What's ‘Left’ in the ‘Garden of Sweden’?

Olsen, Gregg M.

doi:10.2190/hs.43.1.b

Cited by 6 publications

(5 citation statements)

References 35 publications

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“…Most people reported being involved as individual patients and overall, our results are consistent with reports about the Swedish welfare state's gradual liberalization and individualization (Lapidus et al, 2015;Olsen, 2013); trends which we also see in other European health systems. Our results also suggest that the Swedish health system, which is based on equity and participation through the regional democratic system , needs to pay attention to the levels of citizen involvement between elections and the weak effect attributed to voting in regional elections.…”

Section: Discussionsupporting

confidence: 91%

Getting involved: the extent and impact of patient and public involvement in the Swedish health system

Fredriksson

Tritter

2019

HEPL

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Patient and public involvement (PPI) is framed as beneficial for individuals and for the health system. However, little is known about the extent of involvement, or of its impact. Based on data from Sweden, we show that apart from voting in regional elections (76%), more people reported involvement as individual patients (23%) than part of collective activities (5%) or activities relating to a citizen perspective (4%). There was no correlation between how many people participated and the estimated impact – which was generally low. More extensive involvement is thus not linked to the potential to influence decisions. We argue that to achieve the benefits associated with PPI it is crucial to understand more about people's motivation for being involved and what underlies low estimates of impact. This requires a more systematic approach to involvement, how it is evaluated and its results communicated to participants and the society. We also argue that a future challenge for the Swedish health system, and for other similar health systems, is to support long-term collective involvement in the midst of growing individualization of health services and involvement opportunities primarily intended for patients.

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Section: Discussionsupporting

confidence: 91%

Getting involved: the extent and impact of patient and public involvement in the Swedish health system

Fredriksson

Tritter

2019

HEPL

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“…Swedish elderly care, which includes nutritional care practice, is recognised for its comprehensiveness and high quality ( 20 ). Yet malnutrition, with its consequences for the individual and society, is also a reality in Sweden ( 21 , 22 ).…”

Section: Introductionmentioning

confidence: 99%

Quality indicators of nutritional care practice in elderly care

Josefsson

Nydahl

Persson

et al. 2017

The Journal of nutrition, health and aging

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ObjectivesThe aim is to explore the effects of antecedent, structural and process quality indicators of nutritional care practice on meal satisfaction and screened nutritional status among older adults in residential care homes.DesignData for this Swedish cross-sectional study regarding older adults living in residential care homes were collected by i) a national questionnaire, ii) records from the quality registry Senior Alert, iii) data from an Open Comparison survey of elderly care in 2013/2014. The data represented 1154 individuals in 117 of 290 Swedish municipalities.MeasurementsMeal satisfaction (%) and adequate nutritional status, screened by the Mini Nutritional Assessment Short Form (MNA-SF), were the two outcome variables assessed through their association with population density of municipalities and residents’ age, together with 12 quality indicators pertaining to structure and process domains in the Donabedian model of care.ResultsMeal satisfaction was associated with rural and urban municipalities, with the structure quality indicators: local food policies, private meal providers, on-site cooking, availability of clinical/community dietitians, food service dietitians, and with the process quality indicators: meal choice, satisfaction surveys, and ‘meal councils’. Adequate nutritional status was positively associated with availability of clinical/community dietitians, and energy and nutrient calculated menus, and negatively associated with chilled food production systems.ConclusionMunicipality characteristics and structure quality indicators had the strongest associations with meal satisfaction, and quality indicators with local characteristics emerge as important for meal satisfaction. Nutritional competence appears vital for residents to be well-nourished.

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“…Sweden is particularly interesting to study as it excels in many respects when it comes to elderly care in Europe. For instance, Sweden spends most in European elderly care (2.5% of GNP) (European Commission ) and is recognised for its generous state‐run welfare system aiming at nationwide equality (Theobald , Olsen ). Sweden has a municipality‐based and publicly financed elderly care service, serving more than 300,000 people over 65 years of age, residing in nursing homes and receiving home care.…”

Section: Introductionmentioning

confidence: 99%

Structure and process quality as predictors of satisfaction with elderly care

Kajonius

Kazemi

2015

Health Soc Care Community

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What is known about this topic• Quality of care can be decomposed into three distinct but related components of structure, process and outcome.• Quality of caring relationships predicts satisfaction with care. What this paper adds• In a Swedish national survey, structural variables such as budget per elderly person and care personnel certification/training showed no relationships with the elderly person's evaluation of care in terms of satisfaction, while staffing and budget per capita AbstractThe structure versus process approach to quality of care presented by Donabedian is one of the most cited ever. However, there has been a paucity of research into the empirical validity of this framework, specifically concerning the relative effects of structure and process on satisfaction with elderly care as perceived by the older persons themselves. The current research presents findings from a national survey, including a wide range of quality indicators for elderly care services, conducted in 2012 at the request of the Swedish National Board of Health and Welfare in which responses from 95,000 elderly people living in 324 municipalities and districts were obtained. The results revealed that the only structural variable which significantly predicted quality of care was staffing, measured in terms of the number of caregivers per older resident. More interestingly, process variables (e.g. respect and access to information) explained 40% and 48% of the variance in satisfaction with care, over and above the structural variables, in home care and nursing homes respectively. The findings from this large nationwide sample examining Donabedian's model suggest that quality in elderly care is primarily determined by factors pertaining to process, that is, how caregivers behave towards the older persons. This encourages a continued quality improvement in elderly care with a particular focus on process variables.Keywords: elderly care, process, quality of care, satisfaction, structure were weakly associated with satisfaction in nursing homes.• Process factors such as respect and access to information were strongly associated with satisfaction.• The integrated model on quality of care presented by Donabedian is a useful framework for predicting client satisfaction in elderly care.

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What's ‘Left’ in the ‘Garden of Sweden’?

Cited by 6 publications

References 35 publications

Getting involved: the extent and impact of patient and public involvement in the Swedish health system

Getting involved: the extent and impact of patient and public involvement in the Swedish health system

Quality indicators of nutritional care practice in elderly care

Structure and process quality as predictors of satisfaction with elderly care

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