Health services management and research at Nordic School of Public Health.

In Anglo-Saxon countries the subject of health services research has long been an important academic theme. In the Nordic countries, however, this research and training area has been limited and partly hidden by integration into various other sections at universities and colleges. In this respect the Nordic School of Public Health was an exception, as the provision of managerial skills to healthcare professionals and persons working with public health was the backbone of the school during all 60 years.

How to create and terminate a school of public health.

The famous preamble to the Constitution of the World Health Organization (WHO) from 1948, stating that health is not only the absence of disease, has been one of the most influential political statements of our time. The follow-up, reaching a position where health is viewed as instrumental to a good life and not as a goal in itself, as set out in the Ottawa Charter of 1986, has likewise been of the utmost importance for the global development of public health, as well as developing the concept of health promotion. The focus on public health sparked by the WHO was paralleled by expansion of the academic interest in the topic, beginning in the USA and successively adopted around the world.

Spouses of Stroke Survivors Report Reduced Health-Related Quality of Life Even in Long-Term Follow-Up: Results From Sahlgrenska Academy Study on Ischemic Stroke.

Background And Purpose: The consequences for the family of stroke survivor are generally studied in a short-term perspective. The aim of this study was to assess long-term aspects of health-related quality of life among spouses of stroke survivors.

Methods: Data on stroke survivors, controls, and spouses were collected from the 7-year follow-up of the Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS).

Economic burden of stroke in a large county in Sweden.

Background: Stroke remains to be a major burden of disease, often causing death or physical impairment or disability. This paper estimates the economic burden of stroke in a large county of 1.5 million inhabitants in western Sweden.

Does ambulance use differ between geographic areas? A survey of ambulance use in sparsely and densely populated areas.

Aim: The aim of this study was to analyze possible differences in the use of ambulance service between densely and sparsely populated areas.

Methods: This study was designed as a 2-step consecutive study that included the ambulance service in 4 different areas with different geographical characteristics. A specific questionnaire was distributed to the enrolled ambulance services.

Why are people without medical needs transported by ambulance? A study of indications for pre-hospital care.

Objective: The purpose of this report was to describe the characteristics of patients transported by ambulance, in spite of being evaluated by the ambulance staff at the scene as not requiring prehospital care. A second aim was to compare these patients with those judged as being in need of this care.

Methods: Three ambulance service districts located in different rural and metropolitan geographical areas were included in the study and all three were covered by a single emergency dispatch centre.

Initial emergency medical dispatching and prehospital needs assessment: a prospective study of the Swedish ambulance service.

Objectives: To evaluate the setting of priorities and patients' need for the ambulance service.

Methods: A prospective, consecutive study was conducted during a 6-week period. The ambulance staff completed a questionnaire assessing each patient's need for prehospital care.

Evidence-based policy? The use of mobile phones in hospital.

Background: Evidence-based policies have become increasingly accepted in clinical practice. However, policies on many of the non-clinical activities that take place in health care facilities may be less frequently evidence based.

Methods: We carried out a review of literature on safety of mobile phones in hospitals and survey of practice in selected European countries.

Spinal cord injured persons' conceptions of hospital care, rehabilitation, and a new life situation.

Background: The basic aim of spinal cord injury (SCI) rehabilitation is to help patients return to a life worth living. It is therefore important that the staff at spinal units and rehabilitation centres understand how the patients experience their rehabilitation and their adjustment process to the new situation.

Aim: To describe SCI persons' experiences of their rehabilitation process.

Decentralized responsibility for costs of outpatient prescription pharmaceuticals in Sweden. Assessment of models for decentralized financing of subsidies from a management perspective.

In this study, models for decentralization of responsibility for costs of subsidised outpatient prescription pharmaceuticals within the county councils in Sweden were studied. The aims of the decentralization were to cut the escalating costs associated with risk sharing mechanisms on a national level and to integrate utilization of drugs into the priority process in health care. History of development and the characteristics of the solutions on county level were identified, described and analysed from taped interviews with relevant persons in central management positions in the selected counties.

Impact of physician training level on emergency readmission within internal medicine.

Objectives: The research question was whether training level of admitting physicians and referrals from practitioners in primary health care (PHC) are risk factors for emergency readmission within 30 days to internal medicine.

Methods: This report is a prospective multicenter study carried out during 1 month in 1997 in seven departments of internal medicine in the County of Stockholm, Sweden. Two of the units were at university hospitals, three at county hospitals and two in district hospitals.