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Experiences from implementing value-based healthcare at a Swedish University Hospital - an longitudinal interview study.

https://arctichealth.org/en/permalink/ahliterature285858
Source
BMC Health Serv Res. 2017 Feb 28;17(1):169
Publication Type
Article
Date
Feb-28-2017
Author
Kerstin Nilsson
Fredrik Bååthe
Annette Erichsen Andersson
Ewa Wikström
Mette Sandoff
Source
BMC Health Serv Res. 2017 Feb 28;17(1):169
Date
Feb-28-2017
Language
English
Publication Type
Article
Keywords
Delivery of Health Care
Hospitals, University - economics - organization & administration
Humans
Interviews as Topic
Longitudinal Studies
Outcome Assessment (Health Care)
Pilot Projects
Qualitative Research
Reimbursement Mechanisms
Sweden
Abstract
Implementing the value-based healthcare concept (VBHC) is a growing management trend in Swedish healthcare organizations. The aim of this study is to explore how representatives of four pilot project teams experienced implementing VBHC in a large Swedish University Hospital over a period of 2 years. The project teams started their work in October 2013.
An explorative and qualitative design was used, with interviews as the data collection method. All the participants in the four pilot project teams were individually interviewed three times, with interviews starting in March 2014 and ending in November 2015. All the interviews were transcribed and analyzed using qualitative analysis.
Value for the patients was experienced as the fundamental drive for implementing VBHC. However, multiple understandings of what value for patients' means existed in parallel. The teams received guidance from consultants during the first 3 months. There were pros and cons to the consultant's guidance. This period included intensive work identifying outcome measurements based on patients' and professionals' perspectives, with less interest devoted to measuring costs. The implementation process, which both gave and took energy, developed over time and included interventions. In due course it provided insights to the teams about the complexity of healthcare. The necessity of coordination, cooperation and working together inter-departmentally was critical.
Healthcare organizations implementing VBHC will benefit from emphasizing value for patients, in line with the intrinsic drive in healthcare, as well as managing the process of implementation on the basis of understanding the complexities of healthcare. Paying attention to the patients' voice is a most important concern and is also a key towards increased engagement from physicians and care providers for improvement work.
Notes
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PubMed ID
28241823 View in PubMed
Less detail

The influence of hospital drug formulary policies on the prescribing patterns of proton pump inhibitors in primary care.

https://arctichealth.org/en/permalink/ahliterature260099
Source
Eur J Clin Pharmacol. 2014 Jul;70(7):859-65
Publication Type
Article
Date
Jul-2014
Author
Michael Due Larsen
Mette Schou
Anja Sparre Kristiansen
Jesper Hallas
Source
Eur J Clin Pharmacol. 2014 Jul;70(7):859-65
Date
Jul-2014
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cost Savings
Denmark
Drug Costs
Drug Prescriptions
Drug Utilization Review
Female
Formularies, Hospital
Hospital Costs
Hospitals, University - economics - organization & administration - trends
Humans
Male
Middle Aged
Patient Discharge
Physician's Practice Patterns - economics - trends
Policy Making
Primary Health Care - economics - trends
Proton Pump Inhibitors - economics - therapeutic use
Registries
Abstract
This study had two aims: Firstly, to describe how prescriptions for proton pump inhibitor (PPI) in primary care were influenced by a change of the hospital drug policy, and secondly, to describe if a large discount on an expensive PPI (esomeprazole) to a hospital would influence prescribing patterns after discharge.
This register study was conducted at Odense University Hospital, Denmark, and by use of pharmacy dispensing data and a hospital-based pharmacoepidemiological database, the medication regimens of patients were followed across hospitalisation. The influence of hospital drug policy on prescribings in primary care was measured by the likelihood of having a high-cost PPI prescribed before and after change of drug policy.
In total, 9,341 hospital stays in 2009 and 2010 were included. The probability of a patient to be prescribed an expensive PPI after discharge decreased from 33.5 to 9.4%, corresponding to a risk ratio of 0.28. In primary care after discharge, 13.4% of esomeprazole use was initiated in the hospital, and this was 8.4% for PPIs in general. After the change of hospital drug policy, this decreased to 6.5% for esomeprazole and increased for the recommended PPIs pantoprazole and lansoprazole to 14.6 and 26.1%, respectively. The effect of a large discount on expensive PPI to hospital was 14.7%, and this decreased to 2.6% when coordinating drug policy in hospital and primary care.
The likelihood of having an expensive PPI prescribed after hospital stay decreased when coordinating drug policy and the influence of a large discount to hospital could be minimised.
PubMed ID
24770928 View in PubMed
Less detail

The interdependence of productivity, cost, and outcome: studies of service delivery in Finnish university hospitals.

https://arctichealth.org/en/permalink/ahliterature128416
Source
World Hosp Health Serv. 2012;48(4):17-9
Publication Type
Article
Date
2012
Author
Risto Miettunen
Unto Häkkinen
Hanna Rättö
Author Affiliation
Kuopio University Hospital District, Finland.
Source
World Hosp Health Serv. 2012;48(4):17-9
Date
2012
Language
English
Publication Type
Article
Keywords
Cost Control
Efficiency, Organizational
Finland
Hospital Costs
Hospitals, University - economics - organization & administration
Humans
Organizational Case Studies
Treatment Outcome
Abstract
The relationship and interdependence between cost and productivity plays a significant role in understanding and assessing service delivery in university hospitals. This article shows some of the elements and factors, highlighting the further need for studies such as EuroHOPE and others. A broad and consistent data comparison in the Nordic region and Finland especially is presented, based on common DRG criteria. Expanding the Nordic data comparisons to other European countries is also discussed, with notice of further work to be published.
PubMed ID
23484429 View in PubMed
Less detail

[Is the new St Olav Hospital going to collapse?].

https://arctichealth.org/en/permalink/ahliterature164880
Source
Tidsskr Nor Laegeforen. 2007 Mar 1;127(5):623-4
Publication Type
Article
Date
Mar-1-2007
Author
Arne Hedemark
Source
Tidsskr Nor Laegeforen. 2007 Mar 1;127(5):623-4
Date
Mar-1-2007
Language
Norwegian
Publication Type
Article
Keywords
Hospital Planning
Hospitals, University - economics - organization & administration - standards
Humans
Norway
Safety Management
Notes
Comment On: Tidsskr Nor Laegeforen. 2007 Jan 4;127(1):6017205094
PubMed ID
17332825 View in PubMed
Less detail

[Is the new St Olav Hospital on its way to collapse?].

https://arctichealth.org/en/permalink/ahliterature165794
Source
Tidsskr Nor Laegeforen. 2007 Jan 4;127(1):60
Publication Type
Article
Date
Jan-4-2007
Author
Sven Erik Gisvold
Author Affiliation
Anestesi- og intensivavdelingen, St. Olavs Hospital, 7006 Trondheim. sven.e.gisvold@ntnu.no
Source
Tidsskr Nor Laegeforen. 2007 Jan 4;127(1):60
Date
Jan-4-2007
Language
Norwegian
Publication Type
Article
Keywords
Hospital Planning - economics
Hospitals, University - economics - organization & administration - standards
Humans
Norway
Patient-Centered Care
Safety Management
Notes
Comment In: Tidsskr Nor Laegeforen. 2007 Mar 15;127(6):765; author reply 76517363997
Comment In: Tidsskr Nor Laegeforen. 2007 Mar 1;127(5):623-417332825
PubMed ID
17205094 View in PubMed
Less detail

Lessons learned: the implementation of an Alternative Funding Plan at SCO Health Service in Ottawa.

https://arctichealth.org/en/permalink/ahliterature170440
Source
Healthc Manage Forum. 2005;18(4):46-9
Publication Type
Article
Date
2005
Author
Deborah Sarre-McGregor
Frank D Knoefel
Author Affiliation
Alternative Funding Plan, SCO Health Service, Ottawa, Ontario.
Source
Healthc Manage Forum. 2005;18(4):46-9
Date
2005
Language
English
Publication Type
Article
Keywords
Aged
Contract Services
Financing, Organized - methods
Group Practice - economics - organization & administration
Health Services for the Aged - economics - organization & administration
Hospital Departments - economics - organization & administration
Hospital-Physician Joint Ventures - economics - organization & administration
Hospitals, University - economics - organization & administration
Humans
Long-Term Care - economics - organization & administration
Models, organizational
Negotiating
Ontario
Public Health Administration
Research Support as Topic
Societies, Medical
Training Support
Abstract
Physicians of SCO Health Service in Ottawa recently entered into an Alternative Funding Plan agreement with the Ministry for Health and Long-Term Care in Ontario. The plan provides agreed monthly funding to the SCOHS Academic Medical Organization in return for medical services. Funds are then paid to physician Practice Plans for services provided. The plan almost entirely eliminates fee-for-service billing, and also provides funding for teaching and research activities. The process of establishing the plan has provided some insights that might be useful to organizations undertaking the same process. Some of these insights are shared in this paper.
PubMed ID
16509280 View in PubMed
Less detail

Manager Experiences with the Return to Work Process in a Large, Publically Funded, Hospital Setting: Walking a Fine Line.

https://arctichealth.org/en/permalink/ahliterature275623
Source
J Occup Rehabil. 2015 Dec;25(4):752-62
Publication Type
Article
Date
Dec-2015
Author
Mette Jensen Stochkendahl
Corrie Myburgh
Amanda Ellen Young
Jan Hartvigsen
Source
J Occup Rehabil. 2015 Dec;25(4):752-62
Date
Dec-2015
Language
English
Publication Type
Article
Keywords
Absenteeism
Attitude
Communication
Denmark
Female
Focus Groups
Hospital Administrators - ethics - psychology
Hospitals, Public - economics - organization & administration
Hospitals, University - economics - organization & administration
Humans
Interviews as Topic
Male
Organizational Policy
Presenteeism
Professional Role
Qualitative Research
Return to work
Sick Leave
Workplace - organization & administration
Abstract
Previous research on the role of managers in the return to work (RTW) process has primarily been conducted in contexts where the workplace has declared organizational responsibility for the process. While this is a common scenario, in some countries, including Denmark, there is no explicit legal obligation on the workplace to accommodate RTW. The aim of this study was to gain knowledge about the potential roles and contributions of managers in supporting returning employees in a context where they have no legal obligation to actively support RTW.
Nineteen Danish hospital managers participated in a one-on-one interview or focus group discussions aimed at identifying barriers and facilitators for supporting employees in their RTW. Five individual interviews and two focus group discussions were conducted. Transcripts were analysed using thematic content analysis.
Four main themes were identified: (1) 'Coordinator and collaborator'; (2) 'Dilemmas of the RTW policy enforcer'; (3) 'The right to be sick and absent'; and (4) 'Keep the machinery running…'. Our findings indicated that supervisors' capacity to support returning workers was related to individual, communication, organizational, and policy factors. Instances were observed where supervisors faced the dilemma of balancing ethical and managerial principles with requirements of keeping staffing budgets.
Although it is not their legislative responsibility, Danish managers play a key role in the RTW process. As has been observed in other contexts, Danish supervisors struggle to balance considerations for the returning worker with those of their teams.
PubMed ID
25916307 View in PubMed
Less detail

Rebirth of the university hospital: the Finnish strategy.

https://arctichealth.org/en/permalink/ahliterature191419
Source
World Hosp Health Serv. 2001;37(3):12-4, 40, 42
Publication Type
Article
Date
2001
Author
L A Laitinen
A. Seppälä
M. Kekomäki
Author Affiliation
Department Administration, Helsinki and Uusimaa Hospital District, Finland.
Source
World Hosp Health Serv. 2001;37(3):12-4, 40, 42
Date
2001
Language
English
Publication Type
Article
Keywords
Cost-Benefit Analysis
Finland
Health Services Research
Hospital Information Systems
Hospital Restructuring
Hospitals, University - economics - organization & administration - trends
Humans
Organizational Innovation
Organizational Objectives
Randomized Controlled Trials as Topic
Research Support as Topic - legislation & jurisprudence - organization & administration
State Medicine - organization & administration
Treatment Outcome
Abstract
Like the academic hospitals worldwide, the Finnish university hospitals are under increasing economical pressures seeking ways to re-assess their traditional missions. It is strongly felt that new solutions within the field of evaluative sciences could bring added value to university hospitals. In this vein, university hospitals must take a leading position in assessing efficacy, (cost-)effectiveness and, ultimately, cost-utility of both traditional and emerging clinical technologies. This will affect the research culture of university hospitals both profoundly and permanently.
PubMed ID
11858005 View in PubMed
Less detail

9 records – page 1 of 1.