Search PubMed⌕ Search

Biomedical subjects

J Calltorp

Publications and source records attributed to J Calltorp.

At least 19 recordsLinked to original sources

[All physicians--not only physicians in charge need leadership training].

Management education programmes for physicians range from university courses to courses offered by private companies. Some hospitals and regions arrange local management education for physicians in specialist training and certified specialists, but mostly for staff in executive positions. Only 245 places are available on the one-week courses for physicians in specialist training during the whole of year 2000 in Sweden; 637 applications were received for the spring courses only. There are 5,000 physicians in specialist training in Sweden. There is a great need for increased investments in the fields of education in administration, economy, leadership and management for physicians.

Clinical Competence↗

The reorientation of market-oriented reforms in Swedish health-care.

Sweden was an important pioneer of market-oriented reform in publicly funded health-care systems. Yet by the mid-1990s the county councils, which fund and manage most health-care, had substantially scaled back reforms based on provider competition while continuing to constrain health budgets. As policy makers faced new issues, they turned increasingly to longer-term and more cooperative contracts to define relations between hospitals and the county councils. Growing regionalization of government and hospital mergers further reconfigured acute care and limited opportunities for competition between hospitals. We seek to explain this reorientation of market-oriented reforms between 1989 and 1996 in terms of shifts in the positions taken by powerful policy actors, and in particular by county council politicians. During this period, elections moved liberal and conservative politicians, who were the most enthusiastic supporters of market-oriented reform, in and out of control of most county governments. Meanwhile many Social Democratic politicians gradually turned from initial support of competitive reform toward opposition. Politicians and county administrators from all parties were particularly concerned about controlling health expenditures during a period of recession. In addition, the public, politicians in the counties and municipalities, and health professionals resisted steps that threatened health sector employment and would have allowed market mechanisms, rather than governments, to determine the prices and distribution of health services. During the years under study Sweden's market-oriented reforms followed a course of development similar to that taken by other management and policy fashions (Abrahamson E. Management fashion, Academy of Management Review 1996;21: 254-85). At first the reforms enjoyed uncritical support by a broad spectrum of stakeholders. Gradually participants in the reform process recognized inherent tensions among the goals of the reform, conflicts between reform programs and fundamental social and political values, unrealistic assumptions about the effects of competition, technical and organizational obstacles to implementation, and threats to interest groups. Since 1998, there have been indications that Sweden may be entering yet another stage of experimentation with market-oriented reform.

Catchment Area, Health↗

[Big differences in leadership and management training within health care services. Leadership and issues concerning cooperation should be more emphasized in basic medical education].

A recent survey of medical management programmes at universities across the country showed manifest national differences to exist, both quantitative and qualitative. Using a questionnaire, the Swedish Society of Medical Management examined the programmes for physiotherapists, occupational therapists, social workers, nurses and physicians, with respect to such issues as leadership, self-awareness and communication, health economics, and administration. It was concluded that knowledge acquired differs between fields; that physiotherapy programmes tend to have a very didactic approach; that nurses are taught the importance of participation in developmental processes; that doctors are exposed to somewhat the same approach but to a large extent on a voluntary basis; and that social workers obtain good insight into the administrative skills necessary to their work. In the article it is concluded that students would benefit from orientation in the diverse approaches used in the other fields than their own, and that pooling of resources among different programmes might be a more economic alternative to current practice.

Communication↗

Priority setting in health policy in Sweden and a comparison with Norway.

The development of priority setting policies has been an important part of the national agenda for health services in Sweden and Norway during the past 10 years. Both countries have health systems with a pronounced public character and a declared emphasis on equity and solidarity. Both countries have also had National Priority Commissions that have developed general documents providing advice, but not very detailed guidelines, on how to set priorities. Resource constraints and the rapid restructuring of the health care system were important characteristics forming the background for the National Priority Commission in Sweden (1995). In Norway, the starting point for the first-ever Priority Commission in the world (1987) was how to set limits for health care in a society with rapidly increasing wealth. The second Norwegian Commission (1997) critically reviewed the effects of the general principles for priority setting that have been put forward, and demonstrated the importance to link them to steering tools within health care services.

Ethics↗

Children's dental health in Europe.

"Children's Dental Health in Europe" is a collaborative study of a total of 3200 children, comprising samples of 5- and 12-year-old children from eight EU-countries [Belgium, Germany, Greece, Ireland, Italy, Scotland (United Kingdom), Spain and Sweden] who have undergone clinical examination by well calibrated dentists. This study analyses the influence of a number of sociodemographic factors on the dental health of the actual children. Father's and/or mother's occupational status was used to determine the social class of the family, after construction of a family-social class variable, SocFam, and the accuracy of this variable was tested. In 15 of the 16 samples, both treatment provided and unmet treatment need were higher in children from low social class. The treatment need in children from low social class was significantly greater in the Belgium, German, Greek and Italian 5-year-old samples. The differences in both treatment need and treatment already received for children from high respectively low social class were significant in the Scottish and Spanish 12-year-old samples. Taking into account the total material of 1600 children in each age-group, risk indicators for caries, identified by logistic and multiple regression analyses, were social class of the family, the mother's smoking habits, and in the 5-year-olds the number of siblings.

Adult↗

Sweden: no easy choices.

This paper describes some characteristic aspects of the Swedish health care model which can explain why choices and prioritizing have been difficult to discuss officially until very recently. Health care is an important symbol and cornerstone of the welfare society and it is therefore difficult to admit and formulate the concept of limits regarding this part of society. Parallel to a considerable decrease in the health care sector's fraction of GDP during the last 10 years, where real cuts have been more and more visible, a public discussion on choices has emerged. A parliamentary committee of politicians and experts has addressed the issue and published a final report in the spring of 1995. It proposes an 'ethical platform' as a base for addressing the issue and describes guidelines for prioritizing on a political-administrative level and clinical level.

Choice Behavior↗