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- Andersson Bäck, Monica, 1969, et al.
(författare)
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The Norrtaelje model: a unique model for integrated health and social care in Sweden
- 2015
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Ingår i: International Journal of Integrated Care. - 1568-4156. ; 15:Special Issue: SI, s. 1-11
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Tidskriftsartikel (refereegranskat)abstract
- Many countries organise and fund health and social care separately. The Norrtaelje model is a Swedish initiative that transformed the funding and organisation of health and social care in order to better integrate care for older people with complex needs. In Norrtaelje model, this transformation made it possible to bringing the team together, to transfer responsibility to different providers, to use care coordinators, and to develop integrated pathways and plans around transitions in and out of hospital and from nursing homes to hospital. The Norrtaelje model operates in the context of the Swedish commitment to universal coverage and public programmes based on tax-funded resources that are pooled and redistributed to citizens on the basis of need. The experience of Norrtaelje model suggests that one way to promote integration of health and social care is to start with a transformation that aligns these two sectors in terms of high level organisation and funding. This transformation then enables the changes in operations and management that can be translated into changes in care delivery. This “top-down” approach must be in-line with national priorities and policies but ultimately is successful only if the culture, resource allocation and management are changed throughout the local system.
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- Andersson Bäck, Monica, 1969, et al.
(författare)
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What are the effects of financial incentives for health, social care and their professionals?
- 2014
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Ingår i: The 7th Nordic Working Life Conference, Göteborg, Sweden, Stream: Nordic management and organization – now and in the future. .June 11-13 2014..
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Financial incentives, such as managerial system for pay-for-performance, compensation system for reaching specific goals and bonuses, have become popular interventions to boost performance and quality in health and social care based on beliefs that they stimulate professionals to work hard and do the right things. Theories about professions, public service motivation, and economic incentives provide however different explanations for the behaviour and performance of health and care staff. Many debates concern professional duties in conflict with financial incentives and motivational scholars conclude a mismatch between what is done in practice and what research demonstrates effective. Based on a literature review, this paper seeks to discuss financial incentives and its intended as well as unintended effects. The multidisciplinary review embraces a forty studies and metastudies mainly from the US, the UK, Netherlands and Denmark combined with studies from the Nordic countries in general and Sweden in specific. The central focus is the state of art considering financial incentives and its relation to efficiency, quality, professionals’ behaviors, working conditions and environment.
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- Calltorp, Johan
(författare)
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How can our health systems be re-engineered to meet the future challenges? The Swedish experience
- 2012
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Ingår i: Social Science and Medicine. - : Elsevier. - 0277-9536 .- 1873-5347. ; 74:5, s. 677-679
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Tidskriftsartikel (refereegranskat)abstract
- All health systems confront challenges according to their respective level of development linked to social, demographic and economic factors as well as the pattern of disease and its burden on society. Among well developed, mature and highly industrialized countries, it is of great interest to exchange knowledge between countries on their respective economic and health status. In fact, international comparison is one of the main ways to learn how key health system components interact with basic social, economic and epidemiological components. However comparative research on health systems still needs development to improve our understanding of basic issues.
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- Wiig, Siri, et al.
(författare)
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Talking about quality: exploring how ‘quality’ is conceptualized in European hospitals and healthcare systems
- 2014
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Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 14:478, s. 1-12
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Conceptualization of quality of care - in terms of what individuals, groups and organizations include in their meaning of quality, is an unexplored research area. It is important to understand how quality is conceptualised as a means to successfully implement improvement efforts and bridge potential disconnect in language about quality between system levels, professions, and clinical services. The aim is therefore to explore and compare conceptualization of quality among national bodies (macro level), senior hospital managers (meso level), and professional groups within clinical micro systems (micro level) in a cross-national study.METHODS:This cross-national multi-level case study combines analysis of national policy documents and regulations at the macro level with semi-structured interviews (383) and non-participant observation (803 hours) of key meetings and shadowing of staff at the meso and micro levels in ten purposively sampled European hospitals (England, the Netherlands, Portugal, Sweden, and Norway). Fieldwork at the meso and micro levels was undertaken over a 12-month period (2011-2012) and different types of micro systems were included (maternity, oncology, orthopaedics, elderly care, intensive care, and geriatrics).RESULTS:The three quality dimensions clinical effectiveness, patient safety, and patient experience were incorporated in macro level policies in all countries. Senior hospital managers adopted a similar conceptualization, but also included efficiency and costs in their conceptualization of quality. 'Quality' in the forms of measuring indicators and performance management were dominant among senior hospital managers (with clinical and non-clinical background). The differential emphasis on the three quality dimensions was strongly linked to professional roles, personal ideas, and beliefs at the micro level. Clinical effectiveness was dominant among physicians (evidence-based approach), while patient experience was dominant among nurses (patient-centered care, enough time to talk with patients). Conceptualization varied between micro systems depending on the type of services provided.CONCLUSION:The quality conceptualization differed across system levels (macro-meso-micro), among professional groups (nurses, doctors, managers), and between the studied micro systems in our ten sampled European hospitals. This entails a managerial alignment challenge translating macro level quality definitions into different local contexts.
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