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Integrated Diabetes Care in Sweden
Health Economist, Konstanz, Germany.
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Family Medicine, Brickebacken Primary Health Care Center, Örebro, Sweden.ORCID iD: 0000-0001-6864-4679
Department of Endocrinology, Lund University Hospital, Lund, Sweden.
2017 (English)In: Integrated Diabetes Care: A Multidisciplinary Approach / [ed] David Simmons, Helmut Wenzel, Janice C. Zgibor, Springer, 2017, p. 201-214Chapter in book (Other academic)
Abstract [en]

The Swedish health-care system is a kind of “Beveridge model”, with a strong orientation towards subnational levels, i.e. municipalities and regions. The responsibility is shared between the central government, county councils and municipalities. Health care is mainly tax funded both at the Government level and the levels of the county councils and the municipalities. The latter also levy proportional income taxes on the population to cover the services that they provide. In addition, small user fees are paid at the point of use. The health system is highly decentralised and organised: this leads to variation in care provision. To overcome this, the government has created national guidelines for common diagnoses including diabetes. Primary and secondary care is funded and delivered at county level. Municipalities are responsible for nursing and residential homes as well as home care and other social services. The Swedish health-care system is trying to combine decentralisation, a high degree of specialisation, and professional organisation in a system where common health-care goals can be maintained. To avoid fragmentation, ‘chains of care’ have been identified to bridge different care givers. Diabetes is treated by multidisciplinary teams consisting of doctors and diabetes nurses in collaboration with other professionals at primary or secondary care level. This means that virtually all patients with type 1 diabetes have their care provided at hospitals, while patients with type 2 diabetes are managed in primary care. Electronic medical records (EMR) are used by the majority of care givers, and are linked to the National Diabetes Register (NDR) as well as to other national registers. EMR are also used for referrals within or between county councils. For patients without complications the level of care and allocated resources can be defined by national guidelines. For patients with complications the care involves specialist units at the hospital in collaboration with primary care and medical assistance in the home. These chains of care are more difficult to define but instead the government has defined quality indicators in order to keep the frequency of complications as low as possible.

Place, publisher, year, edition, pages
Springer, 2017. p. 201-214
Keywords [en]
Swedish health-care system; Integrated care; Diabetes expenditures; Health-care performance
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:oru:diva-64489DOI: 10.1007/978-3-319-13389-8_12Scopus ID: 2-s2.0-85018877486ISBN: 9783319133881 (print)ISBN: 9783319133898 (print)OAI: oai:DiVA.org:oru-64489DiVA, id: diva2:1177119
Available from: 2018-01-24 Created: 2018-01-24 Last updated: 2018-01-24Bibliographically approved

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Jansson, Stefan P. O.

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