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- Bardage, Cecilia, et al.
(författare)
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Non-prescription medicines for pain and fever : A comparison of recommendations and counseling from staff in pharmacy and general sales stores
- 2013
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Ingår i: Health Policy. - : Elsevier BV. - 0168-8510 .- 1872-6054. ; 110:1, s. 76-83
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The purpose of this study is to map and analyze the content and quality of theencounter when customers buy non-prescription medicines for pain and fever.Methods: 297 pharmacies and 801 general sales stores (GSS) in Sweden were selected. A"Mystery shopper" exercise was conducted. Three scenarios were used and a total of 366units were selected for each scenario. There were in total 625 observers: 208 in the childwith fever scenario, 225 in the Reliv scenario, and 192 in the painkiller during pregnancyscenario. Data collection: 21st September to 20th November 2011.Results: In two out of three visits to GSS, the staff proposed a medicine for a heavily pregnantwoman. The staff suggested in 9% of the visits a medicine that is inappropriate in latepregnancy. The corresponding percentage in pharmacies was 1%.Both pharmacies and GSS proposed, in 6% a medicine that is inappropriate for babies toa feverish child. Only 16% of the pharmacists and 14% of the staff in GSS asked for the ageof the child.General sales staff recommended in 10% ibuprofen and in 4% an acetylsalicylic acid productwhen an acetaminophen preparation was requested. The corresponding percentage inthe pharmacy were 4% ibuprofen, 2% diclofenac, and 1% an acetylsalicylic acid product.Conclusions: The staff in GSS and pharmacies do not pay sufficient attention to the heterogeneityof painkillers, which lead to inappropriate recommendations.
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| 2. |
- Bernsten, Cecilia, et al.
(författare)
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A comparative analysis of remuneration models for pharmaceutical professional services
- 2010
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Ingår i: Health Policy. - : Elsevier BV. - 0168-8510 .- 1872-6054. ; 95:1, s. 1-9
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Forskningsöversikt (refereegranskat)abstract
- Objectives: Pharmacists provide a wide range of professional services to support the appropriate use of medicines by patients. This study aims to conduct an international, comparative analysis of remuneration models for pharmaceutical professional services. Methods: Information about remuneration models was derived from a literature review and a semi-structured questionnaire completed by experts. Results: Remuneration models differ in the way that pharmacists are paid for professional services beyond dispensing medicines. Also, the scope of services that are remunerated varies. The majority of countries regulate remuneration for services only when the medicine is paid for under the reimbursement scheme. Remuneration of services implies a commitment to assure their quality in some countries. Collaborative practice models have been set up where pharmacists work together with other health care professionals to deliver diagnosis-specific services or services based on the patient's use of medicines. The remuneration of services is influenced by the value of services. budgetary constraints, the payer perspective, and the attitude of physicians, pharmacists and patients. Conclusions: Professional organisations need to formulate a clear strategy for developing and gaining remuneration for pharmaceutical professional services. This implies that pharmacists not only demonstrate the value of services, but also assure their quality. (C) 2009 Elsevier Ireland Ltd. All rights reserved.
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| 3. |
- Björkman, Ingeborg, et al.
(författare)
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The Swedish A(H1N1) vaccination campaign : Why did not all Swedes take the vaccination?
- 2013
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Ingår i: Health Policy. - : Elsevier BV. - 0168-8510 .- 1872-6054. ; 109:1, s. 63-70
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundIn Sweden, a mass vaccination campaign against the influenza A(H1N1) 2009 resulted in 60% vaccination coverage. However, many countries had difficulty in motivating citizens to be vaccinated. To be prepared for future vaccination campaigns, it is important to understand people's reasons for not taking the vaccination.ObjectiveThe aim of this qualitative study was to explore motives, beliefs and reactions of individuals with varying backgrounds who did not get vaccinated.Data and methodsThe total 28 individuals participating in the interviews were permitted to speak freely about their experiences and ideas about the vaccination. Interviews were analysed using a Grounded Theory approach. The strength of participants' decisions not to be vaccinated was also estimated.FindingsPatterns of motives were identified and described in five main categories: (A) distinguishing between unnecessary and necessary vaccination, (B) distrust, (C) the idea of the natural, (D) resisting an exaggerated safety culture, and (E) injection fear. The core category, upholding autonomy and own health, constitutes the base on which the decisions were grounded.ConclusionA prerequisite for taking the vaccine would be that people feel involved in the vaccination enterprise to make a sensible decision regarding whether their health will be best protected by vaccination.
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| 8. |
- Fredriksson, Mio, 1976-
(författare)
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Is patient choice democratizing Swedish primary care?
- 2013
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Ingår i: Health Policy. - : Elsevier BV. - 0168-8510 .- 1872-6054. ; 111:1, s. 95-98
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Tidskriftsartikel (refereegranskat)abstract
- Choice and competition reforms in healthcare often involve the idea of empowering patients through the mechanism of ‘exit’. Using Swedish healthcare as an example, this article illustrates that this kind of efforts to empower patients may not only affect patients’ chances of influencing healthcare but also those of citizens, who may lose ‘voice’ as a result. Thus, it is an example of the conflict between representative democracy and the customers’ control over welfare services; a conflict that may be overcome by providing new forms of collective decision-making. This was not the case when introducing a patient choice reform in Swedish primary care in 2010.
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| 9. |
- Glenngård, Anna, et al.
(författare)
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Choice of primary care provider: Results from a population survey in three Swedish counties.
- 2011
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Ingår i: Health Policy. - : Elsevier BV. - 1872-6054 .- 0168-8510. ; 103:1, s. 31-37
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Tidskriftsartikel (refereegranskat)abstract
- Recent reforms in Swedish primary care have involved choice of provider for the population combined with freedom of establishment and privatisation of providers. This study focus to what extent individuals feel they have exercised a choice of provider, why they exercise choice and where they search for information, based on a population survey in three Swedish counties. The design of the study enabled for studying behaviour with respect to differences in time since introduction of the reform and differences in number of alternative providers and establishments of new providers in connection with the reform. About 60% of the population in the three counties felt that they had made a choice of provider in connection with or after the introduction of a reform focusing on choice and privatisation. Establishments of new providers and having enough information increased the likelihood whereas preferences for direct access to a specialist decreased the likelihood of making a choice. The data further suggests that individuals were rather passive in their search for information and tended to choose providers that they previously had been in contact with. This is in line with results from previous studies and poses challenges for county councils governance of reforms.
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| 10. |
- Glenngård, Anna
(författare)
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Productivity and patient satisfaction in primary care-Conflicting or compatible goals?
- 2013
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Ingår i: Health Policy. - : Elsevier BV. - 1872-6054 .- 0168-8510. ; 111:2, s. 157-165
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Tidskriftsartikel (refereegranskat)abstract
- Following recent reforms in Swedish primary care, providers are accountable to both citizens and county councils, in their role as payers. Productivity and quality measurement is fundamental for ensuring health care providers accountability to payers and that resources are spent as intended. The purpose was to study productivity and patient satisfaction in Swedish primary care. One measure of productivity capturing volume of visits and one measure capturing individual's judgment about the quality of services in relation to allocated resources was estimated. The potential conflict between the two measures and variation with respect to different factors was analyzed. There was a great variation in both measures of productivity. No conflict between the two measures of productivity was found. Thus, most providers could increase their volume of services without adverse effects for the quality and vice versa. Providers are however faced with different conditions. Traditional productivity measures are not enough to assess whether allocated resources are used according to set priorities and generates value for money. Information about the length and content of visits and the distribution of services produced is also needed, in particular to assess if resources allocated based on expected great needs among certain groups actually benefits those individuals. Effects of services produced are also needed. This is particularly important to assess if resources allocated based on expected great needs among certain groups actually benefits those individuals.
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