| 1. |
- Andersson, E., et al.
(författare)
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Current and future costs of obesity in Sweden
- 2022
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Ingår i: Health Policy. - : Elsevier BV. - 0168-8510. ; 126:6, s. 558-564
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Tidskriftsartikel (refereegranskat)abstract
- Background: Obesity is a growing health issue. This study estimated the costs of obesity among people aged 25-84 years in Sweden using disease and non-disease specific attributable fractions from published data. A prognosis of costs of obesity in 2030 is presented. Methods and materials: Diseases related to obesity and their respective risks and population attributable fraction were retrieved by literature review. Longitudinal data on age and sex related prevalence of obesity was used to construct three scenarios for costs of obesity in 2030. Results: Nearly 4% of all deaths among people 25-84 years in 2016 ( n = 3,400) were attributed to obesity. Obesity cost EUR 2.7 billion in 2016, or EUR 377 per inhabitant aged >25 years. Non-health care costs were dominant and represented 80% of total societal costs. Main drivers were premature mortality (28%) and permanent sick leave (37%). If the proportion of obese remain at 2016 level, costs will increase 9% by 2030, but with continued linear growth, costs will increase by 66%. Conclusions: The responsibility, costs and treatment fall on several actors with a considerable burden falling on the individual and the society at large. New health promoting interventions and policy programs are needed and must be evaluated in terms of resource use and expected return.(c) 2022 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY license ( http://creativecommons.org/licenses/by/4.0/ )
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| 2. |
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| 3. |
- Bergerum, Carolina, 1967-, et al.
(författare)
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Organising and managing patient and public involvement to enhance quality improvement—Comparing a Swedish and a Dutch hospital
- 2022
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Ingår i: Health Policy. - : Elsevier. - 0168-8510 .- 1872-6054. ; 126:7, s. 603-612
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Tidskriftsartikel (refereegranskat)abstract
- As co-production approaches to quality improvement (QI) gain importance in healthcare, hospital leaders and managers are expected to organise and support such efforts. Yet, patient and public involvement (PPI) can be challenging. Hospital organisations, emphasising knowledge and evidence domains, are characterised by operational-professional rather than patient-preference led management. Thus, PPI adds aspects of influence and responsibility that are not clearly defined or understood, with limited knowledge about how it can be orchestrated. This study, therefore, aimed to explore hospital leaders’ and managers’ contextualised experiences of managing QI efforts involving patients, by comparing two European hospitals.The study draws on field observations and qualitative interviews with a total of 21 QI team leaders and hospital managers in a Swedish and a Dutch hospital organisation. The data were subjected to thematic analysis with a critical realist approach.Results define seven themes, or areas, in which mechanisms are at play: (1) patient involvement in hospital QI, and (2) improving outcomes for patients, originating from the strategic view of achieving the hospital vision. Furthermore, (3) societal influence, (4) knowledge and evidence, (5) complexity, (6) individual resources, and (7) cooperation are areas in which mechanisms operate in the process. These areas are equally relevant for both hospitals, yet the mechanisms involved play out differently depending on contextual structure and local means of action.
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| 4. |
- Brilli, Ylenia, et al.
(författare)
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Influenza vaccination behavior and media reporting of adverse events
- 2020
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Ingår i: Health Policy. - : Elsevier BV. - 0168-8510. ; 124:12, s. 1403-1411
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Tidskriftsartikel (refereegranskat)abstract
- We study the role of media reporting of alleged adverse effects of influenza vaccination on adults’ (aged 50 or more) decisions to vaccinate against the flu. We exploit the diffusion of news linking suspected deaths to the vaccine, during the 2014 vaccination campaign in Italy. Using daily variation in news items across the 2014 campaign and the previous year campaign, unaffected by media cases, we show that media reporting decreases flu vaccination by about 2.5 % (78 fewer vaccinations per day). The effect, however, is short-lived, as it fades away after approximately 10 days from the news outbreak.
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| 5. |
- Carlsson, Fredrik, 1968, et al.
(författare)
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Antibiotic prescription: Knowledge among physicians and nurses in western Sweden
- 2023
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Ingår i: Health Policy. - : Elsevier BV. - 0168-8510. ; 130
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Tidskriftsartikel (refereegranskat)abstract
- Misuse and overuse of antibiotics are common in primary care. Guidelines for prescribing of antibiotics are often not followed We conducted a survey of 120 health centers in western Sweden to investigate to what extent physicians and nurses think they know and comply with the guidelines for prescribing of antibiotics. A large majority of the respondents answered that they know the guidelines well. However, many also believed that physicians/nurses in general know less about and are worse at following the guidelines than themselves, indi-cating optimism bias. According to the respondents the main reason for non-compliance with guidelines was patient expectations. The survey also showed that both physicians' and nurses' actual knowledge of when it is effective to prescribe antibiotics is incomplete. Interventions to reduce unnecessary antibiotic therapy in primary care should target the failing congruence between the perceived knowledge of guidelines for antibiotic therapy and actual knowledge.
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| 6. |
- Dahlgren, Cecilia, et al.
(författare)
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Simply the best? The impact of quality on choice of primary healthcare provider in Sweden
- 2021
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Ingår i: Health Policy. - : Elsevier BV. - 0168-8510 .- 1872-6054. ; 125:11, s. 1448-1454
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Tidskriftsartikel (refereegranskat)abstract
- Objective: One of the more important objectives with the patient choice reform, introducing non-price competition in Swedish primary healthcare, was to improve performance and quality of care. However, in order for choice to lead to quality improvements, citizens need to consider quality aspects in their choices of provider. We hypothesize that quality of care influences choice of provider and the objective of this study is to investigate if citizens are willing to make a trade-off between distance to chosen provider and quality of care. Methods: We use conditional logit models to analyse if quality and other provider attributes influence choice of provider. The study population includes all citizens of Region Stockholm with at least one primary healthcare contact (N ~1.4 million). Results: The results show that distance is the most important factor in choosing a primary healthcare provider but that there seems to be a willingness to make a trade-off between distance and quality measures. However, other provider attributes, such as the Care Need Index of the registered population, seem to influence choice to a greater extent than quality. Conclusion: The results point in the same direction as the arguments behind the patient choice reform. However, the effects are marginal. To enhance quality competition, policy makers should consider making quality information at the provider level more accessible.
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| 9. |
- Fredriksson, Mio, 1976-, et al.
(författare)
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Awareness and opinions on healthcare decommissioning in a Swedish region
- 2020
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Ingår i: Health Policy. - : Elsevier BV. - 0168-8510 .- 1872-6054. ; 124:9, s. 991-997
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Tidskriftsartikel (refereegranskat)abstract
- Decision-makers may have to decommission services as a response to budget deficits. The aim of this study was to investigate a case of decommissioning with regard to the public's awareness and opinions. The analysis of a survey in a Swedish region that begun the implementation of an extensive decommissioning programme in 2015 shows that the majority of respondents were well or very well informed about the programme (68 %). A large proportion of the respondents thought the decision-makers to a low or very low degree had adopted appropriate measures to solve the economic problems (43 %), but together more respondents were either indifferent (39.5 %) or positive (17.5 %). Regarding the level of satisfaction with the region's healthcare system, compared to prior to the decommissioning period, 30 % were less satisfied while together more were either indifferent (48 %) or had become more satisfied (22 %). The large share of indifferent responses opens up for various interpretations or framings of the programme outcomes. Trust in the regions' healthcare system nevertheless increased during the same period. Furthermore, self-assessed health as well as age and utilization seem to be associated with healthcare system satisfaction during decommissioning. This illustrates heterogeneity in the public's responses to decommissioning, which calls for further investigation.
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| 10. |
- Karltun, Anette, 1956-, et al.
(författare)
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Knowledge management infrastructure to support quality improvement : A qualitative study of maternity services in four European hospitals
- 2020
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Ingår i: Health Policy. - : Elsevier. - 0168-8510 .- 1872-6054. ; 124:2, s. 205-215
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Tidskriftsartikel (refereegranskat)abstract
- The influence of multilevel healthcare system interactions on clinical quality improvement (QI) is still largely unexplored. Through the lens of knowledge management (KM) theory, this study explores how hospital managers can enhance the conditions for clinical QI given the specific multilevel and professional interactions in various healthcare systems.The research used an in-depth multilevel analysis in maternity departments in four purposively sampled European hospitals (Portugal, England, Norway and Sweden). The study combines analysis of macro-level policy documents and regulations with semi-structured interviews (96) and non-participant observations (193 hours) of hospital and clinical managers and clinical staff in maternity departments.There are four main conclusions: First, the unique multilevel configuration of national healthcare policy, hospital management and clinical professionals influence the development of clinical QI efforts. Second, these different configurations provide various and often insufficient support and guidance which affect professionals’ action strategies in QI efforts. Third, hospital managers’ opportunities and capabilities for developing a consistent KM infrastructure with reinforcing enabling conditions which merge national policies and guidelines with clinical reality is crucial for clinical QI. Fourth, understanding these interrelationships provides an opportunity for improvement of the KM infrastructure for hospital managers through tailored interventions.
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