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  • 2201.
    Åhgren, Bengt
    Nordic School of Public Health.
    Patient choice and health care integration: a review of the consistency between two Swedish policy concepts2010In: International Journal of Integrated Care: Volume 10, 6 December 2010, 2010Conference paper (Other academic)
    Abstract [en]

    Purpose: Despite of an insignificant track record of quasi market models in Sweden, new models of this kind have recently been introduced in health care; commonly referred to as ‘choice of care’. This time citizens act as purchasers; choosing the primary care centre or family physician they want to be treated by, which, in turn, generates a capitation payment to the chosen unit. Policy makers believe that such systems will be self-remedial, that is, as a result of competition the strong providers survive while unprofitable ones will be eliminated. Because of negative consequences of the fragmented health care delivery, policy makers at the same time also promote different forms of integrated health care arrangements. One example is ‘local health care’, which could be described as an upgraded community-oriented primary care, supported by adaptable hospital services, fitting the needs of a local population. This paper reviews if it is possible to combine this kind of integrated care system with a competition driven model of governance, or if they are incompatible.

    Theory: Inter-organisational and interprofessional collaboration, accessibility of services, and provider continuity.

    Method: Literature-based review.

    Results and conclusions: The findings indicate that some choice of care schemes could hamper the development of integration in local health care. However, geographical monopolies like local health care, enclosed in a non-competitive context, lack the stimulus of competition that possibly improves performance. Thus, it could be argued that if choice of care and local health care should be combined, patients ought to choose between integrated health care arrangements and not among individual health professionals.

  • 2202.
    Åhgren, Bengt
    Nordic School of Public Health, Göteborg, Sweden.
    The Art of Integrating Care: Theories Revisited2012In: Open Public Health Journal, ISSN 1874-9445, Vol. 5, p. 36-39Article in journal (Refereed)
    Abstract [en]

    Integration of care is high on public health agendas all around the world. The development and implementation of integrative arrangements has been promoted for more or less two decades. Despite this every so often extensive history, there are recognised needs to take research into areas yet poorly explored, which include measures and outcomes of integrated care. On the other hand, existing evidence and knowledge can probably become more ennobled and thereby contribute to a deeper understanding of the compound art of integrating of health care services. Accordingly, the aim of this article is to re-evaluate and synthesise some revisited theories for the facilitation of sustainable integrated care solutions.

    This exploration shows it is important to have crucial prerequisites for integration in place: both functional and interactional conditions. This appears to be an organic process where the stakeholders go through gradual changes until the optimum level of integration as well as mutualistic interactions are established.

    It could be argued that refined knowledge could be excerpted from existing research. Then again, this strategy does not exclude actions for new research in poorly explored areas. Both approaches are important for the development of sustainable integrated care.

  • 2203.
    Åhgren, Bengt
    Nordic School of Public Health.
    The mutualism between chains of care and local care2008In: International Journal of Integrated Care – Vol. 8, 4 June 2008, 2008, p. e13-Conference paper (Other academic)
    Abstract [en]

    Introduction

    There is a growing interest in compensating for the fragmented delivery of care by promoting integrated care. This movement is a feature of national and local policy, and it is being supported and encouraged amongst care providers.

    Aims

    Discuss the concepts of Swedish integrated care and their impact on care delivery systems.

    Results

    The chain of care concept is commonly regarded as a means to make a care delivery system better adapted to the needs of patients. In many county councils, this transformation is supported by policies focusing on quality and comprehensiveness. Despite several years of experience, a vast majority of the county councils regard themselves as unsuccessful in developing chains of care.

    In addition, many county councils have changed their delivery systems during recent years and implemented ‘Local Care’, an upgraded family- and community-oriented primary care supported by a flexible hospital system. It is unusual to find a high degree of organisational cohesiveness in the implementation of local care. Instead these solutions are in many cases supposed to be built on chains of care.

    Conclusions

    Chains of care are increasingly regarded as building stones of local care, which means that chains of care are embraced in a context and by conditions more favourable than former non-integrative care delivery systems. In this sense, chains of care may have a renaissance, after assuredly being high on the policy agendas but with several years of modest development results. Thus, local care needs chains of care to evolve and chains of care need the integrative framework of local care to sustain.

  • 2204. Åhgren, Bengt
    Utvärdering av Blekingesjukhuset2005Report (Other academic)
  • 2205. Åhgren, Bengt
    Utvärdering av integration inom närsjukvård2007In: Folkhälsa i samverkan mellan professioner, organisationer och samhällssektorer / [ed] Runo Axelsson och Susanna Bihari Axelsson, Studentlitteratur AB, 2007, p. 305-321Chapter in book (Other academic)
  • 2206.
    Åhgren, Bengt
    Nordic School of Public Health.
    Utvärdering av samverkan2007Conference paper (Other academic)
  • 2207.
    Åhgren, Bengt
    Nordic School of Public Health.
    Whys and Wherefores of Integrated Health Care2008In: Integrated Health Care Delivery / [ed] Leonie A. Klein and Emily L. Neumann, Nova Science Publishers, Inc., 2008, p. 137-150Chapter in book (Other academic)
  • 2208.
    Åhgren, Bengt
    Nordic School of Public Health.
    Översyn av operations- och anestesiverksamheten inom länssjukvården i Landstinget Kronoberg2004Report (Other academic)
  • 2209. Åhgren, Bengt
    Översyn av operations- och anestesiverksamheten vid Länssjukhuset Ryhov2004Report (Other academic)
  • 2210.
    Åhgren, Bengt
    et al.
    Nordic School of Public Health.
    Axelsson, Runo
    Determinants of integrated health care development: chains of care in Sweden2007In: International Journal of Health Planning and Management, ISSN 0749-6753, E-ISSN 1099-1751, Vol. 22, no 2, p. 145-157Article in journal (Refereed)
    Abstract [en]

    Local health care in Sweden is an emerging form of integrated care, linked together by chains of care. Experiences show, however, that the development of chains of care is making slow progress. In order to study the factors behind this development, an embedded multiple-case study design was chosen. The study compared six health authorities in Sweden, three with successful and three with unsuccessful chain of care development. Three major determinants of integrated health care development were identified: professional dedication, legitimacy and confidence. In more detail, space for prime movers and trust between participants were crucial success factors, while top-down approaches targeting at the same time a change of management systems were negative for the development of chains of care. Resistance from the body of physicians was a serious obstacle to such a development. Local health care depends on developed chains of care, but it seems that health care managers do not have the management systems necessary to run these clinical networks, mainly due to a lack of acceptance from the medical profession. This is an impossible situation in the long run, since the number of chains of care is likely to increase as a result of the emerging local health care. Copyright (c) 2007 John Wiley & Sons, Ltd.

  • 2211.
    Åhgren, Bengt
    et al.
    Nordic School of Public Health.
    Axelsson, Runo
    Nordic School of Public Health.
    Evaluating integrated health care: a model for measurement2005In: International journal of integrated care, ISSN 1568-4156, Vol. 5, no Jul-Sep, p. e01-Article in journal (Refereed)
    Abstract [en]

    PURPOSE: In the development of integrated care, there is an increasing need for knowledge about the actual degree of integration between different providers of health services. The purpose of this article is to describe the conceptualisation and validation of a practical model for measurement, which can be used by managers to implement and sustain integrated care.

    THEORY: The model is based on a continuum of integration, extending from full segregation through intermediate forms of linkage, coordination and cooperation to full integration.

    METHODS: The continuum was operationalised into a ratio scale of functional clinical integration. This scale was used in an explorative study of a local health authority in Sweden. Data on integration were collected in self-assessment forms together with estimated ranks of optimum integration between the different units of the health authority. The data were processed with statistical methods and the results were discussed with the managers concerned.

    RESULTS: Judging from this explorative study, it seems that the model of measurement collects reliable and valid data of functional clinical integration in local health care. The model was also regarded as a useful instrument for managers of integrated care.

    DISCUSSION: One of the main advantages with the model is that it includes optimum ranks of integration beside actual ranks. The optimum integration rank between two units is depending on the needs of both differentiation and integration.

  • 2212.
    Åhgren, Bengt
    et al.
    Nordic School of Public Health.
    Axelsson, Runo
    Sahlgrenska Academy, Gothenburg University.
    Integrated Care: Pathfindings from Sweden2013In: Integrated care for Ireland in an international context: challenges for policy, institutions and specific service user needs / [ed] Tom O'Connor, Cork, Ireland: Oak Tree Press , 2013, p. 90-102Chapter in book (Other academic)
  • 2213.
    Åhgren, Bengt
    et al.
    Nordic School of Public Health.
    Axelsson, Susanna Bihari
    Nordic School of Public Health.
    Axelsson, Runo
    Nordic School of Public Health.
    Evaluating intersectoral collaboration: a model for assessment by service users2009In: International journal of integrated care, ISSN 1568-4156, Vol. 9, p. e03-Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: DELTA was launched as a project in 1997 to improve intersectoral collaboration in the rehabilitation field. In 2005 DELTA was transformed into a local association for financial co-ordination between the institutions involved. Based on a study of the DELTA service users, the purpose of this article is to develop and to validate a model that can be used to assess the integration of welfare services from the perspective of the service users.

    THEORY: The foundation of integration is a well functioning structure of integration. Without such structural conditions, it is difficult to develop a process of integration that combines the resources and competences of the collaborating organisations to create services advantageous for the service users. In this way, both the structure and the process will contribute to the outcome of integration.

    METHOD: The study was carried out as a retrospective cross-sectional survey during two weeks, including all the current service users of DELTA. The questionnaire contained 32 questions, which were derived from the theoretical framework and research on service users, capturing perceptions of integration structure, process and outcome. Ordinal scales and open questions where used for the assessment.

    RESULTS: The survey had a response rate of 82% and no serious biases of the results were detected. The study shows that the users of the rehabilitation services perceived the services as well integrated, relevant and adapted to their needs. The assessment model was tested for reliability and validity and a few modifications were suggested. Some key measurement themes were derived from the study.

    CONCLUSION: The model developed in this study is an important step towards an assessment of service integration from the perspective of the service users. It needs to be further refined, however, before it can be used in other evaluations of collaboration in the provision of integrated welfare services.

  • 2214.
    Åhgren, Bengt
    et al.
    Nordic School of Public Health, Göteborg, Sweden.
    Nordgren, Lars
    Lunds universitet.
    Is choice of care compatible with integrated health care?: an exploratory study in Sweden2012In: International Journal of Health Planning and Management, ISSN 0749-6753, E-ISSN 1099-1751, Vol. 27, no 3, p. e162-e172Article in journal (Refereed)
    Abstract [en]

    Competitive and integrative policy actions are simultaneously being promoted in Swedish primary care; citizens' choice of care is launched while primary care is expected to integrate its activities with other providers for the creation of ‘local health care’. Competition tends, however, to fragment the provision of services. The aim of this study is, accordingly, to explore whether or not these policies are compatible in practice. For this purpose, strategically designed group interviews were conducted with citizens. When citizens make active choices, they are under the influence of self-perceived conditions: that is, the accessibility of the care, its continuity and the treatment offered by the care provider, conditions which, in turn, have a lot in common with the guiding principles of local health care. On the other hand, citizens who choose passively, because of not being in contact with primary care, have no difficulties in being disloyal to the chosen unit when becoming patients. In doing so, they also contribute to the fragmentation of local health care. Making entirely free choices when it comes to primary care seems to be incompatible with local health care. However, choice of care only partly equals the conditions of free choice. Choice of care and local health care would thus seem to be compatible, in practice, for the majority of patients.

  • 2215. Åhgren, Bengt
    et al.
    Romberg, Rune
    Avveckling av sjukhusbolagen: Bevaras frihetsformade värden när leden rättas? - Slutrapport2004Report (Other academic)
  • 2216.
    Åhlfeldt, Emanuel
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Hållbart utvecklingsarbete i vård och omsorg: Ett institutionellt perspektiv på projekt i en professionell och byråkratisk kontext2017Doctoral thesis, monograph (Other academic)
    Abstract [en]

    There are many development projects in the public sector, but there is a lack of knowledge about how these projects can be made sustainable. The aim of the thesis is to explain how project results and knowledge can be integrated into public organizations and contribute to long-term effects and value for clients, organizations and employees.

    The scientific literature lacks an established conceptual framework for studying sustainability in organizations. Therefore, it has been a challenge to identify and analyze previous research in order to delineate and define the concept of sustainable change in organizations. The research is based on an institutional perspective: neo-institutional theory in combination with Giddens' structuration theory and sociological profession theory, which reveal tensions between three competing logics of control, i.e., bureaucracy, market and professionalism.

    The method is inspired by an interactive research approach and comprises two empirical parts: a quantitative survey study, including 348 development projects in health and social care, and a qualitative multi-case study of four development projects.

    The studies showed that different sets of factors supported short-term project success and long-term sustainability. Project-related factors, such as goal setting and project management, had little impact on sustainability. Instead, it was primarily active ownership, and other factors related to management of the recipient organization, that influenced the routinization of project results. The studies also exposed several conflicts and tensions that affected project sustainability. There were conflicts between occupational groups, between management and professionals, and between the logic of rational, bureaucratic management and the logic of occupational professionalism. Thus, understanding sustainable change in organizations requires a professional perspective to complement the organizational and institutional perspectives.

  • 2217.
    Åhlström, Linda
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Dellve, Lotta
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare. 1KTH – Royal Institute of Technology, School of Technology and Health, Stockholm, Sweden.
    Implementation of lean and the 3-year-trends of sick-leave among health care workers in different hospital care context2015Conference paper (Refereed)
  • 2218. Åkerborg, Örjan
    et al.
    Lang, Andrea
    Wimo, Anders
    Sköldunger, Anders
    Fratiglioni, Laura
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Gaudig, Maren
    Rosenlund, Mats
    Cost of Dementia and Its Correlation With Dependence2016In: Journal of Aging and Health, ISSN 0898-2643, E-ISSN 1552-6887, Vol. 28, no 8, p. 1448-1464Article in journal (Refereed)
    Abstract [en]

    Objective: To estimate the cost of dementia care and its relation to dependence. Method: Disease severity and health care resource utilization was retrieved from the Swedish National Study on Aging and Care. Informal care was assessed with the Resource Utilization in Dementia instrument. A path model investigates the relationship between annual cost of care and dependence, cognitive ability, functioning, neuropsychiatric symptoms, and comorbidities. Results: Average annual cost among patients diagnosed with dementia was Euro43,259, primarily incurred by accommodation. Resource use, that is, institutional care, community care, and accommodation, and corresponding costs increased significantly by increasing dependency. Path analysis showed that cognitive ability, functioning, and neuropsychiatric symptoms were significantly correlated with dependence, which in turn had a strong impact on annual cost. Discussion: This study confirms that cost of dementia care increases with dependence and that the impact of other disease indicators is mainly mediated by dependence.

  • 2219.
    Årestedt, Liselott
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Persson, Carina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Benzein, Eva
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Families Living With Chronic Illness: Beliefs About Illness, Family, and Health Care2015In: Journal of Family Nursing, ISSN 1074-8407, E-ISSN 1552-549X, Vol. 21, no 2, p. 206-231Article in journal (Refereed)
    Abstract [en]

    Beliefs can be described as the lenses through which we view the world. With emerging illness, beliefs about the illness experience become important for nurses to understand to enhance well-being and healing. The aim of this study was to illuminate illness beliefs of families living with chronic illness. A qualitative design was chosen, including repeated narrative research interviews with seven Swedish families living with chronic illness. Hermeneutic analysis was used to interpret the transcribed family interviews. The result described beliefs in families, both within and across families. Both core beliefs and secondary beliefs about illness, family, and health care were revealed. Illness beliefs have importance for how families respond to and manage situations that arise from their encounters with illness. Nurses have to make space for and listen to families’ stories of illness to become aware of what beliefs may support and encourage family well-being and healing. The Illness Beliefs Model provides a touchstone whereby nurses can distinguish both individual and shared beliefs within families living with chronic illness and provide ideas for family intervention if needed.

  • 2220.
    Åsling Monemi, Kajsa
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Women's and Children's Health.
    The Impact of Violence Against Women on Child Growth, Morbidity and Survival: Studies in Bangladesh and Nicaragua2008Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aim of this thesis was to explore the impact of physical, sexual and emotional violence against women of reproductive age and the level of controlling behaviour in marriage on child health and survival in two different cultural settings: Bangladesh and Nicaragua.

    Data were acquired from four quantitative community-based studies. In two studies, a cohort including a prospective two year follow-up of 3164 mother-infant pairs in rural Bangladesh was investigated. A third study was a case-referent study in Nicaragua including mothers of 110 cases of under-five deaths and 203 referents, and in a forth study an other cohort of 1048 rural Bangladeshi women and their 2691 children was followed until 5 years of age.

    Maternal exposure to any form of violence, including physical, sexual, emotional, and controlling behaviour was independently associated with lower body size at birth, increased risk of stunting and under-weight at 24 months of age, slower growth velocity during the first two years of life and a higher incidence of diarrhoeal episodes and respiratory tract infections. In the Nicaraguan setting, the children of women who experienced any history of physical violence had a two-fold increase in risk of death before the age of 5 years, and those whose mothers experienced both physical and sexual violence had a six-fold increase in risk of death. In Bangladesh, an association between violence against women and under-five mortality was found among daughters of educated mothers who were exposed to severe physical violence or a high level of controlling behaviour in marriage. In all four studies, lifetime violence experience among participating mothers was high (37-69%), and the timing was less relevant than the exposure to violence per se.

    In conclusion, this investigation revealed that violence against women severely affects child health and survival. The findings are especially relevant in a context of high level of child under-nutrition, morbidity and under-five mortality. Efforts for protecting women from all forms of violence are needed as part of the interventions for improved child health.

  • 2221.
    Ödman, Linda
    Jönköping University, School of Health and Welfare, HHJ, Quality Improvement and Leadership in Health and Welfare. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Ge barnen tid!: En studie av ett förbättringsarbete för ökad tillgänglighet till barnpsykiatriska utredningar genom samordnat processflöde.2016Independent thesis Advanced level (degree of Master (Two Years)), 80 credits / 120 HE creditsStudent thesis
    Abstract [sv]

    Reducerad väntetid till barnpsykiatrisk vård är ett prioriterat område då försenad vård har negativ inverkan på barns liv och hälsa.

    Syftet med förbättringsarbetet: Ökad tillgänglighet till barnpsykiatrisk utredning samt sammanhållen utredningstid med stöd av förbättringsmetoder.

    Syftet med studien: Beskriva användarnas, utredningsteamets, upplevelser av införandet av samordnat tvärprofessionellt processflöde för barnpsykiatrisk utredning.

    Förbättringsarbetet genomfördes med stöd av förbättringsmetoder. Förbättringsidén utgörs av ett tvärprofessionellt samordnat processflöde, där barnpsykiatrisk utredning skall vara planerad, genomförd och återlämnad inom fem veckor.

    Studiens metod: Kvalitativ och utgörs av fokusgruppsinterjuver.

    Resultat: Samordnat processflöde medförde att 93 % av patienterna utreddes inom regionala riktlinjers rekommenderade 120 dagar. Väntetiden reducerades från 9 till 4 månader efter utgången vårdgaranti. Utredningslängd minskade från bakgrundsmätnings 236 dagar till 48 dagar. Studien visar att samordnat utredningsschema kräver tvärprofessionell samordning, delaktiga medarbetare, lärande organisation, styrande, stödjande och delegerat ledarskap samt att omkringliggande system är effektiva. Systemet är sårbart och arbetsmiljön belastas.

     

    Slutsats: Samordnat tvärprofessionellt processflöde ökade tillgänglighet till barnpsykiatriska utredningar samt sammanhållen utredningstid. Tvärprofessionell samordning, implementering av förbättringskunskap, lärande organisation, involverade och delaktiga medarbetare, effektiv organisation samt ett styrande, stödjande och delegerat ledarskap är avgörande faktorer för processens görlighet. Processflödet var sårbart för yttre faktorer. Upplevelsen var att arbetsmiljön belastas.

  • 2222.
    Öhman, Ann
    et al.
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS). Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Keisu, Britt-Inger
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Enberg, Birgit
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Team social cohesion, professionalism, and patient-centeredness: gendered care work, with special reference to elderly care – a mixed methods study2017In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 17, article id 381Article in journal (Refereed)
    Abstract [en]

    Background: Healthcare organisations are facing large demands in recruiting employees with adequate competency to care for the increasing numbers of elderly. High degrees of turnover and dissatisfaction with working conditions are common. The gendered notion of care work as 'women's work', in combination with low salaries and status, may contribute to negative work experiences. There is abundant information about the negative aspects of elderly care health services, but little is known about positive aspects of this work. The study aim was to investigate work satisfaction from a gender perspective among Swedish registered nurses, physiotherapists, and occupational therapists, focusing specifically on healthcare services for the elderly.

    Methods: A mixed methods approach was adopted in which we combined statistics and open-ended responses from a national survey with qualitative research interviews with healthcare professionals in elderly care organisations. The survey was administered to a random sample of 1578 registered nurses, physiotherapists, and occupational therapists. Qualitative interviews with 17 professionals were conducted in six elderly care facilities. Qualitative and quantitative content analyses, chi2 and constructivist grounded theory were used to analyse the data.

    Results: There was a statistically significant difference in overall work satisfaction between those who worked in elderly care and those who did not (64 and 74,4% respectively, p < 0.001). Nine themes were derived from open-ended responses in the questionnaire. The qualitative interviews revealed four prominent storylines: 'Team social cohesion', 'Career development and autonomy', 'Client-centeredness', and 'Invisible and ignored power structures'.

    Conclusions: The results show the complexity of elderly care work and describe several aspects that are important for work satisfaction among health professionals. The results reveal that work satisfaction is dependent on social interrelations and cohesion in the work team, in possibilities to use humour and to have fun together, and in the ability to work as professionals to provide client-centered elderly care. Power relations such as gendered hierarchies were less visible or even ignored aspects of work satisfaction. The storylines are clearly linked to the two central discourses of professionalism and gender equality.

  • 2223.
    Öhrn, Annica
    et al.
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Health and Developmental Care.
    Ericsson, Carin
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Health and Developmental Care.
    Andersson, Christer
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Health and Developmental Care.
    Elfström, Johan
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Health and Developmental Care.
    High Rate of Implementation of Proposed Actions for Improvement With the Healthcare Failure Mode Effect Analysis Method: Evaluation of 117 Analyses2018In: Journal of patient safety, ISSN 1549-8417, E-ISSN 1549-8425, Vol. 14, no 1, p. 17-20Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The aims of this study were to investigate what kind of impact the Healthcare Failure Mode Effect Analysis (HFMEA) had on the organization in 1 county council in Sweden and to evaluate the method of working for multidisciplinary teams performing HFMEA. Three main outcome measures were used: the quality of the documentation from the HFMEAs, fulfillment of the primary goal of the HFMEA, and, finally, whether proposed actions for improvement were implemented.

    METHODS: The study involved retrospective analysis of the documentation from 117 performed HFMEAs from 3 hospitals in the county council of Östergötland, Sweden, and interviews or questionnaires with team leaders and managers between 2006 and 2010.

    RESULTS: A proposed change in the organizational structure was the most common issue in the analyses. Eighty-nine percent of the written reports were of high quality. A median of 10 serious risks were detected, and 10 proposed actions (median) were made. In 78% of the HFMEAs, all or a large part of these had been implemented a few years afterward. We were unable to find factors that promoted the rate of implementation of proposed actions. Seventy-eight percent of the managers were completely satisfied with the results of the HFMEA. The mean cost per risk analysis was &OV0556;1909.

    CONCLUSIONS: Most of the proposed actions were implemented. The use of HFMEA can be improved using fewer team leaders but with more experience. The work involved in writing a report can be reduced without loss of impact on the organization.This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.

  • 2224. Öresland, Stina
    et al.
    Määttä, Sylvia
    University of Borås, School of Health Science.
    Norberg, Astrid
    Lützén, Kim
    Patients as 'Safeguard' and Nurses as 'Substitute' in Home Health Care2009In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 16, no 2, p. 219-230Article in journal (Refereed)
    Abstract [en]

    One aim of this study was to explore the role, or subject position, patients take in the care they receive from nurses in their own home. Another was to examine the subject position that patients say the nurses take when giving care to them in their own home. Ten interviews were analysed and interpreted according to a discourse analytical method. The findings show that patients constructed their subject position as ‘safeguard’, and the nurses’ subject position as ‘substitute’ for themselves. These subject positions provided the opportunities, and the obstacles, for the patients’ possibilities to receive care in their home. The subject positions described have ethical repercussions and illuminate that the patients put great demands on tailored care.

  • 2225.
    Östling, Ann
    et al.
    Landstinget Västmanland.
    Weitz, Per
    Landstinget Västmanland.
    Bäckman, Karin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Department of Molecular and Clinical Medicine.
    Garpenby, Peter
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics.
    Öppna prioriteringar i Landstinget Västmanland2010Report (Other academic)
    Abstract [sv]

    Landstinget Västmanland genomförde under 2009 en öppen prioriteringsprocess. I landstinget hade en medvetenhet vuxit fram bland politiker, högre tjänstemän och medarbetare om att de traditionella metoderna ‒ såsom att förändra strukturer, effektivisera och rationalisera ‒ inte räckte som verktyg för en bra resursfördelning.

    Motivet för landstinget att påbörja detta arbete var främst de stora utmaningar som väntade i form av ökade medicinska möjligheter som gör att fler människor kan bli föremål för insatser från hälso- och sjukvården. Ett medel för landstinget att möta detta var öppna prioriteringar – såväl vertikalt (inom verksamheter och specialiteter) som horisontellt (mellan verksamheter och specialiteter). Samtliga partier inom såväl majoritet som opposition ställde sig bakom processen. Syftet med prioriteringsprocessen var att den skulle bidra till en mer rättvis öppen fördelning av landstingets tillgängliga resurser. Arbetet med "Öppna prioriteringar", som processen kom att kallas, ingick också som en del av en större förändringsprocess inom landstinget – som gick under namnet HOPP (Helhet Och PatientPerspektiv.

    I denna rapport presenteras planeringen och genomförandet av prioriteringsprocessen i Landstinget Västmanland 2009/2010. Beskrivningen bygger till största delen på erfarenheter sammanställda av landstingets två projektledare. I Appendix presenteras även delar av den uppföljning av arbetet som Prioriteringscentrum gjorde genom enkäter till olika aktörer i prioriteringsarbetet.

    Ett viktigt inslag i förberedelsearbetet var att genomföra ett antal studiebesök i landsting som tidigare genomfört prioriteringsarbeten, såsom Västerbottens läns landsting, Landstinget Kronoberg och Jämtlands läns landsting. Avsikten var att ta fasta på deras erfarenheter och överväga dessa inför byggandet av den egna prioriteringsprocessen. Det som kom att utmärka Västmanlands prioriteringsprocess var ansträngningarna att skapa en process där intern öppenhet och interaktion mellan många olika parter stod i fokus; verksamhetsföreträdare, politiker och koncernledningen. Förutsättningar för insyn och dialog skapades genom att de tillsammans arbetade med förslagen fram till slutresultatet.

    Den 15 januari 2010 fattade Landstingsstyrelsen i Västmanland slutligen det formella beslutet om vilka objekt som skulle ingå i listan över öppna prioriteringar som arbetats fram. Beslutsunderlaget omfattade såväl effektiviseringsobjekt som prioriteringsobjekt, motsvarande 2,4 procent av nettobudgeten, i siffror 106 miljoner kronor.

     

    Den lista över prioriteringsobjekt som slutligen presenterades för verksamheterna och för allmänheten innehöll ca 160 objekt fördelade under fyra olika rubriker:

    1.  Objekt för bortprioritering

    2.  Objekt med lägre ambitionsnivå alternativt högre indikationsnivå

    3.  Objekt som underlag för dialog med framför allt kommunerna

    4.  Objekt som rörde avgifter och bidrag.

  • 2226. Östlund, Britt
    Hur kan teknik skapa möjligheter för äldre människor?2012In: E-hälsa: innovationer, metoder, interventioner och perspektiv. / [ed] Gunvor Gard, Anita Melander Wikman, Studentlitteratur AB, 2012, p. 209-221Chapter in book (Other academic)
  • 2227.
    Östlund, Gunnel
    et al.
    Department of Social Work, School of Health Care and Social Welfare, Mälardalen University, Eskilstuna, Sweden.
    Björk, Mathilda
    Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Rehabilitation Center. Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Department of Rehabilitation, School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Valtersson, Eva
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Rehabilitation Center.
    Sverker, Annette
    Linköping University, Department of Social and Welfare Studies, Social Work. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Rehabilitation in Central County. Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Lived Experiences of Sex Life Difficulties in Men and Women with Early RA - The Swedish TIRA Project.2015In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 13, no 4, p. 248-257Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Men and women with rheumatoid arthritis (RA) experience restrictions in everyday life, in spite of the development of new medications. Recent research has described in detail how participation limitations are experienced in everyday life from a patient perspective. However, knowledge of how sex and intimate relationships are affected is still scarce.

    OBJECTIVES: The aim of the present study was to explore sex life experiences in relation to sexual function and sexual relationships in men and women with early RA.

    METHODS: The study formed part of TIRA-2 (the Swedish acronym for the prospective multicentre early arthritis project). The data collection included 45 interviews with 21 men and 24 women, aged 20-63, which were recorded and transcribed verbatim. The critical incident technique was used to collect data, and content analysis to categorize the results.

    RESULTS: Half the participants stated that RA affected their sex life. The general descriptions formed five categories: sex life and tiredness; sex life and ageing; emotional consequences of impaired sexual function; facilitators of sexual function and sexual relationships; and strain on the sexual relationship.

    CONCLUSIONS: Sex life is affected in early RA, in spite of new effective treatment strategies. New strategies of communication, assessment and self-managing interventions concerning the sex lives of patients with RA need to be implemented by a multidisciplinary healthcare team. Copyright © 2015 John Wiley & Sons, Ltd.

  • 2228.
    Östlund, Gunnel
    et al.
    Division of Social Work, School of Health, Care and Social Welfare, Mälardalen University.
    Thyberg, Ingrid
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Rheumatology. Linköping University, Faculty of Medicine and Health Sciences.
    Valtersson, Eva
    Linköping University, Department of Medical and Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Activity and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Björk, Mathilda
    Linköping University, Faculty of Medicine and Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Rehabilitation Center. Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy.
    Sverker, Annette
    Linköping University, Department of Social and Welfare Studies, Social Work. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Activity and Health. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine.
    The Use of Avoidance, Adjustment, Interaction and Acceptance Strategies to Handle Participation Restrictions Among Swedish Men with Early Rheumatoid Arthritis.2016In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 14, no 4, p. 206-218Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Living with a chronic disease means learning to live under new circumstances and involves a continuous adaptation to new ways of living. There is increasing knowledge about how people cope with stressful life events and adapt to new life situations. Approximately a third of patients diagnosed with rheumatoid arthritis (RA) are men; however, few studies have described the needs and experiences of men living with RA. The aim of the present study was to explore men's strategies for handling challenges related to participation in everyday life.

    METHODS: The present study was associated with the prospective Swedish multicentre early arthritis project (given the Swedish acronym TIRA), which, in 2006-2009, included patients with early RA, contemporarily treated, with a mean disease duration of three years. From this cohort, 25 men, aged 20-63 years, were recruited consecutively. Data were collected in individual interviews, using the critical incident technique. The strategies for dealing with the challenges of RA in everyday life were analysed and categorized using content analysis.

    RESULTS: Men with RA described four types of strategy for dealing with participation restrictions in everyday life: (i) Adjustment strategies - adjust behaviour, movements, medication, equipment and clothing to find new ways to conduct tasks or activities; (ii) Avoidance strategies - avoid activities, movements, social contacts and sometimes medication; (iii) Interaction strategies - say no, ask for help and work together to handle participation restrictions; and (iv) Acceptance strategies - learn to accept RA, with the pain, the slower work pace and the extended time needed.

    CONCLUSIONS: According to men's lived experiences, a combination of strategies was used to deal with RA, depending on the situation and the experienced restriction. The results provided an understanding of how men with RA manage their disease, to reduce physical, social and emotional challenges. This knowledge may be used further to develop multi-professional interventions and patient education tailored to men with RA.

  • 2229. Östlund, Petra
    et al.
    Rüter, Anders
    Sophiahemmet University.
    Franklin Larsson, Lise-Lotte
    Sophiahemmet University.
    Patienters upplevelser av delaktighet i vården: En intervjustudie på en akutvårdsavdelning2016Conference paper (Other academic)
  • 2230.
    Hässel, Brita (Editor)
    Hässel & Palm, Västra Frölunda .
    West, Emma (Editor)
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences.
    Ansvar för prioriteringar i ett nytt hälso- och sjukvårdslandskap: Dokumentation från konferensen Sjunde nationella prioriteringskonferensen, Gävle 21-22 oktober 20132013Report (Other academic)
    Abstract [sv]

    Temat för den sjunde upplagan av Nationella prioriteringskonferensen var Ansvar för prioriteringar i ett nytt hälso- och sjukvårdslandskap. Under två fullspäckade oktoberdagar möttes drygt 300 deltagare i Gävle för att lyssna till erfarenheter och insikter om prioriteringar inom hälso- och sjukvården, få nya idéer och själva bidra med tankar och kunskap om ämnet. Under konferensens två dagar gjordes både in- och utblickar, det reflekterades kring genomförda insatser, kring framtiden och nästa steg inom området. Inblick i några föredrag ges i denna textsamling. Vi hoppas att dokumentationen ger dig som besökte konferensen en chans till återspegling och för dig som inte hade möjlighet att delta denna gång, ett smakprov av årets konferens.

  • 2231.
    Bergman, Olle (Editor)
    Bergmans Bokstäver AB, Eskilstuna.
    Kernell Tolf, Malin (Editor)
    PrioriteringsCentrum, Landstinget i Östergötland.
    Lika vård på olika villkor: Rapport från den fjärde nationella prioriteringskonferensen, Örebro 4–5 oktober 20072007Report (Other academic)
    Abstract [sv]

    Många delar uppfattningen att befolkningens växande behov av vård och  omsorg kommer att vara större än resurserna. Likaså finns det en stor enighet om att nödvändiga prioriteringar inte skall vara godtyckliga eller slumpartade. Däremot saknas det enighet om vem som skall göra valen och hur det ska gå till.

    Det övergripande syftet med den fjärde nationella konferensen om prioriteringar var att bidra till ett fördjupat utbyte av kunskap mellan olika aktörer samt att skapa möten för debatt och dialog mellan politiker och dem som arbetar med vårdfrågor i praktiken.

  • 2232.
    Bergman, Olle (Editor)
    Bergmans Bokstäver AB, Eskilstuna.
    Kernell Tolf, Malin (Editor)
    PrioriteringsCentrum, Landstinget i Östergötland.
    Lika vård på olika villkor: Rapportering från den fjärde nationella prioriteringskonferensen 3-5 oktober 20072007Report (Other academic)
    Abstract [sv]

    I den internationella sessionen fick vi ta del av hur det står till i den norska hälso- och sjukvården samt utvecklingsprojekt kring prioriteringar i Kanada. Vi fick även möjlighet att reflektera kring vilka erfarenheter vi kan ta till oss i Sverige. Medverkande vid denna session var flera personer: Elizabeth Nygaard från Sosial- og helsedirektoratet och seniorrådgivare vid Avdelningen för kvalitet och prioriteringar i Norge; Craig Mitton, Assistant Professor vid Health Studies vid University of British Columbia; Christina Kärvinge, enhetschef på Enheten för Nationella riktlinjer vid Socialstyrelsens Hälso- och sjukvårdsavdelning; Gösta Andersson, Direktör i Landstinget Dalarna samt Bo-Eric Malmvall, Verksamhetschef i Jönköpings läns landsting. Moderator var Peter Garpenby, docent vid Centrum för utvärdering av medicinsk teknologi vid Linköpings universitet samt projektledare vid PrioriteringsCentrum.

  • 2233. Prioriteringscentrum, (Creator)
    Nationell modell för öppna prioriteringar inom hälso- och sjukvård: ett verktyg för rangordning2017Report (Other academic)
    Abstract [en]

    The intention with the National Model for Transparent Prioritisation in Swedish Health Care is to provide a tool for systematic ranking of different health conditions and their interventions, based on the existing parliamentary decision on priority settings within healthcare in Sweden. In short, this means that the model is based on the parliamentary decision that more resources will be allocated for the effective care of those in great need of care, provided there is a reasonable relationship between patient benefit and cost, and that human dignity is respected.

    The national model is intended to be used to produce rankings:

    • of state of health (both for confirmed ill health/suspected ill health, as well as the risk of future ill health) combined with its interventions.
    • at group level (i.e. for ranking of patient groups and/or groups at risk of future ill health).
    • both within a patient group with similar ill health and between patient groups with different types of ill health.
    • primarily in publicly financed healthcare controlled by the Health and Medical Services Act, HSL, but also within other health and social care services, taking into account the applicable laws.

    The model should, on the other hand, not be seen as a tool for how a prioritisation process as a whole is organised, or what acceptable needs coverage or cost limitations should be. This type of question must be answered locally/regionally.

    The model comprises the following steps:

    1. Defining of purpose and area of prioritisation
    2. Identification of what should be ranked (so-called prioritisation object)
    3. Appraisal of severity
    4. Appraisal of patient benefit
    5. Appraisal of cost in relation to patient benefit
    6. Valuation of the quality in the basis for assessment
    7. Weighing and ranking Ranking is on a scale of ten where 1 represents the highest priority and 10 the lowest. The logic of the model is based on the fact that lesser severity and little patient benefit cannot give rise to high prioritisation.
    8. Presentation of ranking and its basis
  • 2234.
    Carlsson, Per (Editor)
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    Nationellt kunskapscentrum för prioritering inom vård och omsorg: Verksamheten 20032003Report (Other academic)
  • 2235.
    Carlsson, Per (Editor)
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    Nationellt kunskapscentrum för prioritering inom vård och omsorg: Verksamheten 20042004Report (Other academic)
  • 2236.
    Carlsson, Per (Editor)
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    Nationellt kunskapscentrum för prioritering inom vård och omsorg: Verksamheten 20052005Report (Other academic)
  • 2237.
    Carlsson, Per (Editor)
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    Nationellt kunskapscentrum för prioritering inom vård och omsorg: Verksamheten 20062006Report (Other academic)
  • 2238.
    Carlsson, Per (Editor)
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    Nationellt kunskapscentrum för prioritering inom vård och omsorg: Verksamheten 20072007Report (Other academic)
  • 2239.
    Carlsson, Per (Editor)
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    Nationellt kunskapscentrum för prioritering inom vård och omsorg: Verksamheten 20082008Report (Other academic)
  • 2240.
    Carlsson, Per (Editor)
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    Nationellt kunskapscentrum för prioritering inom vård och omsorg: Verksamheten 20092009Report (Other academic)
  • 2241.
    Green, Magdalena (Editor)
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    Nationellt kunskapscentrum för prioritering inom vård och omsorg: Verksamheten 20102010Report (Other academic)
  • 2242.
    Green, Magdalena (Editor)
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    Nationellt kunskapscentrum för prioritering inom vård och omsorg: Verksamheten 20112011Report (Other academic)
  • 2243.
    Green, Magdalena (Editor)
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    Nationellt kunskapscentrum för prioritering inom vård och omsorg: Verksamheten 20122012Report (Other academic)
  • 2244.
    Carlsson, Per (Editor)
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    Nationellt kunskapscentrum för prioritering inom vård och omsorg: Verksamheten 20132013Report (Other academic)
  • 2245.
    Carlsson, Per (Editor)
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences.
    Nationellt kunskapscentrum för prioritering inom vård och omsorg: Verksamheten 20142014Report (Other academic)
  • 2246.
    Carlsson, Per (Editor)
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences.
    Nationellt kunskapscentrum för prioritering inom vård och omsorg: Verksamheten 20152015Report (Other academic)
  • 2247.
    Mossberg, Lennart (Editor)
    LM Bild & Bokstav AB, Västra Frölunda.
    Perspektiv på prioritering: Dokumentation från en nationell konferens om principer och arbetsformer för öppen prioritering inom vård och omsorg i Linköping den 1-2 oktober 20012001Report (Other academic)
    Abstract [sv]

    I sitt hälsningsanförande uttryckte Per Carlsson att konferensen skulle ge en allsidig belysning av prioriteringsfrågorna inom vård och omsorg.

    Han påminde om att skälen för öppna prioriteringar är goda: värna människors lika värde, värna svaga grupper, värna ”den okända patienten”, värna de patienter som har de största vårdbehoven samt värna god hushållning.

    Han konstaterade att prioritering är ett ”svårsålt” begrepp, dvs ytterst få känner någon spontan entusiasm inför uppgiften att behöva prioritera. Enda sättet att komma fram är därför att göra alla aktörer, patienter, allmänhet, politiker, vårdpersonal, media, medvetna om argumenten för öppna prioriteringar.

    Per Carlsson såg fram emot en konferens som han önskade skulle besvara följande frågor:

    • Vad menas med öppna prioriteringar?
    • Är det önskvärt med öppna prioriteringar?
    • Varför händer så lite i praktiken?
    • Vilka hinder finns?
    • Om det inte är önskvärt med öppna prioriteringar, vilka är då skälen?
  • 2248.
    Mossberg, Lennart (Editor)
    LM Bild & Bokstav AB, Västra Frölunda.
    Prioritering i praktiken: Rapport från den andra nationella prioriteringskonferensen, Umeå den 16-17 juni 20032003Report (Other academic)
    Abstract [sv]

    – Vår förmåga att lära av varandra avgör hur vi kommer att lyckas. Därför hoppas jag mycket på den här andra nationella prioriteringskonferensen med mottot ”Hur går vi från ord till handling?”

    Med de orden hälsade Harriet Hedlund, ordförande i folkhälsonämnden i Västerbottens läns landsting, konferensdeltagarna välkomna.

    – Vårdbehoven ökar snabbt, men det gör inte resurserna, konstaterade hon. Nu måste vi också bli överens om hur vi praktiskt löser detta dilemma. Vi ska enas om vilka verktyg vi behöver, hur vi delar upp arbetsuppgifterna rationellt och vi kommer att få ta del av internationella erfarenheter.

    Några fakta om värdstaden Umeå gav Eva Andersson från Kommunförbundet Västerbotten, bland annat att Umeå har cirka 100.000 invånare.

    – Men vi skulle behöva öka till 150.000 till år 2050 för att få tillräcklig skattekraft.

    – Bland alla dem som vill bo i Umeå finns också människor med stort  vårdbehov och antalet 85 år och äldre ökar. Hemtjänst, äldreboende och  förebyggande hälsoarbete prioriteras.

  • 2249.
    Bergman, Olle (Editor)
    Bergmans Bokstäver AB, Eskilstuna.
    Kernell Tolf, Malin (Editor)
    PrioriteringsCentrum, Landstinget i Östergötland.
    Prioriteringar i vården: Om konsten att bygga broar: Rapport från den femte nationella prioriteringskonferensen Malmö 15-16 oktober 20092009Report (Other academic)
    Abstract [sv]

    Öppna prioriteringar har blivit hetare än någonsin. Syftet med den femte nationella konferensen om prioriteringar är att fördjupa utbytet av kunskap och erfarenheter mellan olika aktörer och att skapa möten för debatt och dialog. Det pågår en mängd prioriteringsarbeten runt om i landet som borgar för att denna prioriteringskonferens kommer mer än föregående att präglas av praktiska erfarenheter. Vad har vi lärt oss och hur går vi vidare?

  • 2250.
    Recruitment and Retention of Health Care Professionals in the Nordic Countries: A Cross-national Analysis2014Book (Other academic)
    Abstract [en]

    The demographic trends and financial constraints in the Nordic countries, and all over Europe, are posing challenges, especially in the health care sectors. The rising number of elderly with "new" diseases, as well as new technology and inventions, create a growing demand for health care services and health care personnel. The aim of this report is to establish a clearer picture of the challenges in the future health care sectors in the Nordic countries, especially in terms of lack of health care personnel, and the strategies and initiatives implemented for recruitment and retention of personnel.

4243444546 2201 - 2250 of 2255
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