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- Ekman, Björn, et al.
(author)
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Utilization of digital primary care in Sweden : Descriptive analysis of claims data on demographics, socioeconomics, and diagnoses
- 2019
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In: International Journal of Medical Informatics. - : Elsevier. - 1386-5056 .- 1872-8243. ; 127, s. 134-140
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Journal article (peer-reviewed)abstract
- Objective: As digital technologies for health continue to develop, the ability to provide primary care services to patients with new symptoms will grow. In Sweden, two providers of digital primary care have expanded rapidly over the past years giving rise to a heated debate with clear policy implications. The purpose of the study is to present a descriptive review of digital primary care as currently under development in Sweden.Methods: Descriptive analysis of national coverage data on the utilization of digital care by sex, age, place of residence, socioeconomic status, and most common diagnoses. The data are compared with samples of corresponding data on traditional, office-based primary care, out-of-hours care, and on non-emergency telephone consultations to obtain a comparative analysis of digital care.Results: Digital primary care in Sweden has increased rapidly over the past two years. Currently, more than 30,000 digital consultations are made per month, equivalent to around two percent of all physician-led primary care. Digital care differs in some ways to that of traditional care as users are generally younger and seek for different conditions compared with office-based primary care. Digital care is also similar to traditional care as utilization is higher in metropolitan areas compared with rural areas. Similar to general health care use, there is a negative correlation between use of digital care and socioeconomic status. User profiles by age and sex of digital care are also similar to those of out-of-hours care and non-emergency telephone medical consultations.Conclusions: By providing a detailed description of the development of digital primary care the study contributes to a growing understanding of the contributions that digital technologies can make to health care. Based on current trends digital primary care is likely to continue to increase in frequency over the coming years. As technologies develop and the public becomes more familiar to interacting with medical providers over the Internet also the scope of digital care is likely to expand. As the provision of digital primary care expands across Europe and beyond, policy makers will need to develop regulating capacities to ensure its safe, effective and equitable integration into existing health systems.
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| 3. |
- Thulesius, Hans O, et al.
(author)
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Diagnosis and prognosis of breast and ovarian cancer--a population-based study of 234 women
- 2004
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In: Acta Oncologica. - : Informa UK Limited. - 1651-226X .- 0284-186X. ; 43:2, s. 81-175
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Journal article (peer-reviewed)abstract
- The diagnosis and prognosis for 135 women with breast cancer and 99 women with ovarian cancer in a well-defined geographical area, and a follow-up of 7-15 years are described, based on patients' records. Diagnosis was initiated in primary care for 53% of women with breast cancer, and for 57% of women with ovarian cancer. Median patient delay was 1 week for breast cancer, and 3.5 weeks for ovarian cancer patients, and median provider delay was 3 weeks for both groups. Crude, relative, and corrected 5-year survival was 73%, 91%, and 82% in breast cancer, and 40%, 49%, and 43% in ovarian cancer. Cox multiple regression analyses showed that stage IIIA and IV, and young age were associated with impaired disease-related survival in breast cancer. In patients with ovarian cancer, stages III and IV at diagnosis, old age, and systemic symptoms dominating at presentation were predictive of reduced disease-related survival while a family history of cancer was predictive of increased survival.
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| 4. |
- Wilkens, Jens, et al.
(author)
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Study protocol : effects, costs and distributional impact of digital primary care for infectious diseases-an observational, registry-based study in Sweden
- 2020
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In: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 10:8, s. 1-8
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Journal article (peer-reviewed)abstract
- Introduction The ability to provide primary care with the help of a digital platform raises both opportunities and risks. While access to primary care improves, overuse of services and medication may occur. The use of digital care technologies is likely to continue to increase and evidence of its effects, costs and distributional impacts is needed to support policy-making. Since 2016, the number of digital primary care consultations for a range of conditions has increased rapidly in Sweden. This research project aims to investigate health system effects of this development. The overall research question is to what extent such care is a cost-effective and equitable alternative to traditional, in-office primary care in the context of a publicly funded health system with universal access. Three specific areas of investigation are identified: clinical effect; cost and distributional impact. This protocol describes the investigative approach of the project in terms of aims, design, materials, methods and expected results. Methods and analysis The research project adopts a retrospective study design and aims to apply statistical analyses of patient-level register data on key variables from seven regions of Sweden over the years 2017-2018. In addition to data on three common infectious conditions (upper respiratory tract infection; lower urinary tract infection; and skin and soft-tissue infection), information on other healthcare use, socioeconomic status and demography will be collected. Ethics and dissemination This registry-based study has received ethical approval by the Swedish Ethical Review Authority. Use of data will follow the Swedish legislation and practice with regards to consent. The results will be disseminated both to the research community, healthcare decision makers and to the general public.
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