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Rahmqvist, Mikael
Publications (10 of 40) Show all publications
Rahmqvist, M. (2017). Läkarbesök och läkemedelskonsumtion bland barn med astma, diabetes och andra kroniska sjukdomar: Ett metodexempel på hur journaldata kan omvandlas till epidemiologi och sjukvårdskostnader. Linköping: Linköping University Electronic Press
Open this publication in new window or tab >>Läkarbesök och läkemedelskonsumtion bland barn med astma, diabetes och andra kroniska sjukdomar: Ett metodexempel på hur journaldata kan omvandlas till epidemiologi och sjukvårdskostnader
2017 (Swedish)Report (Other academic)
Abstract [sv]

Det finns få svenska studier om vårdkostnader för barn med astma eller diabetes och det finns få publikationer som beskriver hur man gör för att kunna använda journaldata till epidemiologiska studier. Denna rapport kan bidra till att bringa klarhet inom båda dessa områden.

Av de kroniska sjukdomar som kan drabba barn beskrivs i denna rapport tidigare forskning om kostnader för astma och diabetes typ 1. Nästan alla barn med diabetes i Östergötland kunde hittas i sjukvårdens register för läkarbesök i öppen sjukhusvård medan för barn med astma blev täckningsgraden under 50 % trots att sökningen i dessa journaler omfattade 7 år.

Barnen med kroniska sjukdomar enligt den definition som används här och som kunde hittas med dessa register utgjorde 5 % av befolkningen 2- 17 år 2012, men deras kostnader för läkarbesök på sjukhus och läkemedel motsvarade 22 % av de totala kostnaderna för åldersgruppen. När kostnaderna för sluten sjukhusvård adderas så kvarstår proportionen för de drabbade barnen till 23 % av de totala kostnaderna.

Den genomsnittliga vårdkostnaden för de med blodsjukdomar eller diabetes under ett år var ungefär 12 gånger högre jämfört med den grupp som inte hade något kroniskt problem registrerat. Patientgrupper med andra typer av kroniska problem hade en lägre kostnad. Totalt sett var den genomsnittliga vårdkostnaden för barn med kroniska problem ungefär 6 gånger högre jämfört med de i populationen utan problem. Uppräknat till riksnivå blev merkostnaden en miljard kronor för vård av patienter 2-17 år med en kronisk sjukdom.

Inom hälsoekonomiska utvärderingar delas kostnader ofta upp i olika poster, såsom kostnader för patientbesök, kostnader för slutenvård och läkemedel, samt även kostnader för produktionsbortfall för sjukdom och förtida död. Att sammanställa alla dessa olika typer av kostnader ned på individnivå fordrar ofta ganska avancerad datahantering.

Sjukvårdens journaldata är tillfällesorienterad, besök och vårdtillfällen registreras som enskilda poster medan man inom epidemiologi är intresserad av individer och hur dessa individer är representativa för befolkningen. Ett moment som beskrivs i denna rapport är hur rådata transponeras till individdata och därefter matchas ihop till att bygga individernas egna sammanhållna ”journaler” och anamnes.

Abstract [en]

There are few studies about the Swedish health care costs for children with asthma or diabetes, and there are few publications that describes how to transform data from medical records into epidemiology. This report can help to bring some clarity in both these areas.

Young patients with asthma and diabetes type 1 contribute to the example about health care costs. These two diseases are quite different in character, and this difference mirror how well medical records can be suitable for epidemiology. In principle, all children in the group with diabetes in the county of Östergötland could be found in the medical records of visits to a physician during a year, while for the children with asthma less than 50% was found, even when the records covered 7 years.

Children with chronic diseases, according to the definition used here, that could be found in these medical records constituted 5% of the population 2-17 years in 2012. However, their costs for doctor visits at hospitals together with the actual costs for drugs represented 22% of the health care costs. When the costs of inpatient hospital services were added, the proportion remain, and those affected children accounted for 23% of the total annual health care costs.

The average annual cost of care for those with blood diseases or diabetes was about 12 times higher compared to those who had no chronic problems registered. Patient groups with other types of chronic problems had a lower cost, and overall, the average cost of care for children with chronic problems was about 6 times higher than the residents without these problems.

In health economics several different costs is usually calculated, such as; patient visits, costs for inpatient care and pharmaceuticals, as well as costs for loss of productivity and eventually also costs for premature death. Putting together all these different types of costs down to the individual level often requires fairly advanced data management. In this report it is described how raw data is transposed from single medical records into individual journal data, and then merged together to build the individual's own cohesive "record" and history.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2017. p. 45
Series
CMT Report, ISSN 0283-1228, E-ISSN 1653-7556 ; 2017:1
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Public Administration Studies
Identifiers
urn:nbn:se:liu:diva-145658 (URN)LIU CMT RA/1701 (ISRN)
Available from: 2018-03-13 Created: 2018-03-13 Last updated: 2018-03-13Bibliographically approved
Rahmqvist, M., Samuelsson, A., Bastami, S. & Rutberg, H. (2016). Direct health care costs and length of hospital stay related to health care-acquired infections in adult patients based on point prevalence measurements. American Journal of Infection Control, 44(5), 500-506
Open this publication in new window or tab >>Direct health care costs and length of hospital stay related to health care-acquired infections in adult patients based on point prevalence measurements
2016 (English)In: American Journal of Infection Control, ISSN 0196-6553, E-ISSN 1527-3296, Vol. 44, no 5, p. 500-506Article in journal (Refereed) Published
Abstract [en]

Background: The incidence of health care-acquired infection (HAI) and the consequence for patients with HAI tend to vary from study to study. By including all patients, all medical specialties, and performing a follow-up analysis, this study contributes to previous findings in this research field. Methods: Data from the Swedish National Point Prevalence Surveys of HAI 2010-2012 was merged with cost per patient data from the county Health Care Register (N=6,823). Extended length of stay (LOS) and costs related to an HAI were adjusted for sex, age, intensive care unit use, and surgery. Results: Patients with HAI (n=732) had a larger proportion of readmissions compared with patients with no HAI (29.0% vs 16.5%). Of the total bed days, 9.3% was considered to be excess days attributed to the group of patients with an HAI. The excess LOS comprised 11.4% of the total costs (95% CI, 10.2-12.7). The 1-year overall mortality rate for patients with HAI in comparison to all other patients was 1.75 (95% CI, 1.45-2.11), all 5 of these differences were statistically significant (P<.001). Conclusions: Even if not all outcomes for patients with an HAI can be explained by the HAI itself, the increase in inpatient days, readmissions, associated costs, and higher mortality rates are quite notable. (C) 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Place, publisher, year, edition, pages
MOSBY-ELSEVIER, 2016
Keywords
Point prevalence survey; Readmission; Mortality rate
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:liu:diva-128727 (URN)10.1016/j.ajic.2016.01.035 (DOI)000375483200006 ()26988332 (PubMedID)
Note

Funding Agencies|Region Ostergotland, Sweden [LiO 2014-580]

Available from: 2016-06-01 Created: 2016-05-30 Last updated: 2017-11-30
Rahmqvist, M. (2016). Hur fungerar punktprevalensmetoden som mätinstrument i sluten sjukhusvård?: Kostnader och prevalenser för vårdrelateradei nfektioner i somatisk slutenvård i Östergötland 2012. Linköping: Linköping University Electronic Press
Open this publication in new window or tab >>Hur fungerar punktprevalensmetoden som mätinstrument i sluten sjukhusvård?: Kostnader och prevalenser för vårdrelateradei nfektioner i somatisk slutenvård i Östergötland 2012
2016 (Swedish)Report (Other academic)
Abstract [sv]

Vårdrelaterade infektioner (VRI) är ett ständigt uppmärksammat problem inom hälso- och sjukvården och patienter som drabbas fordrar ytterligare vård i termer av omsorg, läkemedel, vårddagar och får även en ökad mortalitetsrisk. Denna metodstudie försöker kvantifiera och diskutera hur stor del av vårdresurserna som ägnas till patienter som drabbats av VRI. Genom att slå samman de båda registren Vårddatalagret för Region Östergötland (VDL) och lokala data från det nationella registret med Punktprevalens-mätningarna för VRI (PPM), gavs möjlighet att koppla antal vårddagar och vårdkostnader till de PPMdata som samlades in i Östergötland 2012.

När de båda registren matchades visade det sig att patienturvalet i PPM inte var representativt för verksamheten och att alla liknande prevalensmätningar mer eller mindre per automatik får en överrepresentation av patienter med långa vårdtider. Med denna överrepresentation följer en överskattning av prevalensen för VRI och framförallt så framstår medelvårdtiden som avsevärt längre både för de som drabbats av en VRI och de övriga patienterna. I en analys av materialet visade det sig att minst 15 % av patienter i de använda prevalensmätningarna kom med på grund av att de hade långa vårdtider.

Prevalenstalet för patienter med VRI i PPM kan dock användas som ett stabilt mått på hur stor del av sjukhusbeläggningen som utgörs av patienter med VRI. Den genomsnittliga prevalensen av VRI var 10 % i mätningarna under 2012 och således svarade patienter med VRI för 10 % av beläggningen.

Denna studie och en del andra har visat att patienter som drabbas av en VRI har i genomsnitt ungefär dubbelt så långa vårdtider jämfört med de som inte drabbas. Vården för patienter med en registrerad VRI motsvarade 10,7 % av vårdkostnaderna under 2012. Hälften av dessa vårdkostnader (5,3 %), antas bestå av kostnader för den förlängda vårdtiden i denna patientgrupp. Ifall en reducering av dessa vårddagar kunde göras med 40 %, och patienter med VRI bara utgöra 6 % av beläggningen till så skulle det ge en besparing i storleksordningen av 2,1 % av kostnaderna i sluten somatisk sjukhusvård, motsvarande 64 miljoner kronor per år i Östergötland.

En valideringsstudie har dock visat att förekomsten av patienter som drabbats av en VRI underskattas signifikant i de ordinarie PPM och med stor sannolikhet upptas fler vårdplatser av patienter med en dokumenterad VRI än vad en traditionell PPM visar. Detta innebär att merkostnaden för VRI  underskattas, men också att en reducering av antalet patienter med VRI troligtvis kan ge ännu större besparingar av vårddagar och vårdplatser samt kostnader för dessa.

Abstract [en]

In hospital care a constant alert is payed to Healthcare-associated infections (HAI). Patients who suffers from a HAI requires additional care in terms of, medication, longer hospital stays and these patients also have a higher mortality risk than average. This methodological study attempts to provide information on how much of health care resources is devoted to patients affected by a HAI. By merging two registers, the Healthcare register for Region Östergötland (HCR) and local data from a set of Prevalence point surveys (PPS), it was possible to add length of stay (LOS) and health care costs and one year overall mortality to the PPS data collected in the county of Östergötland 2012.

In the merge of the two registers it was found that the patient composition in the PPS was not representative for the total patient mix in the region and that all similar point prevalence measurements more or less automatically gives an overrepresentation of patients with long hospital stays. With this over-representation of patients with LOS above average, follows an overestimation of the prevalence of HAI. An analysis of the material revealed that at least 15% of patients in the PPS were included just because of their long LOS.

However, the PPS gives another unbiased answer that can be used for cost-calculations, this since it tells us the number of occupied beds are used by patients with a registered HAI. The average prevalence of HAI was 10 % in 2012 and thereby follows that 10 % of the beds lodge a patient with a documented HAI, the particular day of survey. Roughly this means that 10 % of the costs for caring patients in somatic inpatient care is related to patients with a HAI. That does not equal that 10 % of the costs are related to HAI but that 10 % of the costs are related to patients with a HAI.

Several studies (including this) have found that patients with an HAI, on average has a twice as long LOS compared to patients without any registered HAI. Such a proportion makes 5 % of the total costs attributable to the HAI itself. After adjustments for the true expenditures of hospital bed days at different departments it was considered that 5.3 % of the health care costs was attributable to the additional treatment of the HAI. If a reduction of the prevalence of HAI could be 40 %, and only affect 6 % of the bed days per year, there would be a total cost reduction of 2.1 % per year in somatic inpatient care in the county of Östergötland.

However, a validation survey of one PPS showed that the prevalence figures of HAI was significant underestimated and if the proportion of patients that suffers from a HAI are larger, the portion of the total costs increases, but the gain in any reduction can in turn be even more favorable.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2016. p. 51
Series
CMT Report, ISSN 0283-1228, E-ISSN 1653-7556 ; 2016:1
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:liu:diva-128104 (URN)
Available from: 2016-05-17 Created: 2016-05-17 Last updated: 2018-02-06Bibliographically approved
Rahmqvist, M., Gjessing, K. & Faresjö, T. (2016). Influenca-like illness among children: Young children suffer, primary care takes the strain, society bears the cost. In: : . Paper presented at Nordic Vaccine Meeting, Reykjavik Iceland, April 28-29 2016.
Open this publication in new window or tab >>Influenca-like illness among children: Young children suffer, primary care takes the strain, society bears the cost
2016 (English)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

Conclusions

Our results demonstrated a significant increase in the burden of disease during the peak influenza season with increased direct medical costs, especially in primary care. The largest impact of ILI was identified among the youngest children (2-4 years). Increased absence from work due to parents' care of ill children correlates strongly with the ILI encounters in health care. This loss of productivity represents a large indirect cost for society.

National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-130721 (URN)
Conference
Nordic Vaccine Meeting, Reykjavik Iceland, April 28-29 2016
Available from: 2016-08-22 Created: 2016-08-22 Last updated: 2018-03-22
Ernesäter, A., Engström, M., Winblad, U., Rahmqvist, M. & Holmström, I. K. (2016). Telephone nurses' communication and response to callers' concern-a mixed methods study.. Applied Nursing Research, 29, 116-121
Open this publication in new window or tab >>Telephone nurses' communication and response to callers' concern-a mixed methods study.
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2016 (English)In: Applied Nursing Research, ISSN 0897-1897, E-ISSN 1532-8201, Vol. 29, p. 116-121Article in journal (Refereed) Published
Abstract [en]

AIMS: The aim of this study was to describe telephone nurses' and callers' communication, investigate relationships within the dyad and explore telephone nurses' direct response to callers' expressions of concern

BACKGROUND: Telephone nurses assessing callers' need of care is a rapidly growing service. Callers with expectations regarding level of care are challenging.

METHOD: RIAS and content analysis was performed on a criterion sampling of calls (N=25) made by callers who received a recommendation from telephone nurses of a lower level of care than expected.

RESULTS: Telephone nurses mainly ask close-ended questions, while open-ended questions are sparsely used. Relationships between callers' expressions of Concern and telephone nurses responding with Disapproval were found. Telephone nurses mainly responded to concern with close-ended medical questions while exploration of callers' reason for concern was sparse.

CONCLUSION: Telephone nurses' reluctance to use open-ended questions and to follow up on callers' understanding might be a threat to concordance, and a potential threat to patient safety.

Place, publisher, year, edition, pages
Elsevier, 2016
Keywords
Communication; RIAS; Sweden; Telephone advice nursing; Triage
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:liu:diva-125984 (URN)10.1016/j.apnr.2015.04.012 (DOI)000370881800022 ()26856500 (PubMedID)
Note

Funding agencies: Swedish Research Council [522-2005-7461]; AFA insurance; Faculty of Medicine, Uppsala University; Faculty of Health and Occupational Studies, University of Gavle, Sweden

Available from: 2016-03-10 Created: 2016-03-10 Last updated: 2017-11-30
Hallert, E., Husberg, M., Kalkan, A., Rahmqvist, M., Skogh, T. & Bernfort, L. (2015). Changes in sociodemographic characteristics at baseline in two Swedish cohorts of patients with early rheumatoid arthritis diagnosed 1996-98 and 2006-09. Scandinavian Journal of Rheumatology, 44(2), 100-105
Open this publication in new window or tab >>Changes in sociodemographic characteristics at baseline in two Swedish cohorts of patients with early rheumatoid arthritis diagnosed 1996-98 and 2006-09
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2015 (English)In: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732, Vol. 44, no 2, p. 100-105Article in journal (Refereed) Published
Abstract [en]

Objectives: To compare baseline sociodemographic characteristics in two rheumatoid arthritis (RA) cohorts enrolled 10 years apart, and to examine differences with respect to the general population. Method: Clinical and sociodemographic data were collected in 320 early RA patients during 1996-98 (TIRA-1) and 467 patients in 2006-09 (TIRA-2). Multivariate logistic regression tests were performed and intercohort comparisons were related to general population data, obtained from official databases. Results: TIRA-2 patients were older than TIRA-1 (58 vs. 56 years). Women (both cohorts, 67%) were younger than men in TIRA-1 (55 vs. 59 years) and in TIRA-2 (57 vs. 61 years). Disease activity was similar but TIRA-2 women scored worse pain and worse on the HAQ. Approximately 73% were cohabiting, in both cohorts and in the general population. Education was higher in TIRA-2 than in TIRA-2 but still lower than in the general population. Women had consistently higher education than men. Education was associated with age, younger patients having higher education. In both cohorts, lower education was associated with increased disability pension and increased sick leave. Sick leave was lower in TIRA-2 than in TIRA-1 (37% vs. 50%) but disability pension was higher (16% vs. 10%). In TIRA-1, 9% of women had disability pension compared with 17% in TIRA-2. A similar decrease in sick leave and an increase in disability pension were also seen in the general population. Older age and a higher HAQ score were associated with increased sick leave and being in the TIRA-2 cohort was associated with decreased sick leave. Conclusions: TIRA-2 patients were slightly older, better educated, had lower sick leave and higher disability pension than those in TIRA-1. Similar changes were seen simultaneously in the general population. Belonging to the TIRA-2 cohort was associated with decreased sick leave, indicating that societal changes are of importance.

Place, publisher, year, edition, pages
Informa Healthcare, 2015
National Category
General Practice
Identifiers
urn:nbn:se:liu:diva-117271 (URN)10.3109/03009742.2014.930926 (DOI)000351182100003 ()25352338 (PubMedID)
Note

Funding Agencies|Norrbacka-Eugenia Foundation; Medical Research County Council of South-East Sweden (FORSS); County Council in Ostergotland; Swedish Rheumatism Association

Available from: 2015-04-22 Created: 2015-04-21 Last updated: 2018-01-11
Bernfort, L., Gerdle, B., Rahmqvist, M., Husberg, M. & Levin, L.-Å. (2015). Chronic pain in an elderly population in Sweden: Impact on costs and quality of life. Linköping: Linköping University Electronic Press
Open this publication in new window or tab >>Chronic pain in an elderly population in Sweden: Impact on costs and quality of life
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2015 (English)Report (Other academic)
Abstract [en]

Chronic pain among elderly people has long been a well-known problem, in terms of both societal costs and the quality of life of affected individuals. To estimate the magnitude of the problems associated with chronic pain in an elderly population, data on both costs and quality of life were gathered. A postal questionnaire was sent out to a stratified sample of 10 000 inhabitants 65 years and older in Linköping and Norrköping. The survey included questions on demographics, habits, and life situation, and different kinds of questions and instruments related to well-being (e.g., quality-of-life and pain-specific questions). In the questionnaire respondents were asked whether they were receiving any help—informal care—from a relative. If they answered yes, they were asked for permission to contact the informal caregiver and to provide contact details. The amount of informal care provided by relatives to persons with chronic pain was investigated by use of a questionnaire directed to the caregiving relatives, containing questions about time spent providing informal care.

Data on costs were collected from registers of consumption of health care, drugs, and municipal services.

The results of the study showed a very clear association between existence and severity of chronic pain and societal costs. The study population was subdivided into three groups with respect to having chronic pain or not, and a pain intensity during the last week of 0–4 (mild), 5–7 (moderate), or 8–10 (severe) on a scale of 0–10. Taking all costs (health care, drugs, municipal services, and informal care) into account, persons in the severe chronic pain group consumed on average 72% more resources than persons in the moderate chronic pain group and 143% more than those in the no or mild chronic pain group. Differences were most pronounced concerning municipal services and informal care costs.

Even more alarming are the results on the quality of life of persons in the different groups. On the EQ-5D index, the average value for persons in the no or mild chronic pain group was 0.82. For those in the moderate chronic pain group the average value was 0.64, and for those in the severe chronic pain group the average value was only 0.38. EQ-VAS resulted in less pronounced but still clearly significant differences.

It is concluded that this study, reaching a rather large part of the target population, shows that existence and severity of chronic pain among people 65 years and older affects costs to society and the quality of life of affected individuals in a massive way.

Abstract [sv]

Kronisk smärta bland äldre är sedan länge ett välkänt problem, både i termer av samhälleliga kostnader och i termer av nedsatt livskvalitet hos drabbade individer. I syfte att uppskatta omfattningen av problemen med kronisk smärta i den äldre befolkningen insamlades data avseende såväl kostnader som livskvalitet. Ett frågeformulär sändes med post ut till ett stratifierat urval om 10 000 invånare 65 år och äldre i Linköpings och Norrköpings kommuner. Frågeformuläret innehöll frågor om demografi, levnadsvanor, livssituation samt olika frågor och instrument relaterade till personernas mående (t.ex. livskvalitet och smärtspecifika frågor). I frågeformuläret tillfrågades respondenterna om huruvida de mottog någon hjälp, informell vård, från någon närstående. Om så var fallet tillfrågades respondenten om tillstånd att kontakta dennes informella vårdgivare, samt kontaktuppgifter. Mängden informell vård tillhandahållen av närstående undersöktes med hjälp av ett frågeformulär innehållande frågor om tid som använts till informella vårdinsatser.

Uppgifter om kostnader inhämtades från register avseende konsumtion av sjukvård, läkemedel och kommunala insatser.

Studiens resultat visade på ett mycket tydligt samband mellan å ena sidan förekomst och grad av kronisk smärta och å andra sidan samhälleliga kostnader. Studiepopulationen delades in i tre grupper med avseende på kronisk smärta eller inte, och smärtintensitet på en 10-gradig skala under den senaste veckan (0–4 = lindrig, 5–7 = måttlig, 8–10 = svår). Med hänsyn tagen till alla kostnader (sjukvård, läkemedel, kommunal service och informell vård) konsumerade personerna med svår kronisk smärta i snitt 72% mer resurser än personerna med måttlig kronisk smärta, och 143% mer än personer med ingen eller lindrig kronisk smärta. Skillnaderna var tydligast avseende kommunala insatser och informell vård.

Ännu mer uppseendeväckande är resultaten gällande livskvalitet för personer i de olika grupperna. Genomsnittligt indexvärde utifrån EQ-5D var för personer med ingen eller lindrig kronisk smärta 0.82. För personer med måttlig kronisk smärta var motsvarande värde 0.64, och för personer med svår kronisk smärta var värdet 0.38. EQ-VAS resulterade i mindre uttalade men tydligt signifikanta skillnader.

Denna studie, som når en relativt stor andel av målpopulationen, visar att förekomst och intensitet av kronisk smärta bland personer 65 år och äldre påverkar samhälleliga kostnader och drabbade personers livskvalitet mycket tydligt.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2015. p. 32
Series
CMT Report, ISSN 0283-1228, E-ISSN 1653-7556 ; 2015:2
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:liu:diva-117729 (URN)CMT RA/1502 (ISRN)
Available from: 2015-05-07 Created: 2015-05-07 Last updated: 2018-02-19Bibliographically approved
Rahmqvist, M., Gjessing, K. & Faresjö, T. (2015). Influenza-like illness: Young children, working parents and primary care take the strain. In: : . Paper presented at European Society for Paediatric Infectious Diseases. 33rd Annual Meeting, Leipzig, May 12-16 2015.
Open this publication in new window or tab >>Influenza-like illness: Young children, working parents and primary care take the strain
2015 (English)Conference paper, Oral presentation only (Refereed)
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-119296 (URN)
Conference
European Society for Paediatric Infectious Diseases. 33rd Annual Meeting, Leipzig, May 12-16 2015
Available from: 2015-06-12 Created: 2015-06-12 Last updated: 2015-07-01
Bernfort, L., Gerdle, B., Rahmqvist, M., Husberg, M. & Levin, L.-Å. (2015). Severity of chronic pain in an elderly population in Sweden-impact on costs and quality of life. Pain, 156(3), 521-527
Open this publication in new window or tab >>Severity of chronic pain in an elderly population in Sweden-impact on costs and quality of life
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2015 (English)In: Pain, ISSN 0304-3959, E-ISSN 1872-6623, Vol. 156, no 3, p. 521-527Article in journal (Refereed) Published
Abstract [en]

Chronic pain is associated with large societal costs, but few studies have investigated the total costs of chronic pain with respect to elderly subjects. The elderly usually require informal care, care performed by municipalities, and care for chronic diseases, all factors that can result in extensive financial burdens on elderly patients, their families, and the social services provided by the state. This study aims to quantify the societal cost of chronic pain in people of age 65 years and older and to assess the impact of chronic pain on quality of life. This study collected data from 3 registers concerning health care, drugs, and municipal services and from 2 surveys. A postal questionnaire was used to collect data from a stratified sample of the population 65 years and older in southeastern Sweden. The questionnaire addressed pain intensity and quality of life variables (EQ-5D). A second postal questionnaire was used to collect data from relatives of the elderly patients suffering from chronic pain. A total of 66.5% valid responses of the 10,000 subjects was achieved; 76.9% were categorized as having no or mild chronic pain, 18.9% as having moderate chronic pain, and 4.2% as having severe chronic pain. Consumed resources increased with the severity of chronic pain. Clear differences in EQ-5D were found with respect to the severity of pain. This study found an association between resource use and severity of chronic pain in elderly subjects: the more severe the chronic pain, the more extensive (and expensive) the use of resources.

Place, publisher, year, edition, pages
Elsevier / Lippincott, Williams andamp; Wilkins, 2015
Keywords
Age; Costs; Elderly; Intensity; Pain; Severity
National Category
Clinical Medicine Basic Medicine
Identifiers
urn:nbn:se:liu:diva-116965 (URN)10.1097/01.j.pain.0000460336.31600.01 (DOI)000350526300021 ()25599240 (PubMedID)
Note

Funding Agencies|Grunenthal Sweden AB

Available from: 2015-04-13 Created: 2015-04-10 Last updated: 2018-01-11
Nygren, M., Roback, K., Öhrn, A., Rutberg, H., Rahmqvist, M. & Nilsen, P. (2013). Factors influencing patient safety in Sweden: perceptions of patient safety officers in the county councils. BMC Health Services Research, 13(52)
Open this publication in new window or tab >>Factors influencing patient safety in Sweden: perceptions of patient safety officers in the county councils
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2013 (English)In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 13, no 52Article in journal (Refereed) Published
Abstract [en]

Background

National, regional and local activities to improve patient safety in Sweden have increased over the last decade. There are high ambitions for improved patient safety in Sweden. This study surveyed health care professionals who held key positions in their county council’s patient safety work to investigate their perceptions of the conditions for this work, factors they believe have been most important in reaching the current level of patient safety and factors they believe would be most important for achieving improved patient safety in the future.

Methods

The study population consisted of 218 health care professionals holding strategic positions in patient safety work in Swedish county councils. Using a questionnaire, the following topics were analysed in this study: profession/occupation; number of years involved in a designated task on patient safety issues; knowledge/overview of the county council’s patient safety work; ability to influence this work; conditions for this work; and the importance of various factors for current and future levels of patient safety.

Results

The response rate to the questionnaire was 79%. The conditions that had the highest number of responses in complete agreement were “patients’ involvement is important for patient safety” and “patient safety work has good support from the county council’s management”. Factors that were considered most important for achieving the current level of patient safety were root cause and risk analyses, incident reporting and the Swedish Patient Safety Law. An organizational culture that encourages reporting and avoids blame was considered most important for improved patient safety in the future, closely followed by improved communication between health care practitioners and patients.

Conclusion

Health care professionals with important positions in the Swedish county councils’ patient safety work believe that conditions for this work are somewhat constrained. They attribute the current levels of patient safety to a broad range of factors and believe that many different solutions can contribute to enhanced patient safety in the future, suggesting that this work must be multifactorial.

Place, publisher, year, edition, pages
BioMed Central, 2013
Keywords
Patient safety, Patient involvement, Communication, Safety culture, Root cause analysis, Risk analysis, Incident reporting
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-90200 (URN)10.1186/1472-6963-13-52 (DOI)000315330200001 ()
Note

Funding Agencies|Swedish Association of Local Authorities and Regions (SALAR)||

Available from: 2013-03-28 Created: 2013-03-21 Last updated: 2017-12-06Bibliographically approved
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