Abstract
BackgroundThe national strategy for treatment of chronic diseases - including MS - and changes in the Swedish welfare system, call for analyses of the use of, and patient satisfaction with, care in a long-term perspective. The aim was therefore to explore the use of care and the predictive value of personal factors, disease-specific factors and functioning on the use of care and to explore patient satisfaction with care in a 10-year perspective.MethodsInformation regarding personal factors, disease-specific factors, functioning and satisfaction with care was collected by home-visits; use of care was collected from the Stockholm County Council computerised register.ResultData from 121 people with MS (PwMS) was collected. Primary care accounted for the majority of all care. Neurology and Rehabilitation Departments together accounted for two-thirds of all hospital outpatient care. Rehabilitation Departments accounted for one-third of the total number of inpatient days. Lower coping capacity, impaired manual dexterity and activity of daily living dependency at baseline, together with progress in MS disability predicted a higher use of care. Overall, patient satisfaction with care was stable over time.ConclusionThe extensive use of care offers challenges to care coordination. Implementation of person-centred care could be a strategy to increase efficacy/outcome of care.
Highlights
The national strategy for treatment of chronic diseases - including Multiple sclerosis (MS) - and changes in the Swedish welfare system, call for analyses of the use of, and patient satisfaction with, care in a long-term perspective
A total of 166 people with MS (PwMS) were included at baseline, of which 32 were deceased at the 10-year follow-up
An additional 12 PwMS declined to participate and one PwMS had moved from Stockholm County and was excluded
Summary
The national strategy for treatment of chronic diseases - including MS - and changes in the Swedish welfare system, call for analyses of the use of, and patient satisfaction with, care in a long-term perspective. Since MS has a great impact on functioning in people with MS (PwMS), the majority will need health care over a period of many years. Previous cross-sectional and short-term (up to three years) studies have found that PwMS use a large amount of care [5, 6] and that a more severe MS is associated with a higher cost and a higher total amount of care used [5]. It has been found that depressive symptoms [7] and fatigue [8] are associated with a higher use of care, but the impact of other variables has not been explored. Studies have demonstrated that PwMS are not satisfied with a number of areas of care, for example; accessibility of care [9] and Chruzander et al BMC Health Services Research (2015) 15:480 psychosocial support [10, 11]; advice on social security matters; and continuity of rehabilitation services [10]
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