| 1. |
- Agerholm, J, et al.
(författare)
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Socioeconomic differences in healthcare utilization, with and without adjustment for need: an example from Stockholm, Sweden
- 2013
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 41:3, s. 318-325
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Previous studies have shown varying degrees of inequity of utilization of healthcare in Sweden. Studies based solely on register data cannot take into account differences in health status while studies based solely on self-reported data from surveys may potentially have biased data on healthcare utilization. The aim of this study was to investigate socioeconomic differences in utilization of outpatient healthcare services in Stockholm County, comparing analysis based on only register data, with analysis based on health survey data linked to register data. Methods: We linked data from a public health survey in Stockholm County 2006 ( n = 34,707) to register data on sociodemographic background characteristics and outpatient healthcare utilization in 2007. Negative binomial regression analysis was used to estimate income differentials in healthcare utilization adjusting for self-rated health and limiting longstanding illness. Results: Income differentials in the number of visits to doctors were found in favour of lower-income groups among people aged 25–64 years when only controlling for age. When controlling for health status, income differentials in favour of higher-income groups were observed among men (all ages) and among women aged 65+ years, with higher-income groups having 11–49% more visits than the lowest income group. Conclusions: The findings suggest that health status should be taken into account when analysing socioeconomic differences in healthcare utilization. When using only register based data there is a risk of underestimating or disregarding differences.
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| 2. |
- Aglen, B., et al.
(författare)
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Self-help and self-help groups for people with long-lasting health problems or mental health difficulties in a Nordic context : A review
- 2011
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 39:8, s. 813-822
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Forskningsöversikt (refereegranskat)abstract
- Aim: The aim of this review is to provide systematic knowledge of research from Nordic countries about the meaning of self-help and self-help groups when these are used as a concept or method addressing issues related to long-lasting health problems or mental health difficulties. Methods: Included were studies conducted in the Nordic countries that were published between January 1999 and September 2009. These studies investigated self-help and self-help groups addressing issues related to long-lasting health problems. Results: A total of 83 publications met the inclusion criteria. Four major characteristics of self-help were found to be present in the publications: self-help as an intrapsychological process, self-help as an interpsychological or group process, self-help as a coping, individual learning or empowerment process, and self-help as an alternative or complement to medical treatment. Of the 83 studies, 72 publications used a professional treatment perspective for studying self-help and 11 publications used a perspective derived from alternative or complementary therapies. Conclusions: The review shows that most of the research on self-help and self-help groups for people with long-lasting health problems or disability is conducted with an interest to improve the professional healthcare system. That is, the health-promotion strategy is mainly considered in the framework of treatment or care settings. This means that self-help in this context does not challenge the dominant biomedical health model. © 2011 the Nordic Societies of Public Health.
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| 3. |
- Ahlner, Johan, et al.
(författare)
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Prevalence of alcohol and other drugs and the concentrations in blood of drivers killed in road traffic crashes in Sweden
- 2014
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications (UK and US). - 1403-4948 .- 1651-1905. ; 42:2, s. 177-183
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Tidskriftsartikel (refereegranskat)abstract
- Background: Drunk or drug-impaired drivers represent a major public health and societal problem worldwide. Because over 95% of drivers killed on the roads in Sweden are autopsied, reliable information is available about the use of alcohol and/or other drug before the crash. Methods: This retrospective 4-year study (2008-2011) used a forensic toxicology database (TOXBASE) to evaluate the concentrations of alcohol and other drugs in blood samples from drivers killed in road-traffic crashes. Results: The mean age of all victims (N = 895) was 48 +/- 20 years, and the majority were male (86%). In 504 drivers (56%), the results of toxicological analysis were negative and these victims were older; mean age (+/- SD) 47 +/- 20 years, than alcohol positive cases (35 +/- 14 years) and illicit drug users (34 +/- 15 years). In 21% of fatalities, blood-alcohol concentration (BAC) was above the statutory limit for driving (0.2 g/L), although the median BAC was appreciably higher (1.72 g/L). Illicit drugs (mainly amphetamine and cannabis) were identified in similar to 7% of victims, either alone (2.5%), together with alcohol (1.8%) or a prescription drug (2%). The psychoactive prescription drugs identified were mainly benzodiazepines, z-hypnotics and tramadol, which were found in the blood of 7.6% of crash victims. Conclusions: The high median BAC in fatally-injured drivers speaks strongly towards alcohol-induced impairment as being responsible for the crash. Compared with alcohol, the prevalence of illicit and psychoactive prescription drugs was fairly low despite a dramatic increase in the number of drug-impaired drivers arrested by the police after a zero-tolerance law was introduced in 1999.
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| 4. |
- Al-Emrani, Faisal, et al.
(författare)
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The influences of childhood and adult socioeconomic position on body mass index: A longitudinal Swedish cohort study.
- 2013
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 41:5, s. 463-469
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Tidskriftsartikel (refereegranskat)abstract
- Background: Low socioeconomic position (SEP) in adulthood has been associated with overweight and obesity in high-income countries. However, little is known about the contribution of childhood SEP to weight change. Using a Swedish general population sample, this study aimed to examine the association between five-year weight gain among adults and socioeconomic position in childhood and adulthood. Methods: The data was drawn from the Scania Public Health Cohort and included 4244 individuals (1816 males and 2428 females) between the ages of 29 and 60 years, stratified by sex and age (29-39 and 40-60 years). General linear and logistic regression models were used to analyse the data. Results: Adult SEP was inversely correlated to BMI at baseline in males and older females. Childhood SEP showed no clear pattern regarding current BMI or the risk of being overweight at baseline, either in males or females. However, BMI increase between baseline and follow-up was greater in the highest adult SEP groups than in lowest ones for both males and females, although with a weaker trend among females. High childhood SEP was associated with a greater BMI increase in older males, but the pattern was the opposite in older females. Conclusions: Adult as well as childhood SEP influences weight gains, but differently among males and females and in different age groups. The findings suggest two waves of socioeconomic weight gain patterns in the Swedish population: one across generations and another contemporary one.
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| 5. |
- Alharbi, Tariq, 1979, et al.
(författare)
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The impact of organizational culture on the outcome of hospital care: After the implementation of person-centred care
- 2014
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 42:1, s. 104-110
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To measure the effect of organizational culture on health outcomes of patients 3 months after discharge. Methods: a quantitative study using Organizational Values Questionnaire (OVQ) and a health-related quality of life instrument (EQ-5D). A total of 117 nurses, 69% response rate, and 220 patients answered the OVQ and EQ-5D, respectively. Results: The regression analysis showed that; 16% (R2 = 0.02) of a decreased health status, 22% (R2 = 0.05) of pain/discomfort and 13% (R2 = 0.02) of mobility problems could be attributed to the combination of open system (OS) and Human Relations (HR) cultural dimensions, i.e., an organizational culture being dominated by flexibility. Conclusions: The results from the present study tentatively indicated an association between an organizational culture and patients' health related quality of life 3 months after discharge. Even if the current understanding of organizational culture, which is dominated by flexibility, is considered favourable when implementing a new health care model, our results showed that it could be hindering instead of helping the new health care model in achieving its objectives.
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| 6. |
- Almquist, Ylva B., et al.
(författare)
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Friendship network characteristics and psychological well-being in late adolescence : Exploring differences by gender and gender composition
- 2014
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Ingår i: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 42:2, s. 146-154
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The aim of the present study was to examine the association between friendship networks and psychological well-being among 19-year-olds. Methods: The data used was a random sample of Swedish individuals born in 1990 who answered a questionnaire in 2009-2010. Friendship networks were considered in terms of three measures of emotional support. Six statements about the individual's emotional state were used to create a summary measure of psychological well-being. Gender and gender composition were included as potentially moderating factors. The association between friendship networks and psychological well-being was analysed by means of linear regression analysis (n = 1289). Results: The results indicate that males' and females' friendship networks were similar with regard to quality and trust, whereas males' networks were characterized by less self-disclosure and a stronger preference for same-gender friendships. Gender composition did not matter for the support levels. Emotional support was associated with psychological well-being but there were gender differences: females seemed to benefit more health-wise from having high-quality (and trusting) networks. Moreover, whereas self-disclosure among males was positively linked to well-being, this was not the case among females. None of these associations were moderated by gender composition. Conclusions: In sum, friendship networks are beneficial for the psychological well-being among late adolescents, but there are some important differences according to gender.
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| 7. |
- Almquist, Ylva B.
(författare)
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School performance as a precursor of adult health : Exploring associations to disease-specific hospital care and their possible explanations
- 2013
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 41:1, s. 81-91
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Tidskriftsartikel (refereegranskat)abstract
- Aims: While past research has shown that school performance is associated with some specific health outcomes in adulthood, few studies have taken a general approach to the link between school performance and adult disease. The aim of the present study was therefore to investigate sixth grade school performance in relation to disease-specific hospital care in adulthood and, moreover, to examine whether other conditions in childhood could account for any such associations. Methods: The data used was the Stockholm Birth Cohort, consisting of 14,294 individuals born in 1953. Associations between school performance and disease-specific hospital care were analysed by means of Cox regression. Results: Poor school performance was shown to be linked to a variety of diseases in adulthood, e.g. drug dependence, stomach ulcer, cerebrovascular diseases, and accidents. Some differences according to gender were found. Most associations, but not all, were explained by the simultaneous inclusion of various family-related and individual factors (e.g. social class, cognitive ability, and behavioural problems). Conclusions: In sum, the results of this study suggest that poor school performance may be an essential part of risk clustering in childhood with important implications for the individual's health career.
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| 8. |
- Anderberg, Eva, et al.
(författare)
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Use of healthcare resources after gestational diabetes mellitus: A longitudinal case-control analysis.
- 2012
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 40:4, s. 385-390
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To analyse whether gestational diabetes mellitus (GDM) was associated with increases in healthcare utilisation after delivery. METHODS: A longitudinal case-control registry-based study of 579 women with GDM delivered in 1995-2001. Two controls for each case were selected from the Swedish National Board of Health and Welfare, matched for year of birth, year of delivery, and municipality of residence. Data regarding healthcare utilisation was provided by the Patients' Administrative System in Skåne County, Sweden, covering the period from the years of delivery up to year 2009. RESULTS: Women with previous GDM had higher mean number of contacts and total cost in the years after delivery as compared to controls, also when excluding utilisation related to subsequent pregnancies and childbirth. By year 2009, 31% of women with prior GDM were diagnosed with diabetes, compared to 1% of controls. Women diagnosed with diabetes were more likely to use health care (odds ratio 14.22, 95% confidence interval 5.87-34.45) controlling for age and time since delivery, whereas cases not diagnosed with diabetes did not differ from controls. The average annual cost of healthcare utilisation was 101% higher (p<0.001) for women with diabetes 10 years after delivery compared to controls. CONCLUSIONS: GDM was associated with higher healthcare utilisation postpartum for women who had a diabetes diagnosis. The results call for implementation of structured programmes to follow up women with GDM postpartum for early detection of diabetes and effective management, which may have the potential for improved health and savings in healthcare costs.
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| 9. |
- Andersson, A, et al.
(författare)
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A five-year rehabilitation programme for younger women after a coronary event reduces the need for hospital care
- 2010
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 38:6, s. 566-573
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Cardiovascular disease (CVD) is the dominant diagnosis in in-patient care in Sweden and the third most common cause for long-term sick leave and disability pension. Women are higher consumers of health care than men and have higher frequencies of sickness absenteeism. The aim of this paper was to evaluate whether a five-year long rehabilitation programme for women with CVD affected the use of hospital care and sickness absenteeism. Methods: 130 women below 65 years of age with CVD were randomized to either intervention (n = 69, mean age 52.4 years) with an intensive lifestyle programme (e.g. physical exercise, smoking cessation, dietary advice), including stress management or to standard care (n = 61, mean age 54.3 years). All patients went through baseline medical examinations, including self-administered questionnaires. This procedure was repeated yearly during the rehabilitation period. The frequency of cardiac-related healthcare use was followed via official registers. Results: Emergency visits and number of in-patient days decreased significantly in the intervention group from year one to year five (p < 0.05) but remained unchanged in the control group. Scheduled doctor visits decreased significantly in both groups. There were no significant differences between groups regarding proportion of women on sick leave after one, three and five years. Conclusions: This extensive intervention programme reduced visits at emergency wards and numbers of in-patient days, which in the long run may have beneficial effects on public finances and the patient’s quality of life. The study confirmed previous findings from interventions showing difficulties in influencing sick-leave rates.
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| 10. |
- André, Malin, et al.
(författare)
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Cohort differences in personality in middle-aged women during a 36-year period. Results from the Population Study of Women in Gothenburg
- 2010
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 38:5, s. 457-464
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To investigate secular trends in personality traits in adult female populations. METHODS: Two representative, population-based cohorts of women, 38 (n = 318) and 50 (n = 593) years of age participated in a health examination in 1968 and 2004 in Gothenburg, Sweden. The Eysenck Personality Inventory (EPI) and Cesarec-Marke Personality Schedule (CMPS) were used to measure personality traits. Socioeconomic and lifestyle variables (personal income, education, marital status, children at home, physical activity and smoking) were reported. RESULTS: In both age groups, secular comparisons in psychological profile subscales showed an increase in dominance, exhibition, aggression and achievement. Only small divergences were seen concerning affiliation, guilt feelings, nurturance and succorance. EPI showed a corresponding rise in extroversion. Social data showed a statistically significant increase in percentage of unmarried women, personal income levels, and higher educational achievement. While around 70% of women in 1968-69 had elementary school education only, around 90% had high school or university education in 2004-05. CONCLUSIONS: The results indicate major transitions in the adult Swedish female population in the direction of a more stereotypically ''male'' personality profile, but not at the expense of traditionally socially important female traits, which remained constant. These results are consistent with the hypothesis that society and the environment influence personality.
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