Swedish Health Care Centres Research Articles

P036 IMPACT OF THE COVID-19 PANDEMIC ON HERNIA SURGERY IN A SWEDISH HEALTH-CARE REGION WITHOUT LOCKDOWN: A RETROSPECTIVE COHORT STUDY

AimDuring the COVID-19 pandemic, Swedish health care centers were restructured. This was accompanied by changes in the surgical programme. The aim of this study was to determine the effects of COVID-19 on emergency and elective hernia surgeries in a Swedish health-care region.Material and MethodsThis was a retrospective, observational cohort study. Data from inguinal and ventral hernia surgeries were retrieved from a medical database using procedure codes from all three hospitals in Region Jönköping County from March 1, 2019 to January 31, 2021. The participants were divided into two groups: COVID-19 group (March 1, 2020 - January 31, 2021) and reference group (March 1, 2019 - January 31, 2020). The incidence rate (IR) and relative risk (RR) of operations over different time frames were analyzed.ResultsA total 1351 participants met the inclusion criteria. 590 were operated during the COVID-19 period and 761 during the reference period. The IR of elective operations was decreased during the COVID-19 pandemic; 146 operations/100.000 population vs 192 operations/100.000 population during the reference period. RR was 0,76 (95% CI 0.6813-0.8545, p < 0.0001). Moreover, IR of emergency operations decreased insignificantly during the COVID-19 pandemic; 17,5 operations/100.000 population vs 19,4 operations/100.000 population during the reference period. RR was 0,9 (95% CI 0.6404- 1.2649, p 0.5441). No significant variations in the emergency operations have identified when different time frames were compared.ConclusionsThere is no evidence to support that COVID-19 pandemic has increased emergency hernia operations during the studied period despite the significant reduction of elective operations.

Two sides of the coin – General Practitioners' experience of working in multidisciplinary teams

Multidisciplinary teamwork, defined as the collaboration between different professional groups to achieve a common purpose, is commonly regarded as a means to meet the complex tasks that medicine has to deal with today. However, many attempts to introduce the method in primary care have failed and this is supposed to be partly due to the fact that general practitioners (GPs) did not participate in the implementation of the method. The aim of this investigation was to get a deeper understanding of their attitude to teamwork by interviewing nine GPs at four Swedish health care centres, where successful teamwork had been ongoing since 1997. Themes and categories in the interviews were identified according to content analysis. Although the attitude in general was in favour of teamwork, four major themes: time-consuming versus time-saving; shared responsibility versus main responsibility; medical expert versus generalist; shared knowledge versus all knowing, could be identified, which all revealed ambivalence towards teamwork among the interviewees. It was concluded that, if teamwork is to be successfully introduced into primary care, the GPs' self-perception has to be taken into consideration as has the prestige and status associated with their traditional role and the benefits of teamwork to the profession of medicine. Apart from time, teamwork requires, professional supervision and doctors need to be trained in this method as early as in medical school.

The influence of complaint symptoms on health care utilisation, medicine use, and sickness absence: A comparison between retrospective and prospective utilisation

Objective The main aim was to examine the impact of reported individual symptoms on health care utilisation (HCU) in a primary health care practice population and to evaluate the impact of these symptoms on utilisation over time. Method The study was performed in 1055 out of 1442 consecutive adult patients visiting a Swedish health care centre. Logistic regression analyses were applied to assess the relationships between symptoms and HCU outcomes. Results Each of the 30 symptoms was related to consultations with GPs and a provider of alternative medicine, use of medications and herbals, and sickness absence. Depression and tension groups were the strongest predictors of utilisation. Multisymptomatics had higher OR for most of the outcome variables than those with no symptoms. Conclusion The results of this study show a linear correlation between the numbers of symptoms and increasing GP consultations, medicine use and sickness absences days, and this persisted during the years 2001 and 2002.

Determinants of complaint symptoms in a Swedish health care practice—results of a questionnaire survey

Objective The aim of this study was to identify predictors of complaint symptoms in an adult general practice population. Method The study was performed in 1055 out of 1442 consecutive adult patients visiting a Swedish health care centre. The relationship between complaint symptoms and sociodemographic characteristics, perceived health, and chronic disease was assessed using multiple regression analysis. Results Gender and perceived health were related to all symptom categories independently of each other, and when the effects of various symptom categories were taken into account in the regression analysis, the depression and tension symptom categories could predict about 50% of the explanation. Conclusion The results of this study suggest that psychiatric symptoms, particularly depression and tension symptoms, interact and have an impact on somatic symptom reporting in addition to sociodemographic characteristics, perceived health, and chronic disease, which have impact on only some symptom categories.

Time study of doctors and nurses at two Swedish health care centers

Time study of doctors and nurses at two Swedish health care centers

Time study of doctors and nurses at two Swedish health care centers: Swedish health center doctors and nurses.

The activities of six general practitioners, four office nurses, and a nurse specially trained in the care of diabetic patients as part of an experiment in medical care were studied in two Swedish ambulatory health care centers using time-motion methods. The doctors averaged 45.7 per cent of their time with patients, 28.7 per cent in indirect patient care activities, and 25.6 per cent in other activities. These averages are identical to those obtained from a study of a group of eight Oregon general practitioners in a previous study. The organization of personnel was different at the two health centers, as determined by factors of patient load and personnel experience. A nurse trained in chronic care of diabetics at one of the centers spent an average of 50.4 minutes per patient visit as opposed to 15.9 minutes per visit spent by doctors at the other center. The study has implications for the rational design of ambulatory care systems of good quality with high efficiency.