| 1. |
- Winblad Spångberg, Ulrika, et al.
(författare)
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Dags att öka äldreinflytandet
- 1998
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Ingår i: Kommunaktuellt. ; 7, s. 29-
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 2. |
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| 3. |
- Arnetz, Judith E., et al.
(författare)
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Is patient involvement during hospitalization for acute myocardial infarction associated with post-discharge treatment outcome? : an exploratory study
- 2010
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Ingår i: Health Expectations. - : Wiley. - 1369-6513 .- 1369-7625. ; 13:3, s. 298-311
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Tidskriftsartikel (refereegranskat)abstract
- Objective To investigate whether patient involvement during hospitalization for acute myocardial infarction (MI) was associated with health and behavioural outcomes 6–10 weeks after hospital discharge. Background Patient involvement has been associated with improved health outcomes in chronic disease, but less research has focused on the effects of patient involvement in acute conditions, such as MI. Design Self-administered questionnaire study. Questionnaire results were run against medical outcome data in a national database of cardiac patients. Setting and participants Cardiac patients (n = 591) on their first follow-up visit after hospitalization for MI at 11 Swedish hospitals. Main outcome measures Patient ratings of three questionnaire scales related to involvement; cardiovascular symptoms, medication compliance, participation in cardiac rehabilitation, and achievement of secondary preventive goals. Results More positive patient ratings of involvement were significantly associated with fewer cardiovascular symptoms 6–10 weeks after hospital discharge. In contrast, patients who attended cardiac rehabilitation and achieved the goals for smoking cessation and systolic blood pressure were significantly less satisfied with their involvement. No association was found between involvement ratings and medication compliance. Conclusion This study represents a first attempt to examine associations between patient involvement in the acute phase of illness and short-term health outcomes. Some significant associations between involvement and health and behavioural outcomes after acute MI were found. However, higher involvement ratings were not consistently associated with more desirable outcomes, and involvement during hospitalization was not associated with MI patient health and behaviour 6–10 weeks after hospital discharge to the extent hypothesized.
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| 4. |
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| 5. |
- Ernesäter, Annica, 1970-, et al.
(författare)
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A comparison of calls subjected to a malpractice claim versus 'normal calls' within the Swedish Healthcare Direct : a case–control study
- 2014
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 4:10, s. e005961-
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The purpose of this study is to compare communication patterns in calls subjected to a malpractice claim with matched controls. Setting: In many countries, telephone advice nursing is patients' first contact with healthcare. Telenurses' assessment of callers' symptoms and needs are based on verbal communication only, and problems with over-triage and under-triage have been reported. Participants: A total sample of all reported medical errors (n=33) during the period 2003-2010 within Swedish Healthcare Direct was retrieved. Corresponding calls were thereafter identified and collected as sound files from the manager in charge at the respective call centres. For technical reasons, calls from four of the cases were not possible to retrieve. For the present study, matched control calls (n=26) based on the patient's age, gender and main symptom presented by the caller were collected. Results: Male patients were in majority (n=16), and the most common reasons for calling were abdominal pain (n=10) and chest pain (n=5). There were statistically significant differences between the communication in the cases and controls: telenurses used fewer open-ended medical questions (p<0.001) in the cases compared to the control calls; callers provided telenurses with more medical information in the control calls compared to the cases (p=0.001); and telenurses used more facilitation and patient activation activities in the control calls (p=0.034), such as back-channel response (p=0.001), compared to the cases. Conclusions: The present study shows that telenurses in malpractice claimed calls used more closed-ended questioning compared to those in control calls, who used more open-ended questioning and back-channel response, which provided them with richer medical descriptions and more information from the caller. Hence, these communicative techniques are important in addition to solid medical and nursing competence and sound decision aid systems.
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| 7. |
- Fredriksson, Mio, 1976-, et al.
(författare)
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Recentralizing healthcare through evidence-based guidelines – striving for national equity in Sweden
- 2014
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Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 14, s. 509-
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Tidskriftsartikel (refereegranskat)abstract
- Background: The Swedish government has increasingly begun to rely on so called informative governance when regulating healthcare. The question this article sets out to answer is: considered to be “the backbone” of the Swedish state’s strategy for informative governance in healthcare, what kind of regulatory arrangement is the evidence-based National Guidelines? Together with national medical registries and an extensive system of quality and efficiency indicators, the National Guidelines constitutes Sweden’s quality management system. Methods: A framework for evaluating and comparing regulatory arrangements was used. It asks for instance: what is the purpose of the regulation and are regulation methods oriented towards deterrence or compliance? Results: The Swedish National Guidelines is a regulatory arrangement intended to govern the prioritizations of alldecision makers – politicians and administrators in the self-governing county councils as well as healthcare professionals – through a compliance model backed up by top-down benchmarking and built-in mechanisms for monitoring. It is thus an instrument for the central state to steer local political authorities. The purpose is to achieve equitable and cost-effective healthcare. Conclusions: This article suggests that the use of evidence-based guidelines in Swedish healthcare should be seen in the light of Sweden’s constitutional setting, with several autonomous levels of political authority negotiating the scope for their decision-making power. As decision-making capacity is relocated to the central government – from the democratically elected county councils responsible for financing and provision of healthcare – the Swedish National Guidelines is part of an ongoing process of healthcare recentralization in Sweden, reducing the scope for local decision-making. This represents a new aspect of evidence-based medicine (EBM) and clinical practice guidelines (CPGs).
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| 8. |
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| 9. |
- Hanning, Marianne, et al.
(författare)
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Köer och väntetider i sjukvården : det politiska perspektivet : intervjustudie med sjukvårdspolitiker i den södra sjukvårdsregionen våren 1997.
- 1997
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- Denna studie ingår i ett projekt där Landstingsförbundet, Samverkansnämndens kansli och sjukvårdshuvudmännen i den södra sjukvårdsregionen samarbetar för att ta fram ett förslag till uppföljningsmodell vad gäller köer och väntetider i sjukvården. Syftet med denna studie var att studera den landstingspolitiska nivåns uppfattning och upplevelse av köer och väntetider. I studien intervjuades sammanlagt 12 ledamöter i Södra samverkansnämnden. Intervjustudien visar att tillgänglighetsfrågor är mycket centrala i den lokala politiska debatten om sjukvården. Det var en allmän uppfattning att det inte enbart rör sig om resursbrist utan att det är fråga om komplicerade samband mellan många olika faktorer.
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| 10. |
- Hanning, Marianne, et al.
(författare)
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Maximum waiting time - a threat to clinical freedom? : Implementation of a policy to reduce waiting times
- 2000
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Ingår i: Health Policy. - 0168-8510 .- 1872-6054. ; 52:1, s. 15-32
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Tidskriftsartikel (refereegranskat)abstract
- This article focuses on physicians as implementers of health policy reforms. In 1992, a maximum waiting-time guarantee was introduced in Sweden. Initially the policy was a successful way to come to terms with long waiting times. However, after 2 years the waiting lists started to increase. To understand this development it is important to look at the reactions to the policy among the implementers, i.e. the physicians. Three questions are addressed: Did the implementers understand the intentions and the goals of the reform? Were they able to fulfil the guarantee? And, did they approve of the initiative? The study subjects were chief physicians at the hospital departments involved with the guarantee. Their attitudes towards the policy were ascertained by two surveys. Other material, such as statistics on waiting times, was also used. The study shows that the physicians approved of the guarantee initially. The measures taken in the first years were effective and did not conflict with earlier practice. However, increased demand in combination with economic restraints necessitated new priorities among patient groups. These changes of clinical practice did not coincide with the physicians’ professional values and hence they became more critical to the initiative and finally chose to abandon the intentions in the guarantee.
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