Palvelusetelikokeilun arviointikehikko

Sosiaali- ja terveysministeriön käynnistämän palvelusetelikokeilun tavoitteena on löytää valinnanvapauden malli, joka on sekä taloudellisesti tarkoituksenmukainen että mahdollistaa asiakkaiden yhdenvertaisen hoitoon pääsyn. Lisäksi asiakkaiden osallistumisella palvelujen valintaan kannustetaan tuottajia kehittämään palvelujaan. Kokeiluun osallistuvat kunnat valittiin syksyllä 2016 ja kokeilut ovat käynnistyneet vuoden 2017 alussa. Palvelusetelikokeilu on osa hallituksen Palvelut asiakaslähtöiseksi –kärkihanketta. Palvelusetelikokeilun arviointityön tukemista varten Terveyden ja hyvinvoinnin laitos on laatinut arviointikehikon, joka nostaa esiin kokeilun onnistumisen ja kokeilun tuottaman tiedon hyödynnettävyyden kannalta keskeisiä kysymyksiä. Toimivan arviointikehikon rakentaminen liittyy läheisesti koko kokeiluasetelman luomiseen. Kehikon muodostamisessa on pyritty huomioimaan kokeilualueiden erityispiirteet ja mahdollisuudet kerätä ja raportoida arvioinnin kannalta keskeistä tietoa. Arvioinnin lähtökohtana on selvittää, toteutuvatko valinnanvapauden välttämättömät edellytykset: Ovatko asiakkaat tietoisia oikeudesta valita? Onko riittävästi vaihtoehtoisia palvelutuottajia? Onko asiakkailla saatavilla riittävästi vertailutietoa vaihtoehdoista? Seuraako raha sujuvasti asiakasta valitulle tuottajalle? Arviointityössä on tärkeää tarkastella myös mitkä ovat kokeilujen seurannaisvaikutukset järjestäjien, palvelutuotannon, talouden, henkilöstön ja asiakkaiden näkökulmast

Body Weight, Physical Activity, and Risk of Cancer in Lynch Syndrome

Lynch syndrome (LS) increases cancer risk. There is considerable individual variation in LS cancer occurrence, which may be moderated by lifestyle factors, such as body weight and physical activity (PA). The potential associations of lifestyle and cancer risk in LS are understudied. We conducted a retrospective study with cancer register data to investigate associations between body weight, PA, and cancer risk among Finnish LS carriers. The participants (n = 465, 54% women) self-reported their adulthood body weight and PA at 10-year intervals. Overall cancer risk and colorectal cancer (CRC) risk was analyzed separately for men and women with respect to longitudinal and near-term changes in body weight and PA using extended Cox regression models. The longitudinal weight change was associated with an increased risk of all cancers (HR 1.02, 95% CI 1.00–1.04) and CRC (HR 1.03, 1.01–1.05) in men. The near-term weight change was associated with a lower CRC risk in women (HR 0.96, 0.92–0.99). Furthermore, 77.6% of the participants retained their PA category over time. Men in the high-activity group had a reduced longitudinal cancer risk of 63% (HR 0.37, 0.15–0.98) compared to men in the low-activity group. PA in adulthood was not associated with cancer risk among women. These results emphasize the role of weight maintenance and high-intensity PA throughout the lifespan in cancer prevention, particularly in men with LS

Body Weight, Physical Activity, and Risk of Cancer in Lynch Syndrome

Lynch syndrome (LS) increases cancer risk. There is considerable individual variation in LS cancer occurrence, which may be moderated by lifestyle factors, such as body weight and physical activity (PA). The potential associations of lifestyle and cancer risk in LS are understudied. We conducted a retrospective study with cancer register data to investigate associations between body weight, PA, and cancer risk among Finnish LS carriers. The participants (n = 465, 54% women) self-reported their adulthood body weight and PA at 10-year intervals. Overall cancer risk and colorectal cancer (CRC) risk was analyzed separately for men and women with respect to longitudinal and near-term changes in body weight and PA using extended Cox regression models. The longitudinal weight change was associated with an increased risk of all cancers (HR 1.02, 95% CI 1.00–1.04) and CRC (HR 1.03, 1.01–1.05) in men. The near-term weight change was associated with a lower CRC risk in women (HR 0.96, 0.92–0.99). Furthermore, 77.6% of the participants retained their PA category over time. Men in the high-activity group had a reduced longitudinal cancer risk of 63% (HR 0.37, 0.15–0.98) compared to men in the low-activity group. PA in adulthood was not associated with cancer risk among women. These results emphasize the role of weight maintenance and high-intensity PA throughout the lifespan in cancer prevention, particularly in men with LS

Valinnanvapaus sosiaali- ja terveydenhuollossa - kriittiset askeleet toteuttamisessa

Perustuu VALVA- ja VALINT-hankkeisiin