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An evaluation of the QSP and the QPP: two methods for measuring patient satisfaction.

https://arctichealth.org/en/permalink/ahliterature71895
Source
Int J Qual Health Care. 2001 Jun;13(3):257-64
Publication Type
Article
Date
Jun-2001
Author
J. Nathorst-Böös
I M Munck
I. Eckerlund
C. Ekfeldt-Sandberg
Author Affiliation
Department of Obstetrics and Gynaecology, Karolinska Institute, Karolinska Hospital, Stockholm, Sweden. jorgen.nathorst-boos@ks.se
Source
Int J Qual Health Care. 2001 Jun;13(3):257-64
Date
Jun-2001
Language
English
Publication Type
Article
Keywords
Female
Health Care Surveys - methods
Hospitals, University - standards
Humans
Models, Statistical
Multivariate Analysis
Obstetrics and Gynecology Department, Hospital - standards
Patient Acceptance of Health Care
Patient Satisfaction - statistics & numerical data
Quality Assurance, Health Care - statistics & numerical data
Questionnaires
Sweden
Abstract
BACKGROUND: Patient satisfaction is a function of several variables addressing reasons why it is important to use methods in which these different factors can be isolated and their importance analysed. OBJECTIVE: In this project, two methods using this approach were used: the 'Quality from the Patient's Perspective' and the 'Quality, Satisfaction, Performance' models. The aim of the present study is to evaluate these two different methods with respect to application, strengths and weaknesses. DESIGN: In the Quality from the Patient's Perspective model, the patient judges the different domains in two dimensions: perceived reality and subjective importance. The Quality, Satisfaction, Performance model uses a multivariate analysis to capture the patient's priorities. Four hundred and sixty forms for each model were distributed to a random sample of patients at the Department of Obstetrics and Gynecology at Karolinska Hospital. MAIN MEASURES: The quality factors 'treatment by the nurse', 'participation', 'information', 'environment' and 'accessibility' were measured. RESULTS: On both forms, 'medical care', 'treatment by the doctor' and 'access to nursing treatment' received high scores in perceived reality' while 'accessibility' and 'participation' received low scores. 'Subjective importance' measured directly and indirectly, respectively, in the two models showed high values for 'medical care' and 'treatment by the doctor'. CONCLUSION: The advantages of the Quality from the Patient's Perspective model are that it has a comprehensive and solid question bank. The Quality, Satisfaction, Performance model's advantage is its immediate usefulness and its clear graphic presentation. An integration and further development of these two approaches may prove useful.
PubMed ID
11476150 View in PubMed
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Change-oriented patient questionnaires--testing a new method at three departments of ophthalmology.

https://arctichealth.org/en/permalink/ahliterature210373
Source
Int J Health Care Qual Assur Inc Leadersh Health Serv. 1997;10(6-7):254-9
Publication Type
Article
Date
1997
Author
I. Eckerlund
B. Jönsson
M. Tambour
A H Westlund
Author Affiliation
Centre for Health Economics, Stockholm School of Economics, Sweden.
Source
Int J Health Care Qual Assur Inc Leadersh Health Serv. 1997;10(6-7):254-9
Date
1997
Language
English
Publication Type
Article
Keywords
Health Care Surveys - methods
Hospital Departments - standards
Humans
Models, organizational
Ophthalmology - standards
Patient satisfaction
Quality of Health Care
Questionnaires
Sweden
Abstract
The use of patient questionnaires has increased widely in recent years. Their purpose, to incorporate patient perspectives into the orientation and design of health care, is, of course, commendable. However, the survey methods themselves have been less adequate, both in terms of validity and reliability, and with respect to the potential for using the results to improve the quality of health care. Presents a pilot study at three departments of ophthalmology in Sweden, involving a new method which meets reasonable demands for validity and reliability, and is explicitly change-oriented.
PubMed ID
10175770 View in PubMed
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A cost-minimization analysis of root canal treatment before and after education in nickel-titanium rotary technique in general practice.

https://arctichealth.org/en/permalink/ahliterature127110
Source
Int Endod J. 2012 Jul;45(7):633-41
Publication Type
Article
Date
Jul-2012
Author
M. Koch
A. Tegelberg
I. Eckerlund
S. Axelsson
Author Affiliation
Department of Endodontics, Public Dental Service, Sörmland County Council, Sweden. margaretha.koch@dll.se
Source
Int Endod J. 2012 Jul;45(7):633-41
Date
Jul-2012
Language
English
Publication Type
Article
Keywords
Costs and Cost Analysis
Dental Alloys - economics
Dentist's Practice Patterns - economics
Endodontics - economics - education
General Practice, Dental - education
Health Care Costs
Humans
Nickel
Public Health Dentistry - economics
Questionnaires
Root Canal Preparation - instrumentation
Root Canal Therapy - economics
Stainless Steel
Sweden
Titanium
Abstract
To compare root canal treatments performed before and after education in a nickel-titanium rotary technique (NiTiR) with respect to costs for instrumentation and number of instrumentation sessions in a County Public Dental Service in Sweden.
Following education, 77% of the general dental practitioners adopted completely the NiTiR. The randomly selected sample comprised 850 root canal treatments: 425 performed after the education, mainly using the NiTiR-technique (group A) and 425 performed before, using mainly stainless steel hand instrumentation (SSI) (group B). The number of instrumentation sessions in root canal treatments in group A and B was calculated. A CMA was undertaken on the assumption that treatment outcome was identical in group A and B. Direct costs associated with SSI and NiTiR were estimated and compared. Investment costs required for implementation of NiTiR were calculated, but not included in the CMA.
Instrumentation sessions were counted in 418 (98%) root canal treatments performed in group A and 419 (99%) in group B. The number of instrumentation sessions in group A was significantly lower; 2.38, compared with 2.82 in group B (P
PubMed ID
22324460 View in PubMed
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Econometric analysis of variation in cesarean section rates. A cross-sectional study of 59 obstetrical departments in Sweden.

https://arctichealth.org/en/permalink/ahliterature64138
Source
Int J Technol Assess Health Care. 1998;14(4):774-87
Publication Type
Article
Date
1998
Author
I. Eckerlund
U G Gerdtham
Author Affiliation
Stockholm School of Economics.
Source
Int J Technol Assess Health Care. 1998;14(4):774-87
Date
1998
Language
English
Publication Type
Article
Keywords
Cesarean Section - economics - statistics & numerical data - utilization
Cross-Sectional Studies
Female
Health Care Costs
Humans
Physician's Practice Patterns - economics
Pregnancy
Sweden
Utilization Review - economics
Abstract
The objective of this study was to explain the variation in cesarean section rates among hospitals (obstetrical departments) in Sweden, and to discuss its potential economic consequences. Using data from The Swedish Medical Birth Registry 1991, we made a cross-sectional study of the cesarean section rate at the departmental level. We identified some 20 determinants, demand-related as well as supply-related. A general model including all these regressors was specified. After reducing this model, we were able to explain about one-quarter of the variation. We conclude that the large variation in cesarean section rates indicates inefficiency, due mainly to overutilization, but perhaps also underutilization. It is difficult to calculate the economic consequences or the welfare loss to society. We estimated an additional cost for unnecessary cesarean sections of 13-16 million Swedish crowns (SEK) per year.
PubMed ID
9885466 View in PubMed
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Estimating the effect of cesarean section rate on health outcome. Evidence from Swedish hospital data.

https://arctichealth.org/en/permalink/ahliterature58865
Source
Int J Technol Assess Health Care. 1999;15(1):123-35
Publication Type
Article
Date
1999
Author
I. Eckerlund
U G Gerdtham
Author Affiliation
Stockholm School of Economics.
Source
Int J Technol Assess Health Care. 1999;15(1):123-35
Date
1999
Language
English
Publication Type
Article
Keywords
Asphyxia Neonatorum - epidemiology
Cesarean Section - statistics & numerical data - utilization
Female
Hospitals - statistics & numerical data
Humans
Infant mortality
Infant, Newborn
Outcome and Process Assessment (Health Care) - statistics & numerical data
Pregnancy
Pregnancy outcome
Registries - statistics & numerical data
Regression Analysis
Research Support, Non-U.S. Gov't
Sweden - epidemiology
Abstract
This paper tests the null hypothesis of a zero effect of cesarean section rate on health outcome against the alternative of a positive effect. Using data from 59 hospitals in Sweden from 1988-92, we specify two separate linear regression models for health outcome, one with perinatal mortality, and the other with rate of asphyxia, as dependent variable. We estimate the models by single-year cross-section regressions and as pooled data systems. The null hypothesis cannot be rejected, i.e., we do not find any significant positive effect of cesarean section rate on health outcome. Thus, we conclude that an increase in cesarean section rate does not imply lower perinatal mortality or lower rate of asphyxia. This in turn indicates that the minimum cesarean section rate is optimal.
PubMed ID
10407600 View in PubMed
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Hypertension case-finding in primary health care. Experience from the Skaraborg Hypertension Project.

https://arctichealth.org/en/permalink/ahliterature235612
Source
Scand J Prim Health Care. 1987 Feb;5(1):9-12
Publication Type
Article
Date
Feb-1987
Author
L. Råstam
I. Eckerlund
L. Rydén
Source
Scand J Prim Health Care. 1987 Feb;5(1):9-12
Date
Feb-1987
Language
English
Publication Type
Article
Keywords
Adult
Aged
Evaluation Studies as Topic
Humans
Hypertension - diagnosis
Middle Aged
Primary Health Care
Sweden
Abstract
This study evaluates the efficacy of a hypertension case-finding program. During office hours (8.00 am to 5.00 pm weekdays), all patients visiting a Swedish primary health care center, had their blood pressure recorded using an automatic equipment. This was made irrespective of the reason for the visit. Analysis of a record sample showed that 56 +/- 4% (95% confidence) of the 40-69 year-old fraction of the population (N = 5,806) served by the center attended the center during a two-year period. Fifty-two percent (N = 3,025) had their blood pressure checked and one percent (N = 65) fulfilled the criteria for hypertension (greater than 170/greater than 105 mmHg at three different times if aged 40-60 years; greater than 180/greater than 110 mmHg greater than 60 years). We conclude that case-finding for hypertension has low efficacy when performed in day-time primary health care.
PubMed ID
3589239 View in PubMed
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[Patient preferences or cost-effectiveness? Priorities are highly affected by introduction of economic dimension].

https://arctichealth.org/en/permalink/ahliterature195898
Source
Lakartidningen. 2000 Dec 6;97(49):5782-6, 5788
Publication Type
Article
Date
Dec-6-2000
Author
I. Eckerlund
J. Eklöf
J. Nathorst-Böös
Author Affiliation
Socialstyrelsen, Stockholm.
Source
Lakartidningen. 2000 Dec 6;97(49):5782-6, 5788
Date
Dec-6-2000
Language
Swedish
Publication Type
Article
Keywords
Cost-Benefit Analysis
Decision Making
Health Services Accessibility - economics
Humans
Interior Design and Furnishings
Patient Participation - economics
Patient Satisfaction - economics
Quality Assurance, Health Care
Questionnaires
Sweden
Abstract
In recent years various methods to measure patient satisfaction have been applied as part of quality improvement programmes in the health services. However, the statistical quality as well as the applicability and change-orientation of the methods have been questioned. Furthermore, most methods pay no attention to economic aspects. Even a methodologically well-founded measurement of patient satisfaction may lead to wrong conclusions unless economic consequences are taken into consideration. It is possible to carry out an integrated analysis that includes patient preferences as well as economic aspects.
PubMed ID
11188037 View in PubMed
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[Utilization of patient questionnaires. A new promising method tested at three different ophthalmology clinics].

https://arctichealth.org/en/permalink/ahliterature211868
Source
Lakartidningen. 1996 May 22;93(21):2078-81
Publication Type
Article
Date
May-22-1996

Variations in resource utilization--the role of medical practice and its economic impact.

https://arctichealth.org/en/permalink/ahliterature73901
Source
Soc Sci Med. 1989;28(2):165-73
Publication Type
Article
Date
1989
Author
I. Eckerlund
S. Håkansson
Author Affiliation
Swedish Planning and Rationalization Institute for the Health and Social Services, Stockholm.
Source
Soc Sci Med. 1989;28(2):165-73
Date
1989
Language
English
Publication Type
Article
Keywords
Cesarean Section - economics
Delivery of Health Care
Dilatation and Curettage - economics
Female
Health Resources - utilization
Humans
Length of Stay
Male
Physician's Practice Patterns - economics
Prostatectomy - economics
Sweden
Abstract
Several studies have indicated that differences in medical practice are often an important factor behind variations in resource utilization. 'Practice', in medical contexts, is used as a comprehensive expression for what is regarded to be adequate care, considering science and proven experience, as well as present resources, demography, organization, and other given conditions. However, experience shows that routines and practice, even under similar conditions (resources, organization, etc.) often vary significantly among departments within the same medical discipline. In this more restricted sense, variations in practice might depend on different--more or less well-founded--opinions among physicians concerning what constitutes appropriate length of stay, level of care, and technology. With examples from some specialties (e.g. general surgery, obstetrics and gynecology), we demonstrate this 'model' and the economic impact of practice variations. Our conclusion is that there are opportunities for achieving greater benefit from existing resources, i.e. increasing efficiency, through reallocation and alternative utilization of resources, altered practice.
PubMed ID
2928826 View in PubMed
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9 records – page 1 of 1.