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- Fridell, Mats, et al.
(author)
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Psychosocial Treatment for Drug Dependence
- 2003
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In: Treating Alcohol and Drug Abuse - An evidence based review. - : Treating Alcohol and Drug Abuse - An evidence based review John Wiley & Sons, Ltd. - 9783527306824 ; , s. 325-404
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Book chapter (other academic/artistic)abstract
- All randomized controlled studies published in international peer-reviewed journals up to July 1999 were meta-analysed with the aim of studying the effect of psychosocial interventions on patients with drug dependence. Systematic literature searches were administered by SBU. In all 104 studies were screened and rated according to the 12 dimension quality score of SBU. The analyses in the chapter studied the effects on drug abuse and retention and aimed at specific domains of research; 1) efficacy of treatment of opiate abuse/ depen¬dence (n=24) containing 5.721 patients, 2) of cocaine abuse/dependence, 26 studies with 5.956 patients), 3) cannabis abuse, (7 studies with 707 patients), 4) of treatment methods for patients with mental illness and (9 studies), 5) residential treatment containing 9 studies and 4.867 patients, 6) finally for structure interventions with other outcome measures than drug use, 5 studies with 461 patients. A clinical methodological model elaborated from Wolberg´s (1988) classification, divided the interventions into three groups: ranging in therapist skills, goals and costs from a) supportive, b) reeducational to c) psychotherapeutic intervenetions. Effect sizes were calcylated using Hedge´s d and groups of interventions were weighted with the root of the variance. In opiate abuse re-educational and psycho-therapeutic interventions had a significant but low Wd of .23 and .29 respectively. Re-educational interventions only gained a significant but low effect size of Wd = .24 in treatment of cocaine abuse. Family therapies finally were efficient in the treatment of teenage cannabis abusers in with an intact family network. Supportive interventions, generally, were not effective. For retention as outcome measure, finally, psychotherapies had a significant medium effect size in retention of opiate abuse (Wd= .56, n=3.380) and a low but significant positive effect size in retention of cocaine abuse (Wd= .30, n=3.381).
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2. |
- Jonsson, Egon
(author)
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Studies in health economics
- 1980
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Doctoral thesis (other academic/artistic)abstract
- During the last few decades, the Swedish public health sector has been greatly expanded. At present, about ten per cent of the gross national product goes to health care. Claims for more resources for health care are in prospect. However, demands are increasing from other sectors as well, and it is doubtful whether the share allocated to the health care sector will be allowed to increase at the same rapid pace as before. In this context it is crucial that policy options for health care be identified and evaluated not only in terms of their risks and benefits but also in terms of their accompanying resource requirements. This will require increased knowledge of the magnitude and measurement of health services resources and their relation to the benefits derived from efforts to prevent, cure and alleviate disease and disability. Concepts fundamental to the practice of health care are benefits of the patient and the associated risk of achieving these. Fundamental to economics is the ever-existing consideration of scarce resources, their efficient use and just allocation. These latter dimensions are considered in the studies presented in this dissertation: a comparison of a Swedish and a U.S. community hospital, an analysis of volume and distribution of coronary care units and an economic assessment of computerized tomography.
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3. |
- Jonsson, Egon, et al.
(author)
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Utilization of Coronary Care Units in Sweden
- 1977
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In: Scandinavian Journal of Social Medicine. - : SAGE Publications. - 0300-8037. ; 5:3, s. 141-144
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Journal article (other academic/artistic)abstract
- Coronary care unit usage has expanded rapidly in all high income countries with little attention to effectivity or cost. A study of six randomly chosen Swedish units showed that larger units in teaching hospitals had significantly lower age-adjusted mortality rates, higher proportions of myocardial infarction patients, and greater productivity and efficiency. Comparisons with a study from the United States showed better results in the Swedish hospital units according to all variables measured. Although proof of effectiveness of CCU's is lacking, their continued use is assured. A less than optimal solution is a rational distribution of units based upon epidemiologically determined need, while stressing good organization and efficiency.
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4. |
- Neuhauser, Dunkan, et al.
(author)
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Structural Differences Between Swedish and us Hospitals
- 1979. - 1 st
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In: Organizations Alike and Unlike (RLE: Organizations) International and Inter-Institutional Studies in the Sociology of Organizations. - London : Routledge. - 9780203370414
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Book chapter (other academic/artistic)abstract
- This is the report of an applied study which was commissioned to explain the difference in hospital employee-to-patient ratios in general hospitals in Sweden and the USA. The impetus for early American enquiries into Swedish health services was the discovery that Swedes live longer and have a lower infant mortality rate than Americans or every other country for that matter. In the process, it was discovered that Swedish hospitals have substantially fewer employees and therefore presumably less cost than American hospitals (see Table 15.1). What could be nicer: longer life at less cost. The Swedish impetus comes from a desire to monitor new ideas and different approaches which might be usefully adapted. Thus, this study which is unabashedly applied in nature. (1)We will not consider the relationship between health measures, such as life expectancy and infant mortality and what doctors and hospitals do, except to report a consensus among researchers that there is very little relationship between the two. (2) If one were to explain the differences in life expectancy between Sweden and the USA, the most fruitful source would be cultural variation related to nutrition, poverty, war, automobile accidents, abortion policy, murder, suicide, smoking, exercise, and such. Whatever effect hospitals have on health is lost among these other variables.
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