Future directions

In this final paper, we summarise briefly the principal conclusions to emerge from the conference. We also review possible future directions in the light of the contributions of different authors and discussions at the conference. The paper argues that changes in the Swedish health services are both inevitable and desirable. The challenge is to maintain the strengths of the existing system while tackling widely acknowledged weaknesses. It is not yet clear what will emerge from the process of reform but the probable outcome is a period of innovation and experimentation leading to greater diversity in service provision. We argue that diversity is most likely to develop within the context of a continuing commitment to equity and comprehensiveness in the delivery of health cars.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/29999/1/0000366.pd

Prospects for comparing European hospitals in terms of quality and safety

Purpose. Being able to compare hospitals in terms of quality and safety between countries is important for a number of reasons. For example, the 2011 European Union directive on patients’ rights to cross-border health care places a requirement on all member states to provide patients with comparable information on health-care quality, so that they can make an informed choice. Here, we report on the feasibility of using common process and outcome indicators to compare hospitals for quality and safety in five countries (England, Portugal, The Netherlands, Sweden and Norway). Main Challenges Identified. The cross-country comparison identified the following seven challenges with respect to comparing the quality of hospitals across Europe: different indicators are collected in each country; different definitions of the same indicators are used; different mandatory versus voluntary data collection requirements are in place; different types of organizations oversee data collection; different levels of aggregation of data exist (country, region and hospital); different levels of public access to data exist; and finally, hospital accreditation and licensing systems differ in each country. Conclusion. Our findings indicate that if patients and policymakers are to compare the quality and safety of hospitals across Europe, then further work is urgently needed to agree the way forward. Until then, patients will not be able to make informed choices about where they receive their health care in different countries, and some governments will remain in the dark about the quality and safety of care available to their citizens as compared to that available in neighbouring countries

Prospects for comparing European hospitals in terms of quality and safety: lessons from a comparative study in five countries

Being able to compare hospitals in terms of quality and safety between countries is important for a number of reasons. For example, the 2011 European Union directive on patients' rights to cross-border health care places a requirement on all member states to provide patients with comparable information on health-care quality, so that they can make an informed choice. Here, we report on the feasibility of using common process and outcome indicators to compare hospitals for quality and safety in five countries (England, Portugal, The Netherlands, Sweden and Norway)

A longitudinal, multi-level comparative study of quality and safety in European hospitals: the QUASER study protocol

although there is a wealth of information available about quality improvement tools and techniques in healthcare there is little understanding about overcoming the challenges of day-to-day implementation in complex organisations like hospitals. The 'Quality and Safety in Europe by Research' (QUASER) study will investigate how hospitals implement, spread and sustain quality improvement, including the difficulties they face and how they overcome them. The overall aim of the study is to explore relationships between the organisational and cultural characteristics of hospitals and how these impact on the quality of health care; the findings will be designed to help policy makers, payers and hospital managers understand the factors and processes that enable hospitals in Europe to achieve-and sustain-high quality services for their patients

Projektet Vårdgaranti 05 - mot en ”kö-fri” sjukvård

En svaghet i den svenska hälso- och sjukvården har varit bristandetillgänglighet. Olika åtgärder har vidtagits i samverkan mellan statenoch landstingen för att underlätta patienternas tillgång till vård.Den centrala vårdgarantin 1992 har kompletterats med lokala åtgärder.I denna artikel beskrivs arbetet med kunskapsunderlag förden vårdgaranti, som trädde i kraft hösten 2005

The Norrtaelje model : a unique model for integrated health and social care in Sweden

Many countries organise and fund health and social care separately. The Norrtaelje model is a Swedish initiative that transformed the funding and organisation of health and social care in order to better integrate care for older people with complex needs. In Norrtaelje model, this transformation made it possible to bringing the team together, to transfer responsibility to different providers, to use care coordinators, and to develop integrated pathways and plans around transitions in and out of hospital and from nursing homes to hospital. The Norrtaelje model operates in the context of the Swedish commitment to universal coverage and public programmes based on tax-funded resources that are pooled and redistributed to citizens on the basis of need. The experience of Norrtaelje model suggests that one way to promote integration of health and social care is to start with a transformation that aligns these two sectors in terms of high level organisation and funding. This transformation then enables the changes in operations and management that can be translated into changes in care delivery. This "top-down" approach must be in-line with national priorities and policies but ultimately is successful only if the culture, resource allocation and management are changed throughout the local system