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Borgquist, Lars
Publications (10 of 72) Show all publications
Borgquist, L., Lundell, L. & Lindgren, S. (2018). Magsårssjukdomens paradigmskiften – från högspecialiserad vårdorganisation till egenvård [The paradigm shift for peptic ulcer disease]. Läkartidningen, 115
Open this publication in new window or tab >>Magsårssjukdomens paradigmskiften – från högspecialiserad vårdorganisation till egenvård [The paradigm shift for peptic ulcer disease]
2018 (English)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 115Article in journal, Editorial material (Refereed) Published
Abstract [en]

Knowledge development and paradigm shift for peptic ulcer disease is described over a fifty-year period using four levels of knowledge that place demands on the healthcare organization. When medical knowledge reached a healing level, continuity became subordinate. However, accessibility to treatment became more important. An important task for future healthcare will be to define and create broader knowledge structures. Efficiency losses can occur when control instruments apply to medical problems at low levels of knowledge which are not mature for this.

Place, publisher, year, edition, pages
Stockholm, Sweden: Läkartidningen Förlag AB, 2018
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:liu:diva-155990 (URN)30040110 (PubMedID)
Available from: 2019-04-01 Created: 2019-04-01 Last updated: 2019-04-18Bibliographically approved
Holtedahl, K., Vedsted, P., Borgquist, L., Donker, G. A., Buntinx, F., Weller, D., . . . Parajuli, R. (2017). Abdominal symptoms in general practice: Frequency, cancer suspicions raised, and actions taken by GPs in six European countries. Cohort study with prospective registration of cancer. Heliyon, 3(6), Article ID e00328.
Open this publication in new window or tab >>Abdominal symptoms in general practice: Frequency, cancer suspicions raised, and actions taken by GPs in six European countries. Cohort study with prospective registration of cancer
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2017 (English)In: Heliyon, ISSN 2405-8440, Vol. 3, no 6, article id e00328Article in journal (Refereed) Published
Abstract [en]

Abdominal symptoms are diagnostically challenging to general practitioners (GPs): although common, they may indicate cancer. In a prospective cohort of patients, we examined abdominal symptom frequency, initial diagnostic suspicion, and actions of GPs in response to abdominal symptoms.

Place, publisher, year, edition, pages
Elsevier, 2017
Keywords
Evidence-based medicine; Medicine; Oncology; Public health
National Category
General Practice
Identifiers
urn:nbn:se:liu:diva-146284 (URN)10.1016/j.heliyon.2017.e00328 (DOI)28707001 (PubMedID)
Available from: 2018-04-07 Created: 2018-04-07 Last updated: 2018-04-25
Olai, L., Borgquist, L. & Svardsudd, K. (2015). Life situations and the care burden for stroke patients and their informal caregivers in a prospective cohort study. Upsala Journal of Medical Sciences, 120(4), 290-298
Open this publication in new window or tab >>Life situations and the care burden for stroke patients and their informal caregivers in a prospective cohort study
2015 (English)In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 120, no 4, p. 290-298Article in journal (Refereed) Published
Abstract [en]

Background. The purpose of this study was to analyse whether the parallel life situation between stroke patients and their informal caregivers (dyads) shown in cross-sectional studies prevails also in a longitudinal perspective.Methods. A total of 377 Swedish stroke patients, aged 65 years, and their 268 informal caregivers were followed from hospital admission and one year on. Analyses were based on patient interviews, functional ability (MMSE) score, Nottingham Health Profile (NHP) score, Hospital Anxiety and Depression (HAD) score, self-rated health score, and the Gothenburg Quality of Life (GQL) activity score. Similar information was obtained by postal questionnaires from informal caregivers, also including information on the nature and amount of assistance provided and on Caregiver Burden (CB) score.Results. Before index admission informal caregivers provided care on average 5 h per week and after discharge 11 h per week (P < 0.0001). Support volume was associated with patient sex (more for men), low patients functional ability, low received municipal social service support, closeness of patient-caregiver relation, and short distance to patients home. Significant positive associations within the dyads were found for HAD anxiety score (P < 0.0001), total NHP score (P < 0.0001), and GQL activity score (P < 0.0001) after adjustment for patients age, sex, functional ability, and patient-caregiver relationship. CB score increased with amount of informal caregiver support, patients age, and with low functional ability and low amount of municipal social service support. All these associations were constant across time.Conclusions. There was an association within the dyads regarding anxiety score, NHP score, and activity score. CB score was generally high.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD, 2015
Keywords
Caregiver burden; dyad; elderly; informal caregiver; stroke
National Category
Basic Medicine
Identifiers
urn:nbn:se:liu:diva-123837 (URN)10.3109/03009734.2015.1049388 (DOI)000365684900009 ()26074171 (PubMedID)
Note

Funding Agencies|Vardal Foundation [V98-401]; Centre for Clinical Research Dalarna; Dalarna County Council; Uppsala University

Available from: 2016-01-11 Created: 2016-01-11 Last updated: 2018-01-10
Sondergaard, E., Grauers Willadsen, T., Dorrit Guassora, A., Vestergaard, M., Olafia Tomasdottir, M., Borgquist, L., . . . Reventlow, S. (2015). Problems and challenges in relation to the treatment of patients with multimorbidity: General practitioners views and attitudes. Scandinavian Journal of Primary Health Care, 33(2), 121-126
Open this publication in new window or tab >>Problems and challenges in relation to the treatment of patients with multimorbidity: General practitioners views and attitudes
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2015 (English)In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 33, no 2, p. 121-126Article in journal (Refereed) Published
Abstract [en]

Objective. To explore views and attitudes among general practitioners (GPs) and researchers in the field of general practice towards problems and challenges related to treatment of patients with multimorbidity. Setting. A workshop entitled Patients with multimorbidity in general practice held during the Nordic Congress of General Practice in Tampere, Finland, 2013. Subjects. A total of 180 GPs and researchers. Design. Data for this summary report originate from audio-recorded, transcribed verbatim plenary discussions as well as 76 short questionnaires answered by attendees during the workshop. The data were analysed using framework analysis. Results. (i) Complex care pathways and clinical guidelines developed for single diseases were identified as very challenging when handling patients with multimorbidity; (ii) insufficient cooperation between the professionals involved in the care of multimorbid patients underlined the GPs impression of a fragmented health care system; (iii) GPs found it challenging to establish a good dialogue and prioritize problems with patients within the timeframe of a normal consultation; (iv) the future role of the GP was discussed in relation to diminishing health inequality, and current payment systems were criticized for not matching the treatment patterns of patients with multimorbidity. Conclusion. The participants supported the development of a future research strategy to improve the treatment of patients with multimorbidity. Four main areas were identified, which need to be investigated further to improve care for this steadily growing patient group.

Place, publisher, year, edition, pages
TAYLOR and FRANCIS LTD, 2015
Keywords
Denmark; Finland; general practice; general practitioner; Iceland; multimorbidity; Nordic countries; primary care; qualitative study; Sweden
National Category
Basic Medicine
Identifiers
urn:nbn:se:liu:diva-121934 (URN)10.3109/02813432.2015.1041828 (DOI)000361329200010 ()26158584 (PubMedID)
Note

Funding Agencies|Lundbeck Foundation

Available from: 2015-10-13 Created: 2015-10-12 Last updated: 2018-01-11
Skoog, J., Midlov, P., Borgquist, L., Sundquist, J. & Halling, A. (2014). Can gender difference in prescription drug use be explained by gender-related morbidity?: a study on a Swedish population during 2006. BMC Public Health, 14(329)
Open this publication in new window or tab >>Can gender difference in prescription drug use be explained by gender-related morbidity?: a study on a Swedish population during 2006
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2014 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 14, no 329Article in journal (Refereed) Published
Abstract [en]

Background: It has been reported that there is a difference in drug prescription between males and females. Even after adjustment for multi-morbidity, females tend to use more prescription drugs compared to males. In this study, we wanted to analyse whether the gender difference in drug treatment could be explained by gender-related morbidity. Methods: Data was collected on all individuals 20 years and older in the county of Ostergotland in Sweden. The Johns Hopkins ACG Case-Mix System was used to calculate individual level of multi-morbidity. A report from the Swedish National Institute of Public Health using the WHO term DALY was the basis for gender-related morbidity. Prescription drugs used to treat diseases that mainly affect females were excluded from the analyses. Results: The odds of having prescription drugs for males, compared to females, increased from 0.45 (95% confidence interval (CI) 0.44-0.46) to 0.82 (95% CI 0.81-0.83) after exclusion of prescription drugs that are used to treat diseases that mainly affect females. Conclusion: Gender-related morbidity and the use of anti-conception drugs may explain a large part of the difference in prescription drug use between males and females but still there remains a difference between the genders at 18%. This implicates that it is of importance to take the gender-related morbidity into consideration, and to exclude anti-conception drugs, when performing studies regarding difference in drug use between the genders.

Place, publisher, year, edition, pages
BioMed Central, 2014
Keywords
Prescription drugs; Multi-morbidity; Gender difference; Gender-related morbidity
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-106971 (URN)10.1186/1471-2458-14-329 (DOI)000335468700001 ()
Available from: 2014-06-04 Created: 2014-06-02 Last updated: 2017-12-05
Thorell, K., Ranstad, K., Midlov, P., Borgquist, L. & Halling, A. (2014). Is use of fall risk-increasing drugs in an elderly population associated with an increased risk of hip fracture, after adjustment for multimorbidity level: a cohort study. BMC Geriatrics, 14(131)
Open this publication in new window or tab >>Is use of fall risk-increasing drugs in an elderly population associated with an increased risk of hip fracture, after adjustment for multimorbidity level: a cohort study
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2014 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 14, no 131Article in journal (Refereed) Published
Abstract [en]

Background: Risk factors for hip fracture are well studied because of the negative impact on patients and the community, with mortality in the first year being almost 30% in the elderly. Age, gender and fall risk-increasing drugs, identified by the National Board of Health and Welfare in Sweden, are well known risk factors for hip fracture, but how multimorbidity level affects the risk of hip fracture during use of fall risk-increasing drugs is to our knowledge not as well studied. This study explored the relationship between use of fall risk-increasing drugs in combination with multimorbidity level and risk of hip fracture in an elderly population. Methods: Data were from Ostergotland County, Sweden, and comprised the total population in the county aged 75 years and older during 2006. The odds ratio (OR) for hip fracture during use of fall risk-increasing drugs was calculated by multivariate logistic regression, adjusted for age, gender and individual multimorbidity level. Multimorbidity level was estimated with the Johns Hopkins ACG Case-Mix System and grouped into six Resource Utilization Bands (RUBs 0-5). Results: 2.07% of the study population (N = 38,407) had a hip fracture during 2007. Patients using opioids (OR 1.56, 95% CI 1.34-1.82), dopaminergic agents (OR 1.78, 95% CI 1.24-2.55), anxiolytics (OR 1.31, 95% CI 1.11-1.54), antidepressants (OR 1.66, 95% CI 1.42-1.95) or hypnotics/sedatives (OR 1.31, 95% CI 1.13-1.52) had increased ORs for hip fracture after adjustment for age, gender and multimorbidity level. Vasodilators used in cardiac diseases, antihypertensive agents, diuretics, beta-blocking agents, calcium channel blockers and renin-angiotensin system inhibitors were not associated with an increased OR for hip fracture after adjustment for age, gender and multimorbidity level. Conclusions: Use of fall risk-increasing drugs such as opioids, dopaminergic agents, anxiolytics, antidepressants and hypnotics/sedatives increases the risk of hip fracture after adjustment for age, gender and multimorbidity level. Fall risk-increasing drugs, high age, female gender and multimorbidity level, can be used to identify high-risk patients who could benefit from a medication review to reduce the risk of hip fracture.

Place, publisher, year, edition, pages
BioMed Central, 2014
Keywords
Hip fracture; Multimorbidity level; Fall risk-increasing drugs; Elderly; Medication review; Sweden
National Category
Basic Medicine
Identifiers
urn:nbn:se:liu:diva-113574 (URN)10.1186/1471-2318-14-131 (DOI)000346745800001 ()25475854 (PubMedID)
Available from: 2015-01-23 Created: 2015-01-23 Last updated: 2018-01-11
Borgquist, L., W-Dahl, A., Dale, H., Lidgren, L. & Stefansdottir, A. (2014). Prosthetic joint infections - a need for health economy studies. Acta Orthopaedica, 85(3), 218-220
Open this publication in new window or tab >>Prosthetic joint infections - a need for health economy studies
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2014 (English)In: Acta Orthopaedica, ISSN 1745-3674, E-ISSN 1745-3682, Vol. 85, no 3, p. 218-220Article in journal, Editorial material (Other academic) Published
Place, publisher, year, edition, pages
Informa Healthcare, 2014
National Category
Health Sciences
Identifiers
urn:nbn:se:liu:diva-109187 (URN)10.3109/17453674.2014.913227 (DOI)000337845000002 ()24758324 (PubMedID)
Available from: 2014-08-12 Created: 2014-08-11 Last updated: 2017-12-05Bibliographically approved
Carlsson, P. & Borgquist, L. (2014). The Importance of Cost Effectiveness in Prioritising Drugs. In: Anthony J Culyer and Gisela Kobelt (Ed.), Portrait of a health economist: ESSAYS BY COLLEAGUES AND FRIENDS OF BENGT JÖNSSON (pp. 17-24). Lund: IHE - The Swedish Institute for Health Economics
Open this publication in new window or tab >>The Importance of Cost Effectiveness in Prioritising Drugs
2014 (English)In: Portrait of a health economist: ESSAYS BY COLLEAGUES AND FRIENDS OF BENGT JÖNSSON / [ed] Anthony J Culyer and Gisela Kobelt, Lund: IHE - The Swedish Institute for Health Economics , 2014, p. 17-24Chapter in book (Other academic)
Place, publisher, year, edition, pages
Lund: IHE - The Swedish Institute for Health Economics, 2014
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:liu:diva-115139 (URN)978-91-88042-24-8 (ISBN)
Available from: 2015-03-09 Created: 2015-03-09 Last updated: 2015-03-20
Engstrom, S., Borgquist, L., Berne, C., Gahnberg, L. & Svardsudd, K. (2013). Can costs of screening for hypertension and diabetes in dental care and follow-up in primary health care be predicted?. Upsala Journal of Medical Sciences, 118(4), 256-262
Open this publication in new window or tab >>Can costs of screening for hypertension and diabetes in dental care and follow-up in primary health care be predicted?
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2013 (English)In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 118, no 4, p. 256-262Article in journal (Refereed) Published
Abstract [en]

Aim. The purpose was to assess the direct costs of screening for high blood pressure and blood glucose in dental care and of follow-up in primary health care and, based on these data, arrive at a prediction function. less thanbrgreater than less thanbrgreater thanStudy population. All subjects coming for routine check-ups at three dental health clinics were invited to have blood pressure or blood glucose measurements; 1,623 agreed to participate. Subjects screening positive were referred to their primary health care centres for follow-up. less thanbrgreater than less thanbrgreater thanMethods. Information on individual screening time was registered during the screening process, and information on accountable time, costs for the screening staff, overhead costs, and analysis costs for the screening was obtained from the participating dental clinics. The corresponding items in primary care, i.e. consultation time, number of follow-up appointments, accountable time, costs for the follow-up staff, overhead costs, and analysis costs during follow-up were obtained from the primary health care centres. less thanbrgreater than less thanbrgreater thanResults. The total screening costs per screened subject ranged from (sic)7.4 to (sic)9.2 depending on subgroups, corresponding to 16.7-42.7 staff minutes. The corresponding follow-up costs were (sic)57-(sic)91. The total resource used for screening and follow-up per diagnosis was 563-3,137 staff minutes. There was a strong relationship between resource use and numbers needed to screen (NNS) to find one diagnosis (P andlt; 0.0001, degree of explanation 99%). less thanbrgreater than less thanbrgreater thanConclusions. Screening and follow-up costs were moderate and appear to be lower for combined screening of blood pressure and blood glucose than for separate screening. There was a strong relationship between resource use and NNS.

Place, publisher, year, edition, pages
Informa Healthcare / Upsala Medical Society, 2013
Keywords
Costs, dental care, diabetes mellitus type 2, early diagnosis, high blood pressure, primary health care
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-100476 (URN)10.3109/03009734.2013.818599 (DOI)000325527300008 ()
Note

Funding Agencies|Centre for Clinical Research at Uppsala University/Gavleborg county council||Public Dental Service, Gavleborg county council||Uppsala University||

Available from: 2013-11-08 Created: 2013-11-08 Last updated: 2017-12-06
Arvidsson, E., André, M., Borgquist, L., Mårtensson, J. & Carlsson, P. (2013). Day-to-day Rationing of Limited Resources in Swedish routine Primary Care: an interview study.
Open this publication in new window or tab >>Day-to-day Rationing of Limited Resources in Swedish routine Primary Care: an interview study
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2013 (English)Manuscript (preprint) (Other academic)
Abstract [en]

Background: Rationing is a reality in all health care, but little is known about day-to-day rationing in routine primary health care (PHC). This study aims to explore strategies to handle limited of resources in Swedish routine primary care.

Methods: Data were compiled from 62 interviews with healthcare professionals (general practitioners, nurses, physiotherapists, and managers at primary care centres). A qualitative research method was applied in the analysis.

Results: The interviewed staff described perceptions of a general public with high expectations on PHC in combination with a lack of resources. Strategies to cope with scarce resources were avoiding rationing, ad hoc rationing, or planned rationing. Rationing was largely implicit and not based on ethical principles or other defined criteria. Trying to avoid rationing resulted in unintended rationing. Ad hoc rationing had undesired consequences, e.g. inadequate continuity of care and displacing certain patient groups, especially the chronically ill and the elderly. The staff expressed a need for support and for applicable guidelines, and called for policy statements based on priority decisions to help manage the situation.

Conclusions: The interviews suggested a need to improve the transparency of priority setting procedures in PHC, although the nature of the PHC setting presents special challenges. Improving transparency could, in turn, improve equity and the efficient use of resources in PHC.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-88085 (URN)
Available from: 2013-01-29 Created: 2013-01-29 Last updated: 2013-01-29Bibliographically approved
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