResultsThree work models were identified. In model A, coordinators were more likely to select certain groups of patients, spend more time in telephone than in face-to-face meetings, and collaborate fairly much. In Model B there was less patient selection and much collaboration and face-to-face meetings. Model C involved little patient selection, much telephone contact and very little collaboration. Model A was more common in primary healthcare, model C in orthopaedics, while model B was distributed equally between primary healthcare and psychiatry.ConclusionThe work models correspond differently to the coordinator’s assignments of supporting patients and collaborating with healthcare and other stakeholders. The differences lie in how much they actively select patients, how much they collaborate, and with whom. Their different distribution across clinical contexts indicates that organisational demands influence how work models evolve in practice.
5.
Berglund, Erik, et al.
(författare)
Physicians' experience of and collaboration with return-to-work coordinators in healthcare : a cross-sectional study in Sweden
2023
Ingår i: Disability and Rehabilitation. - : Taylor & Francis. - 0963-8288 .- 1464-5165.
Tidskriftsartikel (refereegranskat) abstract
PurposeReturn-to-work coordinators (RTWCs) give people on sick leave individualized support and coordinate between different stakeholders, including physicians. The aim of this study was to explore physicians’ experience of RTWCs and investigate factors that influence how much physicians collaborate with RTWCs, or refer patients to them, in primary, orthopaedic, and psychiatric care clinics.Materials and methodsOf the 1229 physicians responding to a questionnaire, 629 physicians who had access to a RTWC in their clinic answered to questions about collaborating with RTWCs.ResultsAmong physicians who had access to a RTWC, 29.0% collaborated with a RTWC at least once a week. Physicians with a more favourable experience of RTWCs reported more frequent collaboration (adjusted OR 2.92, 95% CI 2.06–4.15). Physicians also collaborated more often with RTWCs if they reported to often deal with problematic sick-leave cases, patients with multiple diagnoses affecting work ability, and conflicts with patients over sickness certification.ConclusionsPhysicians who had more problematic sick-leave cases to handle and a favourable experience of RTWCs, also reported collaborating more often with RTWCs. The results indicate that RTWCs’ facilitation of contacts with RTW stakeholders and improvements in the sickness certification process may be of importance for physicians.Implications for RehabilitationThis study of physicians’ experience of collaborating with return-to-work coordinators (RTWCs) observes that physicians reported more collaboration with or referrals to coordinators if they had a favourable experience of coordinators.The results indicate that physicians report more collaboration with or referrals to RTWCs if they had more problematic sick-leave cases to handle in the clinic.These findings imply that it might be possible to increase the collaboration between physicians and RTWCs in clinical settings by managing factors of importance.
6.
Bergman, Mats A., et al.
(författare)
Privatization and quality : evidence from elderly care in Sweden
2016
Ingår i: Journal of Health Economics. - : Elsevier BV. - 0167-6296 .- 1879-1646. ; 49, s. 109-119
Tidskriftsartikel (refereegranskat) abstract
Non-contractible quality dimensions are at risk of degradation when the provision of public services is privatized. However, privatization may increase quality by fostering performance-improving innovation, particularly if combined with increased competition. We assemble a large data set on elderly care services in Sweden between 1990 and 2009 and estimate how opening to private provision affected mortality rates – an important and not easily contractible quality dimension – using a difference-in-difference-in-difference approach. The results indicate that privatization and the associated increase in competition significantly improved non-contractible quality as measured by mortality rates.
7.
Hultman, Lill, et al.
(författare)
Exploring the Sharing and Legitimacy of Experience-Based Knowledge of Living with Acquired Brain Injury in Two Practice Communities
2023
Ingår i: Health & Social Care in the Community. - : Hindawi Publishing Corporation. - 0966-0410 .- 1365-2524. ; 2023
Tidskriftsartikel (refereegranskat) abstract
Background. Involving people with acquired brain injury in service development has the potential to improve service and give experience-based knowledge legitimacy. The objective of this study was to explore experiences of sharing experience-based knowledge of living with acquired brain injury with others, with a particular focus on the conditions for sharing and learning, and the legitimacy of experience-based knowledge. Materials and Methods. Using a single case study design, the processes in two groups that were part of a Swedish supportive network for people with acquired brain injury were explored. One group consisted mainly of people with acquired brain injury who authored a blog and the other group consisted of healthcare staff who produced educational material with the involvement of a person with own experience of acquired brain injury. The data consisted of forty-one collective blogs, fifteen semistructured individual interviews, and ten observations from meetings. The data were analysed by utilizing the community of practice framework and the concepts of legitimate peripheral participation and epistemic injustice. Results. The findings showed that both groups developed learning processes with a focus on everyday rehabilitation as a joint enterprise. Mutual engagement developed from doing activities together and legitimacy in the groups came from engagement in these activities. In the education group, the ambition to involve people with own experience of acquired brain injury was never realized in practice. Hence, experience-based knowledge of living with acquired brain injury never got legitimacy in the group. Conclusions. We conclude that integrating experience-based knowledge from people with own experience of acquired brain injury demands careful and deliberate planning with specific consideration to existing power asymmetries between healthcare professionals and people with own experience. Mitigating epistemic injustice and gaining legitimacy for such knowledge require that people with experience of living with acquired brain injury are recognized as knowledge producers.
8.
Schenk, Linda
(författare)
Comparison of Data Used for Setting Occupational Exposure Limits
2010
Ingår i: International journal of occupational and environmental health. - 1077-3525 .- 2049-3967. ; 16:3, s. 249-262
Tidskriftsartikel (refereegranskat) abstract
It has previously been shown that occupational exposure limits (OELs) for the same substance can vary significantly between different standard-setters. The work presented in this paper identifies the steps in the process towards establishing an OEL and how variations in those processes could account for these differences. This study selects for further scrutiny substances for which the level of OELs vary by a factor of 100, focussing on 45 documents concerning 14 substances from eight standard-setters. Several of the OELs studied were more than 20 years old and based on outdated knowledge. Furthermore, different standard-setters sometimes based their OELs on different sets of data, and data availability alone could not explain all differences in the selection of data sets used by standard-setters. While the interpretation of key studies did not differ significantly in standard-setters' documentations, the evaluations of the key studies' quality did. Also, differences concerning the critical effect coincided with differences in the level of OELs for half of the substances.
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10.
Bergman, Mats A., et al.
(författare)
Reforming the Swedish pharmaceuticals market : Consequences for costs per defined daily dose
2016
Ingår i: International Journal of Health Economics and Management. - : Springer Science and Business Media LLC. - 2199-9023 .- 2199-9031. ; 16:3, s. 201-214
Tidskriftsartikel (refereegranskat) abstract
In 2009 and 2010, the Swedish pharmaceuticals market was reformed. One of the stated policy goals was to achieve low costs for pharmaceutical products dispensed in Sweden. We use price and sales data for off-patent brand-name and generic pharmaceuticals to estimate a log-linear regression model, allowing us to assess how the policy changes affected the cost per defined daily dose. The estimated effect is an 18 % cost reduction per defined daily dose at the retail level and a 34 % reduction in the prices at the wholesale level (pharmacies’ purchase prices). The empirical results suggest that the cost reductions were caused by the introduction of a price cap, an obligation to dispense the lowest-cost generic substitute available in the whole Swedish market, and the introduction of well-defined exchange groups. The reforms thus reduced the cost per defined daily dose for consumers while being advantageous also for the pharmacies, who saw their retail margins increase. However, pharmaceutical firms supplying off-patent pharmaceuticals experienced a clear reduction in the price received for their products.
