Primary Health Care Of Sweden

Kazan State Medical University

By:Mahi

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

Why Is Primary Care Important?

Better health outcomes

Lower costs

Greater equity in healthBy:Mahi

Continuity of care –One of the cornerstones of primary care

By:Mahi

Evidence of the Benefits of a Primary Care-Oriented Health

System

By:Mahi

Primary Care Scores, 1980s and 1990s1980s 1990s

BelgiumFrance*

GermanyUnited States

0.8-

0.50.2

0.40.30.40.4

AustraliaCanadaJapan*

Sweden

1.11.2

-1.2

1.11.20.80.9

DenmarkFinland

NetherlandsSpain*

United Kingdom

1.51.51.5

-1.7

1.71.51.51.41.9 *Scores

available only

for the 1990sBy:Mahi

System and Practice CharacteristicsFacilitating Primary Care, Early-Mid 1990s

0123456789

101112

0 1 2 3 4 5 6 7 8 9 10 11 12 13

System Characteristics (Rank*)

Prac

tice

Char

acte

ristic

s (R

ank*

)

UK

NTH

SP

FIN CANAUS

SWE JAP

GER FRBEL

US

DK

*Best level of health indicator is ranked 1; worst is ranked 13; thus, lower average ranks indicate better performance.By:Mahi

0

0.5

1

1.5

2

1000 1500 2000 2500 3000 3500 4000

Per Capita Health Care Expenditures

Prim

ary

Care

Sco

re

Primary Care Score vs. Health Care Expenditures, 1997

US

NTH

CANAUS

SWE JAP

BEL FRGER

SP

DK

FIN

UK

Based on data in Starfield & Shi, Health Policy 2002; 60:201-18.By:Mahi

Average Rankings* for Health Indicators in Infancy, for Countries

Grouped by Primary Care OrientationLow 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

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

Average Rankings* for Life Expectancy at Ages 40, 65, and 80, for Countries Grouped by Primary Care Orientation

Age 40 Age 65 Age 80Female 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

Average Rankings for World Health OrganizationHealth Indicators for Countries Grouped

by Primary Care Orientation

DALEsChild 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 componentOverall health: DALE minus DALE in absence of a health system Maximum DALE for health expenditures minus same in absence of a health systemBy:Mahi

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

By:Mahi

Referancehttp://www.euro.who.int/__data/assets/pdf_file/0008/164096/e96455.pdfhttps://academic.oup.com/eurpub/article-abstract/2/3-4/165/594041/Primary-Health-Care-in-Sweden?redirectedFrom=PDFhttp://sfamportal.s3.amazonaws.com/files/57c57cb5b86cc90500358c27/Primary%20Health%20Care%20in%20Sweden%20151112.pdfhttps://www.google.ru/url?sa=t&rct=j&q=&esrc=s&source=web&cd=5&ved=0ahUKEwjJtZ626LPSAhVGJ5oKHdFpBwMQFggsMAQ&url=http%3A%2F%2Fwww.bibalex.org%2Fsupercourse%2FsupercoursePPT%2F17011-18001%2F17361.ppt&usg=AFQjCNFtkq7xmJN0YcpUQIO_5guJdIw17A&sig2=S8W1KWXo27AzOls-elsc7A&bvm=bv.148073327,d.bGg

By:Mahi

Thank You Very Much

By:Mahi