Female labour force participation, fertility and public policy in Sweden

This paper analyzes the role of public policy for Sweden's combination of high female labour force participation and high levels of fertility in the late 1980s and early 1990s. We present the central elements in the tax and family policies and use a disaggregated approach to assess their impact on Swedish fertility and female labour force participation. We show that these policies stimulate both fertility and women's paid work by reducing the costs of having children while requiring parents to be employed to collect full benefits. Cet article analyse le rôle des politiques sur le lien entre une forte participation féminine au marché du travail et de hauts niveaux de fécondité en Suède, à la fin des années 1980 et au début des années 1990. Nous présentons d'abord les principaux éléments des politiques fiscales et parentales. Puis nous utilisons une approche désaggrégée pour mettre en évidence leur impact sur la fécondité suédoise et la participation féminine au marché du travail. Nous montrons que ces politiques stimulent à la fois la fécondité et le travail féminin rémunéré en réduisant les coûts en vue d'élever les enfants tout en demandant aux parents d'être actifs pour en recueillir les pleins bénéfices.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/42731/1/10680_2005_Article_BF01797210.pd

Perceived barriers for treatment of chronic heart failure in general practice; are they affecting performance?

BACKGROUND: The aim of this study is to determine to what extent barriers perceived by general practitioners (GPs) for prescribing angiotensin-converting enzyme inhibitors (ACE-I) in chronic heart failure (CHF) patients are related to underuse and underdosing of these drugs in actual practice. METHODS: Barriers were assessed with a semi-structured questionnaire. Prescribing data were extracted from GPs' computerised medical records for a random sample of their CHF patients. Relations between barriers and prescribing behaviour were assessed by means of Spearman rank correlation and multivariate regression modelling. RESULTS: GPs prescribed ACE-I to 45% of their patients and had previously initiated such treatment in an additional 3.5%, in an average standardised dose of 13.5 mg. They perceived a median of four barriers in prescribing ACE-I or optimising ACE-I dose. Many GPs found it difficult to change treatment initiated by a cardiologist. Furthermore, initiating ACE-I in patients already using a diuretic or stable on their current medication was perceived as barrier. Titrating the ACE-I dose was seen as difficult by more than half of the GPs. No significant relationships could be found between the barriers perceived and actual ACE-I prescribing. Regarding ACE-I dosing, the few GPs who did not agree that the ACE-I should be as high as possible prescribed higher ACE-I doses. CONCLUSION: Variation between GPs in prescribing ACE-I for CHF cannot be explained by differences in the barriers they perceive. Tailor-made interventions targeting only those doctors that perceive a specific barrier will therefore not be an efficient approach to improve quality of care