Primary health care of sweden
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This document discusses primary health care in Sweden and other countries with stronger primary care systems. It provides data showing that between the 1980s and 1990s, Sweden and other countries like the UK scored higher on measures of primary care orientation compared to countries like the US and Germany. Countries with stronger primary care had better health outcomes like lower mortality rates and life expectancy rates. They also had more equitable health systems and lower costs. The data demonstrates the benefits of primary care-focused health systems.
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Primary health care of sweden
- 1. Primary Health Care Of Sweden Kazan State Medical University By:Mahi
- 2. Primary Health Care Primary health care is primary care applied on a population level. As a population strategy, it requires the commitment of governments to develop a population- oriented set of primary care services in the context of other levels and types of services. By:Mahi
- 3. Why Is Primary Care Important? Better health outcomes Lower costs Greater equity in health By:Mahi
- 4. Continuity of care – One of the cornerstones of primary care By:Mahi
- 5. Evidence of the Benefits of a Primary Care-Oriented Health System By:Mahi
- 6. Primary Care Scores, 1980s and 1990s 1980s 1990s Belgium France* Germany United States 0.8 - 0.5 0.2 0.4 0.3 0.4 0.4 Australia Canada Japan* Sweden 1.1 1.2 - 1.2 1.1 1.2 0.8 0.9 Denmark Finland Netherlands Spain* United Kingdom 1.5 1.5 1.5 - 1.7 1.7 1.5 1.5 1.4 1.9 *Scores available only for the 1990s By:Mahi
- 7. System and Practice Characteristics Facilitating Primary Care, Early-Mid 1990s 0 1 2 3 4 5 6 7 8 9 10 11 12 0 1 2 3 4 5 6 7 8 9 10 11 12 13 System Characteristics (Rank*) PracticeCharacteristics (Rank*) UK NTH SP FIN CAN AUS SWE JAP GER FR BEL US DK *Best level of health indicator is ranked 1; worst is ranked 13; thus, lower average ranks indicate better performance.By:Mahi
- 8. 0 0.5 1 1.5 2 1000 1500 2000 2500 3000 3500 4000 Per Capita Health Care Expenditures PrimaryCareScore Primary Care Score vs. Health Care Expenditures, 1997 US NTH CAN AUS SWE JAP BEL FR GER SP DK FIN UK Based on data in Starfield & Shi, Health Policy 2002; 60:201-18.By:Mahi
- 9. Average Rankings* for Health Indicators in Infancy, for Countries Grouped by Primary Care Orientation Low Birth Weight (1993) Neonatal Mortality (1993) Postneonatal Mortality (1993) Infant Mortality (1996) Worse primary care (Belgium, France, Germany, US) 9.5 7.8 11.5 8.8 Better primary care (Australia, Canada, Japan, Sweden, Denmark, Finland, Netherlands, Spain, UK**) 5.9 6.7 5.0 6.2 *Best level of health indicator is ranked 1; worst is ranked 13; thus, lower average ranks indicate better performance. By:Mahi
- 10. Average Rankings* for YPLL in Countries Grouped by Primary Care Orientation 5.46.26.36.9Better primary care (Australia, Canada, Japan, Sweden, Denmark, Finland, Netherlands, Spain, UK**) 10.88.88.37.3Worse primary care (Belgium, France, Germany, US) MaleFemaleMaleFemale All Except ExternalSuicide *Best level of health indicator is ranked 1; worst is ranked 13; thus, lower average ranks indicate better performance. By:Mahi
- 11. Average Rankings* for Life Expectancy at Ages 40, 65, and 80, for Countries Grouped by Primary Care Orientation Age 40 Age 65 Age 80 Female Male Female Male Female Male Worse primary care (Belgium, France, Germany, US) 7.8 9.5 8.0 8.0 7.4 6.9 Better primary care (Australia, Canada, Japan, Sweden, Denmark, Finland, Netherlands, Spain, UK**) 6.7 5.9 6.6 6.6 6.8 7.1 *Best level of health indicator is ranked 1; worst is ranked 13; thus, lower average ranks indicate better performance. By:Mahi
- 12. Average Rankings for World Health Organization Health Indicators for Countries Grouped by Primary Care Orientation DALEs Child Survival Equity Overall Health Worse primary care (Belgium, France, Germany, US) 16.3 22.5 36.3 Better primary care (Australia, Canada, Sweden, Japan, Denmark, Finland, Netherlands, Spain, UK) 11.0 15.8 29.1 DALE: Disability adjusted life expectancy (life lived in good health) Child survival: survival to age 2, with a disparities component Overall health: DALE minus DALE in absence of a health system Maximum DALE for health expenditures minus same in absence of a health systemBy:Mahi
- 13. Primary Care Score and Health Outcomes Association with Primary Care Score* Health Outcome In Males In Females All-cause mortality √ Life expectancy √ Infant Mortality Rate √ PYLL (all causes) √ √ PYLL (pneumonia & influenza) √ √ PYLL (asthma & bronchitis) √ √ PYLL (cerebrovascular disease) √ √ PYLL (heart disease) √ √ *Primary care coefficient significant at p<0.05 level and estimated by fixed effects, using pooled cross-sectional time series design. Analysis controlled for GDP, percent elderly, doctors/capita, average income (ppp), alcohol and tobacco use. R2 (within) averaged from to .36 to .84. By:Mahi
- 14. By:Mahi
- 16. Thank You Very Much By:Mahi
Notas del editor
- The benefits of primary care can be examined by comparing different countries. One such study rated 13 OECD countries on the strength of the primary health care systems and practices on a scale of 0 to 2. Higher scores represent better primary health care systems and practices. These scores stayed relatively stable over two decades (1980s and 1990s). Source: Starfield B, Shi L. Policy relevant determinants of health: an international perspective. Health Policy 2002; 60(3):201-218.
- The primary care score has two parts: the first reflects the strength of health policies oriented toward primary care and those reflecting the actual practice of primary care. In this chart, the countries are ranked by each of their two sub-scores. The country with the best sub-score is ranked #1, and the one with the worst sub-score is ranked #13. The better the policies (systems rankings), the better the practices, indicating the importance of governmental policy to good practice. Based on data in Starfield B, Shi L. Policy relevant determinants of health: an international perspective. Health Policy 2002; 60(3):201-218.
- The stronger the primary care, the lower the costs of the entire health services system. This is the case even if the United States, a high cost outlier, is removed from the analysis. Based on data in Starfield B, Shi L. Policy relevant determinants of health: an international perspective. Health Policy 2002; 60(3):201-218.
- More primary care oriented health systems have better low birth weight rates, lower neonatal and postneonatal mortality rates, and lower total infant mortality rates. Based on data in Starfield B, Shi L. Policy relevant determinants of health: an international perspective. Health Policy 2002; 60(3):201-218.
- YPLL indicates “Years of Potential Life Lost.” More primary care-oriented health systems have fewer years of life lost due to suicide and to all causes amenable to health services interventions.. Calculated from: Organization for Economic Cooperation and Development. OECD Health Data 1998. Paris, France: Organization for Economic Cooperation and Development, 1998. Starfield B, Shi L. Policy relevant determinants of health: an international perspective. Health Policy 2002; 60(3):201-218.
- More primary care-oriented health systems have longer life expectancies at all ages, except for males at ages over 80. Calculated from: Organization for Economic Cooperation and Development. OECD Health Data 1998. Paris, France: Organization for Economic Cooperation and Development, 1998. Starfield B, Shi L. Policy relevant determinants of health: an international perspective. Health Policy 2002; 60(3):201-218.
- Better primary care-oriented countries rank better on disability-adjusted life expectancy, child survival equity, and overall health, using World Health Organization health care measures. Calculated from: World Health Organization. The World Health Report 2000. Health Systems: Improving Performance. Geneva: World Health Organization, 2000.
- A more recent time series (1985-95) analysis with 18 OECD countries examined the relationship between the strength of primary care and mortality, while controlling for other possible influences such as Gross Domestic Product per capita, total physicians per 1000 population, percentage of elderly people, average number of ambulatory care visits, per capita income, and alcohol and tobacco consumption. The stronger the primary care orientation in the country, the lower the all-cause mortality, all-cause premature mortality, and cause-specific mortality from asthma and bronchitis, emphysema and pneumonia, cardiovascular disease, and heart disease. Source: Macinko J, Starfield B, Shi L. The contribution of primary care systems to health outcomes within Organization for Economic Cooperation and Development (OECD) countries, 1970-1998. Health Serv Res 2003; 38(3):831-865.