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Is the quality of primary healthcare services influenced by the healthcare centre's type of ownership?-An observational study of patient perceived quality, prescription rates and follow-up routines in privately and publicly owned primary care centres.

https://arctichealth.org/en/permalink/ahliterature276646
Source
BMC Health Serv Res. 2015;15:417
Publication Type
Article
Date
2015
Author
Andy Maun
Catrin Wessman
Pär-Daniel Sundvall
Jörgen Thorn
Cecilia Björkelund
Source
BMC Health Serv Res. 2015;15:417
Date
2015
Language
English
Publication Type
Article
Keywords
Adult
Female
Follow-Up Studies
Health Care Reform - economics - organization & administration
Health Facilities, Proprietary
Health Priorities - economics - organization & administration
Humans
Male
Middle Aged
Organizational Innovation - economics
Patient Satisfaction - statistics & numerical data
Primary Health Care - economics - standards
Privatization - economics - organization & administration
Quality of Health Care - economics - standards
Retrospective Studies
Sweden - epidemiology
Abstract
Primary healthcare in Sweden has undergone comprehensive reforms, including freedom of choice regarding provider, freedom of establishment and increased privatisation aiming to meet demands for quality and availability. In this system privately and publicly owned primary care centres with different business models (for-profit vs non-profit) coexist and compete for patients, which makes it important to study whether or not the type of ownership influences the quality of the primary healthcare services.
In this retrospective observational study (April 2011 to January 2014) the patient perceived quality, the use of antibiotics and benzodiazepine derivatives, and the follow-up routines of certain chronic diseases were analysed for all primary care centres in Region Västra Götaland. The outcome measures were compared on a group level between privately owned (n?=?86) and publicly owned (n?=?114) primary care centres (PCC).
In comparison with the group of publicly owned PCCs, the group of privately owned PCCs were characterized by: a smaller, but continuously growing share of the population served (from 32 to 36%); smaller PCC population sizes (avg. 5932 vs. 9432 individuals); a higher fraction of PCCs located in urban areas (57% vs 35%); a higher fraction of listed citizens in working age (62% vs. 56%) and belonging to the second most affluent socioeconomic quintile (26% vs. 14%); higher perceived patient quality (82.4 vs. 79.6 points); higher use of antibiotics (6.0 vs. 5.1 prescriptions per 100 individuals in a quarter); lower use of benzodiazepines (DDD per 100 patients/month) for 20-74 year olds (278 vs. 306) and >74 year olds (1744 vs.1791); lower rates for follow-ups of chronic diseases (71.2% vs 74.6%). While antibiotic use decreased, the use of benzodiazepines increased for both groups over time.
The findings of this study cannot unambiguously answer the question of whether or not the quality is influenced by the healthcare centre's type of ownership. It can be questioned whether the reform created conditions that encouraged quality improvements. Tendencies of an (unintended) unequal distribution of the population between the two groups with disparities in age, socio-economy and geography might lead to unpredictable effects. Further studies are necessary for evidence-informed policy-making.
Notes
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PubMed ID
26410077 View in PubMed
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Listening to the decision makers: sustainability of PBMA in Alberta.

https://arctichealth.org/en/permalink/ahliterature175968
Source
Appl Health Econ Health Policy. 2004;3(3):143-51
Publication Type
Article
Date
2004
Author
Craig Mitton
San Patten
Cam Donaldson
Author Affiliation
Centre for Healthcare Innovation and Improvement, BC Research Institute for Children's and Women's Health, Vancouver, British Columbia, Canada. cmitton@cw.bc.ca
Source
Appl Health Econ Health Policy. 2004;3(3):143-51
Date
2004
Language
English
Publication Type
Article
Keywords
Administrative Personnel
Alberta
Budgets - methods - organization & administration
Decision Making, Organizational
Delivery of Health Care - economics - organization & administration
Health Care Costs
Health Priorities - economics - organization & administration
Humans
Interviews as Topic
Regional Health Planning - economics - organization & administration
Resource Allocation - economics - organization & administration
Abstract
Decision makers within the Calgary Health Region adopted and applied programme budgeting and marginal analysis (PBMA) for priority-setting activity across major service portfolios within the Region.
Seventeen in-depth qualitative interviews were conducted with senior managers and clinicians to gain a user perspective and identify specific areas for process refinement. Data were thematically coded and categorised into relevant themes.
Key strengths included a culture shift in thinking about the need to reallocate resources within a fixed funding envelope, whereas a key challenge identified was in putting forth genuine disinvestment options. Areas suggested for improvement included evoking an incentive system for stakeholder engagement and having a mechanism for tracking the effect of resource reallocations.
Both an evidence-based approach to priority setting, as well as a way of thinking around managing resource scarcity, can be integrated into organisational processes. Findings reported in this article will influence further application in Calgary and should provide insight for those attempting such activity elsewhere.
PubMed ID
15740170 View in PubMed
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[National and regional prioritisation in Swedish health care: experiences from cardiology].

https://arctichealth.org/en/permalink/ahliterature121989
Source
Z Evid Fortbild Qual Gesundhwes. 2012;106(6):435-42
Publication Type
Article
Date
2012
Author
Jörg Carlsson
Author Affiliation
Linnæus University and Medicinska kliniken, Länssjukhuset i Kalmar, Schweden. jorg.carlsson@ltkalmar.se
Source
Z Evid Fortbild Qual Gesundhwes. 2012;106(6):435-42
Date
2012
Language
German
Publication Type
Article
Keywords
Cardiovascular Diseases - economics - rehabilitation
Cost Savings - economics
Cost-Benefit Analysis - economics - organization & administration
Cross-Cultural Comparison
Evidence-Based Medicine - economics - organization & administration
Guideline Adherence - economics - organization & administration
Health Care Rationing - economics - organization & administration
Health Priorities - economics - organization & administration
Health Services Needs and Demand - organization & administration
Humans
National Health Programs - economics - organization & administration
Regional Health Planning - economics - organization & administration
Sweden
Abstract
Prioritisation of medical services in Sweden takes place on two different levels. On the national level, the Swedish priority guidelines ascribe priority values ranging from 1 (high priority) to 10 (low priority) to measures (in terms of condition-treatment pairs) of prevention, diagnosis, treatment and rehabilitation of cardiovascular diseases. In addition, this list contains interventions that should be avoided and those that should only be provided as part of clinical research projects. The government then commissions a multi-professional team under the supervision of the National Board of Health and Welfare "Socialstyelsen" with the development of corresponding guidelines. In addition to the scientific evidence, the priority lists incorporate ethical and economical aspects and are based on the so-called ethics platform consisting of human dignity, needs, solidarity and cost-effectiveness. At the other level of prioritisation there are regional projects aiming at the in- and exclusion of medical measures. The Swedish prioritisation process will be described using the example of priority lists in cardiology. (As supplied by publisher).
PubMed ID
22857731 View in PubMed
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Priority-setting criteria in the Norwegian health services.

https://arctichealth.org/en/permalink/ahliterature271726
Source
Tidsskr Nor Laegeforen. 2015 Aug 25;135(15):1373-5
Publication Type
Article
Date
Aug-25-2015
Author
Torbjørn Wisløff
Source
Tidsskr Nor Laegeforen. 2015 Aug 25;135(15):1373-5
Date
Aug-25-2015
Language
English
Norwegian
Publication Type
Article
Keywords
Cost-Benefit Analysis
Health Priorities - economics - organization & administration
Humans
Norway
Severity of Illness Index
PubMed ID
26315241 View in PubMed
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Shaping the future of health promotion: priorities for action.

https://arctichealth.org/en/permalink/ahliterature160263
Source
Health Promot Int. 2008 Mar;23(1):98-102
Publication Type
Article
Date
Mar-2008
Source
Health Promot Int. 2008 Mar;23(1):98-102
Date
Mar-2008
Language
English
Publication Type
Article
Keywords
Canada
Consumer Participation - methods
Evidence-Based Medicine - organization & administration
Health Manpower - organization & administration
Health Policy
Health Priorities - economics - organization & administration
Health Promotion - economics - organization & administration
Health Status Disparities
Humans
Internationality
Abstract
The International Union for Health Promotion and Education, in collaboration with the Canadian Consortium for Health Promotion Research, and with support from the Public Health Agency of Canada, have formulated recommendations on priorities for action regarding the policies and system conditions necessary for sustainable and effective health promotion. The statement, launched in June in Vancouver at the IUHPE World Conference on Health Promotion and Health Education, and reproduced below, is the product of an international Project Advisory Group's reflections derived from a collection of commissioned field reports on renewing commitment to the path set out by the Ottawa Charter. The field reports themselves will be published in their entirety in a special issue of 'Promotion & Education', official journal of the International Union for Health Promotion and Education, in December 2007.
PubMed ID
18024422 View in PubMed
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6 records – page 1 of 1.