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Bondesson, Susanne M., et al.
(author)
Hospital utilization and costs for spinal cord stimulation compared with enhanced external counterpulsation for refractory angina pectoris
2013
In: Journal of Evaluation In Clinical Practice. - : Wiley-Blackwell. - 1356-1294 .- 1365-2753. ; 19:1, s. 139-147
Journal article (peer-reviewed) abstract
Rationale, aims and objectives The aim of this study was to compare acute hospital utilization and costs for patients with refractory angina pectoris undergoing spinal cord stimulation (SCS) versus enhanced external counterpulsation (EECP). Method Seventy-three persons were included in this register study. The acute hospital utilization and costs for SCS and EECP were followed over a period from 12 months before treatment to 24 months after treatment using Patient Administrative Support in Skåne for publicly organized care. Results SCS was significantly more expensive than EECP (P < 0.001). Both SCS and EECP entailed fewer days of hospitalization for coronary artery disease in the 12-month follow-up compared with the 12 months preceding treatment. Patients treated with EECP showed an association between reduced hospital admissions and an improved Canadian Cardiovascular Society classification class compared with 1 year before treatment. A significant reduction in cost was seen in both the SCS group (P = 0.018 and P = 0.001, respectively) and the EECP group (P = 0.002 and P = 0.045, respectively) during 12 and 24 months of follow-up compared with before treatment. There were no significant differences between the groups for hospitalization days or admissions, including costs, at the different follow-ups. Conclusions Cost-effective treatment modalities such as SCS and EECP are valuable additions to medical and revascularization therapy in patients with refractory angina pectoris. Pre-existing conditions and the patient's preferences should be taken in consideration when clinicians choose between treatments for this group of patients.
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Furenbäck, Ingela, 1963-
(author)
Improving the quality of care through communication arena
2013
In: International Journal of Integrated Care. - 1568-4156 .- 1568-4156. ; 13:WCIC Conf Suppl
Journal article (other academic/artistic) abstract
Purpose: Collaboration has become an increasingly more common strategy when developing care sectors while, coincidentally, experience and research show that collaboration development may be problematic in itself. This study aims to achieve better understanding of collaboration processes.Method: A local project that aimed at improving the quality of healthcare and social care by developing the co-operation between organizations took place in Sweden, and by using participatory action research, PAR, this process was followed between 2004 and 2008. Material was gathered through participant observation from the perspective of patients, relatives, staff, managers and politicians. A descriptive narrative was compiled and a hermeneutic interpretation was performed.Results: Initially, the development of collaboration was impeded due to lack of communication between the participants from various levels within the organizations. With the support of PAR, communication arenas were arranged to handle social interaction as well as different perspectives and conflicts, which led to improved collaboration within the organizations as well as between the care organizations.Conclusion: Development of collaboration between organizations reflects how collaboration within one organization works. Collaboration is a social and interpersonal phenomenon, and readily available communication arenas are crucial for its development.
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Nordgren, Lars, et al.
(author)
Choice of primary care in Sweden : a discourse analysis of citizen statements
2011
In: Offentlig Förvaltning. Scandinavian Journal of Public Administration. - 2000-8058 .- 2001-3310. ; 15:3, s. 25-40
Journal article (peer-reviewed) abstract
Through a discourse analysis of the end-users’ statements on their choice of primary care, there is a focus on how they use certain discourses in society with regard to which discourses governs their choices of primary care. For this purpose, a group interview was administered in a location in the south of Sweden. It was strategically designed to on the whole include individuals with following characteristics: age between 20-45 years, and 65 year or older, and also living in a small community. The following main discourses have been identified in the discussion; freedom of choice; i.e. to say that one has actively chosen one’s health centre or doctor, to be able to reject and re-select care-givers, networking; i.e. ‘to say that friends’ and acquaintances’ experiences affect the choice of a new health centre and professional service, i.e. to say that doctors and other staff should give professional service. It seems like choice of care has improved the possibilities of the citizens to choose preferred care provider, or drop one due to dissatisfaction. When implementing reforms in health care it is valuable to take into account the voices of the users, as they are able to contribute to the development of health care.
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Nordgren, Lars, et al.
(author)
The value creation-concept in hospitals : Health values from the patients’ perspective
2013
In: Nordisk sygeplejeforskning. - 1892-2678 .- 1892-2686. ; 3:2, s. 105-116
Journal article (peer-reviewed) abstract
Aim: Based on the concept of value creation the aim was to analyse a sample of patients’ unstructured responses, and to show what the patients perceived to be healthcare values.Method: Using content analysis the patients’ responses to three questions underwent a categorization involving the identification, coding, and emerging of themes.Results: This is good: fellow feeling, receptivity, proficiency, efforts matched to requirements, popular food, informed patients. The theme was professional care. This I would like to change: offer more conventional forms of accommodation, better quality food, better cleaning, more time to their patients, better information, and improved accessibility. The theme was patients want good service when in hospital. Other complaints were linked to care, resulting in; improve personal integrity, friendlier demeanour, more focusing on the individual. The theme was patients expect to be acknowledged and respected by nursing staff. However, the answers did not convey anything essentially new.Conclusion: The patients expressed different values. It is debatable to use service management concepts in healthcare in a simplistic way. Practice implications: Patients’ unstructured answers are of interest in improving the attitudes of the co-workers.
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