| 1. |
- Erlandsson, Kerstin, 1961-, et al.
(författare)
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Development of a tool to analyse what resources are needed to implement a midwife-led care framework : the MIDWIZE conceptual framework
- 2022
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Ingår i: Sexual & Reproductive HealthCare. - : Elsevier BV. - 1877-5756 .- 1877-5764. ; 33
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A midwife led care project targeting to decide what to do to achieve the SDG 2030 in maternal and child health, made a project team develop a tool to analyse what health care systems need, to adopt the MIDWIZE Conceptual Framework. The MIDWIZE Conceptual Framework wish to introduce the comprehensive midwifery-managed care provided women in Sweden to other countries, regions, and units where the framework is not fully applied.METHODS: In order to determine what resource needs would have to be met to improve midwife led care, a tool was developed using Delphi study technique.RESULTS: Using Delphi study technique together with on-site visits to two Sub-Saharan African countries, members of a project team went to Ethiopia and Uganda, where they visited governments, clinical or educational institutions and together with African leaders developed availability and efficiency of a tool to determine resource needs.CONCLUSION: If at some future time, a single country, region or unit, might want to use the tool for quality improvement purpose of midwife led care, then the tool might aid in taking the first step to determine what resources might be required and what changes might be recommended as concerns policy at the clinical or educational institution level that are part of already existing health care structures.
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| 2. |
- Friberg, Ingrid Osika, et al.
(författare)
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Patients' perceptions and factors affecting dialysis modality decisions
- 2018
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Ingår i: Peritoneal Dialysis International. - : SAGE Publications. - 0896-8608. ; 38:5, s. 334-342
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Tidskriftsartikel (refereegranskat)abstract
- Background: Home-based dialysis, including peritoneal dialysis (PD) and home hemodialysis (HHD), has been shown to be associated with tower costs and higher health-related quality of life than in-center HD. However, factors influencing the choice of dialysis modality, including gender, are still not well understood. Methods: A questionnaire was sent out to all dialysis patients in the western region of Sweden in order to investigate factors affecting choice of dialysis modality. Logistic regression was used to analyze the data. Results: Patients were more likelyto have home dialysis if they received predialysis information from 3 or more sources and, to a greater extent, perceived the information as comprehensive and of high quality. In addition, patients had a lower likelihood of receiving home dialysis with increasing age and if they lived closer to a dialysis center. Men had in comparison with women a greater likelihood of receiving home dialysis if they lived with a spouse. In-center dialysis patients more often believed that the social interaction and support provided through in-center HD treatment influenced the choice of dialysis modality. Conclusion: This study highlights the need for increased awareness of various factors that influence the choice of dialysis modality and the importance of giving repeated, comprehensive, high-quality information to dialysis and predialysis patients and their relatives. Information and support must be adapted to the needs of individual patients and their relatives if the intention is to improve patients' well-being and the proportion of patients using home dialysis.
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| 3. |
- Friberg, Ingrid Osika, et al.
(författare)
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Sex differences in health care consumption in Sweden: A register-based cross-sectional study
- 2016
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 44:3, s. 264-273
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Tidskriftsartikel (refereegranskat)abstract
- Background: Generally, health care consumption, especially primary care, is greater among women than men. The extent to which this sex difference is explained by reproduction and sex-specific morbidity is unclear. Methods: We examined age- and sex-specific health care service utilization and costs in the western region of Sweden. Data were retrieved from a regional health care database of information on total health care consumption in the population. Use of health care resources was divided into the following diagnosis categories: health care associated with reproduction; health care received for sex-specific morbidity; and health care provided for all other conditions. Results: Total per capita cost for health care was 20% higher for women than for men. When adjusted for reproduction and sex-specific morbidity, the cost-difference decreased to 8%. The remaining cost-difference could be explained by women's substantially higher costs for mental and behavioral disorders and diseases of the musculoskeletal system. Women were more likely to receive more accessible, less expensive primary care, while men were more likely to receive specialist inpatient care. Conclusions: The substantially greater use of reproduction-associated care among women, which largely occurs within primary care, might make it easier to also seek health care for other reasons. Efforts to eliminate barriers that prevent men from investing in their health and seeking primary care could reduce future morbidity and costs for specialist care. More studies and appropriate actions are needed to determine why women are overrepresented in mental, behavioral and musculoskeletal disorders.
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| 4. |
- Friberg, Ingrid Osika
(författare)
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Women's and Men's Health care utilisation from a cost perspective
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis was to explore sex differences in health care utilisation and costs (i) in a region in Sweden, (ii) in treatment of dialysis patients across the region, and (iii) in the treatment of specified dermatological diagnoses at an outpatient specialist clinic. Data were retrieved from medical records and health care and pharmaceutical databases, including cost estimates and survey data, and were analysed stratified by sex. The results showed that total per capita cost for health care was 20 per cent higher for women than for men. When total health care consumption was adjusted for reproduction and costs associated with sex-specific morbidity the cost difference declined to 8 per cent. The remaining cost difference could be explained by women’s substantially higher costs for mental health problems and diseases of the muscles and joints. Women were more likely to receive less expensive primary care, while men were more likely to receive specialist care. No differences in health-care-related dialysis costs were found between women and men, but the health-care-related costs of patients on in-centre dialysis were more than twice as high as those of patients on home dialysis. Men were more than three times more likely to receive home dialysis if they lived with a spouse compared to if they lived alone – an association that was not found among women. Additionally, patients had a higher likelihood of having home dialysis if they received pre-dialysis information from more sources and if the information was perceived as comprehensive and of high quality. The treatment for eczema and psoriasis demonstrated substantially greater cost for men, whilst women were more inclined to self-care in their home. In conclusion, to ensure the provision of gender equal and equitable health care services, it is important to disaggregate and analyse public health care spending by gender, including the impact of unpaid care work.
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| 5. |
- Lindgren, Helena, et al.
(författare)
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The midwife's role in achieving the Sustainable Development Goals: protect and invest together - the Swedish example.
- 2022
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Ingår i: Global health action. - : Informa UK Limited. - 1654-9880 .- 1654-9716. ; 15:1
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Tidskriftsartikel (refereegranskat)abstract
- 'The midwife's role in achieving the Sustainable Development Goals: Protect and Invest Together' is a report providing the reader the opportunity for understanding and appreciating the history of midwifery in Sweden and the interlinked nature of the United Nation's SDGs supporting health and wellbeing of women and children. To realise the opportunity to have a country with well-educated midwives of high academic standard, and, at the same time, promoting gender equality and equity we need to protect and invest together in midwives. This paper provides the foundation for a revitalised discussion on midwives' role for women and child health in the 21st century. The full Swedish Midwifery report was published in October 2021.
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| 6. |
- Oldsberg, Linnea, et al.
(författare)
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Geographical variations in patient-reported outcomes after total hip arthroplasty between 2008 - 2012
- 2019
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Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- © 2019 The Author(s). Background: Health care on equal terms is a cornerstone of the Swedish health care system. Total hip arthroplasty (THA) is considered a success story in Sweden with low frequency of reoperations and restored health-related quality of life (HRQoL). Administratively, health care in Sweden is locally self-governed by 21 counties. In this longitudinal nation-wide observational study we assessed the possible geographical variations in 1-year follow-up patient-reported outcomes (PROs): EQ-5D index, EQ VAS, Pain VAS and Satisfaction VAS. Methods: Study population consisted of 36,235 Swedish THA patients, operated during 2008 to 2012 due to hip osteoarthritis. Individual data came from Swedish Hip Arthroplasty Register, Statistics Sweden and National Board of Health and Welfare. We used descriptive statistics together with multivariable regression analysis to analyse the data. Results: We observed county level differences in both preoperative and postoperative PROs. The results showed that the differences observed in preoperative PROs could not fully explain the differences observed in postoperative PROs, even after adjustment for patient demographics (age, sex, BMI, Elixhauser comorbidity index, marital status, educational level and disposable income). This indicates that other factors might influence the outcome after THA. Conclusion: Likely, structural and process differences such as indication for surgery have an influence on PROs after surgery. Standardization of care at hospital levels may decrease geographical variations in postoperative HRQoL. Remaining differences will then possibly be associated to patient demographics.
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