Digitala Vetenskapliga Arkivet

Ändra sökning
Avgränsa sökresultatet
1 - 18 av 18
RefereraExporteraLänk till träfflistan
Permanent länk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Träffar per sida
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sortering
  • Standard (Relevans)
  • Författare A-Ö
  • Författare Ö-A
  • Titel A-Ö
  • Titel Ö-A
  • Publikationstyp A-Ö
  • Publikationstyp Ö-A
  • Äldst först
  • Nyast först
  • Skapad (Äldst först)
  • Skapad (Nyast först)
  • Senast uppdaterad (Äldst först)
  • Senast uppdaterad (Nyast först)
  • Disputationsdatum (tidigaste först)
  • Disputationsdatum (senaste först)
  • Standard (Relevans)
  • Författare A-Ö
  • Författare Ö-A
  • Titel A-Ö
  • Titel Ö-A
  • Publikationstyp A-Ö
  • Publikationstyp Ö-A
  • Äldst först
  • Nyast först
  • Skapad (Äldst först)
  • Skapad (Nyast först)
  • Senast uppdaterad (Äldst först)
  • Senast uppdaterad (Nyast först)
  • Disputationsdatum (tidigaste först)
  • Disputationsdatum (senaste först)
Markera
Maxantalet träffar du kan exportera från sökgränssnittet är 250. Vid större uttag använd dig av utsökningar.
  • 1.
    Agerholm, Janne
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Burström, Bo
    Schön, Pär
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Liljas, Ann
    How did providers of home care for older adults manage the early phase of the Covid-19 pandemic? A qualitative case study of managers' experiences in Region Stockholm2023Ingår i: BMC Health Services Research, E-ISSN 1472-6963, Vol. 23, artikel-id 1173Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background In the spring of 2020, the Covid-19 outbreak sent a shock wave through the Swedish society and placed an extraordinary pressure on the health and social care system for older people. In the initial phase there were few guidelines for care providers to follow and staff in home care organisations often had to tackle challenges posed by the pandemic as they appeared. The aim of this study was to understand how the spread of Covid-19 was managed in organisations providing home care to older adults in different municipalities in Region Stockholm, and what actions were taken to minimise the spread of the disease among clients and staff.

    Method A descriptive qualitative study was performed based on eight interviews with managers of home care providers for older adults in three different municipalities in Region Stockholm.Three of the eight providers operate within an integrated care system. Data were analysed using conventional content analysis.

    Results Three themes were identified covering actions taken to handle the spread of the virus, feelings of insecurity and anxiety, and internal and external factors influencing how the pandemic was tackled. There was no single strategy followed by all municipalities or organisations, however, there were similarities between the organisations. One such example was the introduction of cohort care and the experience of lacking personal protective equipment. Providers in the integrated care system emphasized some advantages with their system that was seen as facilitators for minimising the risk of spreading the virus, like the joint meetings with managers from both health and social care and the close contact with healthcare professionals in relation to dissemination of hygiene instructions.

    Conclusion Social care workers providing home care to older persons are an important group in preventing dissemination of infectious diseases like Covid-19. For better readiness and preparedness for future pandemics, municipal home care services would need larger stocks of personal protective equipment, clear guidelines and more training on how to reduce dissemination of disease. Ways to achieve closer communication between health and social care providers should also be investigated.

  • 2.
    Agerholm, Janne
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Ponce de Leon, Antonio
    Schön, Pär
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Burström, Bo
    Impact of Integrated Care on the Rate of Hospitalization for Ambulatory Care Sensitive Conditions among Older Adults in Stockholm County: An Interrupted Time Series Analysis2021Ingår i: International Journal of Integrated Care, E-ISSN 1568-4156, Vol. 21, nr 2, artikel-id 22Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Reducing avoidable hospital admissions is often viewed as a possible positive consequence of introducing integrated care (IC). The aim of this study was to investigate the impact of implementing IC in Norrtälje on the rate of admissions for ambulatory care sensitive conditions (ACSC).

    Method: Using interrupted time series analyses we investigated the effect of implementing IC in Norrtälje municipality in the northern part of Stockholm county, Sweden. The time period included 48 time points, from year 2000 to year 2011 with measurements before and after introducing IC in Norrtälje in 2006. In order to control for other extraneous events that could affect the outcome measure, but not related to the introduction of IC, we included a control population from Stockholm municipality.

    Results: After introducing IC in Norrtälje the rate of admissions for ACSC decreased. This decrease was greater in Norrtälje than in the matched control population, however the difference between the two areas was not statistically significant (p = 0.08).

    Conclusion: Introducing IC in Norrtälje may have had positive impact on admissions for ACSC for older people living in Norrtälje; however, the interpretation of the impact of IC on admissions for ACSC is complicated by intervening policy changes in health and social care during the study period. 

  • 3. Agerholm, Janne
    et al.
    Pulkki, Jutta
    Jensen, Natasja K.
    Keskimäki, Ilmo
    Andersen, Ingelise
    Burström, Bo
    Jämsen, Esa
    Tynkkynen, Liina-Kaisa
    Schön, Pär
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Liljas, Ann E. M.
    The organisation and responsibility for care for older people in Denmark, Finland and Sweden: outline and comparison of care systems2024Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 52, nr 2, s. 119-122Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: To outline the organisation and responsibility for health and social care provided to older people in Denmark, Finland and Sweden.

    Methods: Non-quantifiable data on the care systems were collated from the literature and expert consultations. The responsibilities for primary healthcare, specialised healthcare, prevention and health promotion, rehabilitation, and social care were presented in relation to policy guidance, funding and organisation.

    Results: In all three countries, the state issues policy and to some extent co-funds the largely decentralised systems; in Denmark and Sweden the regions and municipalities organise the provision of care services – a system that is also about to be implemented in Finland to improve care coordination and make access more equal. Care for older citizens focuses to a large extent on enabling them to live independently in their own homes.

    Conclusions: Decentralised care systems are challenged by considerable local variations, possibly jeopardising care equity. State-level decision and policy makers need to be aware of these challenges and monitor developments to prevent further health and social care disparities in the ageing population.

  • 4.
    Dahlberg, Lena
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Agahi, Neda
    Karolinska Institutet & Stockholms universitet.
    Schön, Pär
    Karolinska Institutet & Stockholms universitet.
    Lennartsson, Carin
    Karolinska Institutet & Stockholms universitet.
    Planned and unplanned hospital admissions and their relationship with social factors: Findings from a national, prospective study of people aged 76 years or older2018Ingår i: Health Services Research, ISSN 0017-9124, E-ISSN 1475-6773, Vol. 53, nr 6, s. 4248-4267Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective

    To examine the relationship between social factors and planned and unplanned hospital admissions among older people.

    Data Sources/Study Setting

    2011 data from the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) and data from the Swedish National Patient Register until December 31, 2012.

    Study Design

    The study had a prospective design. Data were analyzed via Cox proportional hazard regressions with variables entered as blocks (social factors, sociodemographic and ability factors, health factors).

    Data Collection

    Data were collected via interviews with people aged 76+ (n = 931).

    Principal Findings

    Living in institutions was negatively associated with planned admissions (hazard ratio (HR): 0.29; confidence interval (CI): 0.09–0.88), while being in receipt of home help was positively associated with unplanned admissions (HR: 1.57; CI: 1.15–2.14). Low levels of social contacts and social activity predicted unplanned admissions in bivariate analyses only. Higher ability to deal with public authorities was positively associated with planned admissions (HR: 1.77; CI: 1.13–2.78) and negatively associated with unplanned admissions, although the latter association was only significant in the bivariate analysis.

    Conclusions

    Hospital admissions are not only due to health problems but are also influenced by the social care situation and by the ability to deal with public authorities.

    Ladda ner fulltext (pdf)
    fulltext
  • 5. Doheny, Megan
    et al.
    Agerholm, Janne
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Orsini, Nicola
    Schön, Pär
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Burström, Bo
    Impact of integrated care on trends in the rate of emergency department visits among older persons in Stockholm County: an interrupted time series analysis2020Ingår i: BMJ Open, E-ISSN 2044-6055, Vol. 10, nr 6, artikel-id e036182Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective To investigate the association between the implementation of an integrated care (IC) system in Norrtälje municipality and changes in trends of the rate of emergency department (ED) visits.

    Design Interrupted time series analysis from 2000 to 2015.

    Setting Stockholm County.

    Participants All inhabitants 65+ years in Stockholm County on 31 December of each study year.

    Intervention IC was established by combining the funding, administration and delivery of health and social care for older persons in Norrtälje municipality, within Stockholm County.

    Outcome Rates of hospital-based ED visits.

    Results IC was associated with a decrease in the rate of ED visits (incidence rate ratio: 0.997, 95% CI 0.995 to 0.998) among inhabitants 65+ years in Norrtälje. However, the rate of ED visits remained higher in Norrtälje than the rest of Stockholm in the preintervention and postintervention periods. Stratified analyses showed that IC was associated with a decline in the trend of the rate of ED visits among those 65–79 years, the lowest income group and born outside of Sweden. However, there was no significant decrease in the trend among those 80+ years.

    Conclusion The implementation of IC was associated with a modest change in the trend of ED visits in Norrtälje, though the rate of ED visits remained higher than in the rest of Stockholm. Changes in the composition of the population and contextual changes may have impacted our findings. Further research, using other outcome measures is needed to assess the impact of IC on healthcare utilisation.  

  • 6. Doheny, Megan
    et al.
    Schön, Pär
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Orsini, Nicola
    Fastbom, Johan
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Burström, Bo
    Agerholm, Janne
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Socio-demographic differences in polypharmacy and potentially inappropriate drug use among older people with different care needs and in care settings in Stockholm, Sweden2023Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 51, nr 1, s. 11-20Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: Polypharmacy and potentially inappropriate medications (PIM) are risk factors for negative health outcomes among older people. This study aimed to investigate socio-demographic differences in polypharmacy and PIM use among older people with different care needs in a standard versus an integrated care setting.

    Methods: Population-based register data on residents aged ⩾65 years in Stockholm County based on socio-demographic background and social care use in 2014 was linked to prescription drug use in 2015. A logistic regression analysis was used to estimate socio-demographic differences in polypharmacy and PIM, adjusting for education, age group, sex, country of birth, living alone, morbidity and dementia by care setting based on area and by care need (i.e. independent, home help or institutionalised).

    Results: The prevalence of polypharmacy and PIM was greater among home-help users (60.4% and 11.5% respectively) and institutional residents (74.4% and 11.9%, respectively). However, there were greater socio-demographic differences among the independent, with those with lower education, older age and females having higher odds of polypharmacy and PIM. Morbidity was a driver of polypharmacy (odds ratio (OR)=1.19, confidence interval (CI) 1.16–1.22) among home-help users. Dementia diagnosis was associated with reduced odds of polypharmacy and PIM among those in institutions (OR=0.78, CI 0.71–0.87 and OR 0.52, CI 0.45–0.59, respectively) and of PIM among home-help users (OR=0.53, 95% CI 0.42–0.67).

    Conclusions: Polypharmacy and PIM were associated with care needs, most prevalent among home-help users and institutional residents, but socio-demographic differences were most prominent among those living independently, suggesting that municipal care might reduce differences between socio-demographic groups. Care setting had little effect on inappropriate drug use, indicating that national guidelines are followed.

  • 7.
    Doheny, Megan
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Schön, Pär
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Orsini, Nicola
    Walander, Anders
    Burström, Bo
    Agerholm, Janne
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Socioeconomic differences in inpatient care expenditure in the last year of life among older people: a retrospective population-based study in Stockholm County2022Ingår i: BMJ Open, E-ISSN 2044-6055, Vol. 12, nr 7, artikel-id e060981Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives To investigate the association between inpatient care expenditure (ICE) and income group and the effect of demographic factors, health status, healthcare and social care utilisation on ICE in the last year of life.

    Design Retrospective population-based study.

    Setting Stockholm County.

    Participants Decedents ≥65 years in 2015 (N=13 538).

    Outcome ICE was calculated individually for the month of, and 12 months preceding death using healthcare register data from 2014 and 2015. ICE included the costs of admission and treatment in inpatient care adjusted for the price level in 2018.

    Results There were difference between income groups and ICE incurred at the 75th percentile, while a social gradient was found at the 95th percentile where the highest income group incurred higher ICE (SEK45 307, 95% CI SEK12 055 to SEK79 559) compared with the lowest income groups. Incurring higher ICE at the 95th percentile was driven by greater morbidity (SEK20 333, 95% CI SEK12 673 to SEK29 993) and emergency department care visits (SEK77 995, 95% CI SEK64 442 to SEK79 549), while lower ICE across the distribution was associated with older age and residing in institutional care.

    Conclusion Gaining insight into patterns of healthcare expenditure in the last year of life has important implications for policy, particularly as socioeconomic differences were visible in ICE at a time of greater care need for all. Future policies should focus on engaging in advanced care planning and strengthening the coordination of care for older people.

  • 8. Hoang, Minh Tuan
    et al.
    Kåreholt, Ingemar
    Schön, Pär
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    von Koch, Lena
    Xu, Hong
    Tan, Edwin C. K.
    Johnell, Kristina
    Eriksdotter, Maria
    Garcia-Ptacek, Sara
    The Impact of Educational Attainment and Income on Long-Term Care for Persons with Alzheimer’s Disease and Other Dementias: A Swedish Nationwide Study2023Ingår i: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 96, nr 2, s. 789-800Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Long-term care improves independence and quality of life of persons with dementia (PWD). The influence of socioeconomic status on access to long-term care was understudied.

    Objective: To explore the socioeconomic disparity in long-term care for PWD.

    Methods: This registry-based study included 14,786 PWD, registered in the Swedish registry for cognitive and dementia disorders (2014–2016). Education and income, two traditional socioeconomic indicators, were the main exposure. Outcomes were any kind of long-term care, specific types of long-term care (home care, institutional care), and the monthly average hours of home care. The association between outcomes and socioeconomic status was examined with zero-inflated negative binomial regression and binary logistic regression.

    Results: PWD with compulsory education had lower likelihood of receiving any kind of long-term care (OR 0.80, 95% CI 0.68–0.93), or home care (OR 0.83, 95% CI 0.70–0.97), compared to individuals with university degrees. Their monthly average hours of home care were 0.70 times (95% CI 0.59–0.82) lower than those of persons with university degrees. There was no significant association between education and the receipt of institutional care. Stratifying on persons with Alzheimer’s disease showed significant association between lower education and any kind of long-term care, and between income and the hours of home care.

    Conclusions: Socioeconomic inequalities in long-term care existed in this study population. Lower-educated PWD were less likely to acquire general long-term care, home care and had lower hours of home care, compared to their higher-educated counterparts. Income was not significantly associated with the receipt of long-term care.

  • 9. Liljas, Ann E. M.
    et al.
    Agerholm, Janne
    Schön, Pär
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Burström, Bo
    Risk factors for infection in older adults who receive home healthcare and/or home help: A protocol for systematic review and meta-analysis2022Ingår i: Medicine, ISSN 0025-7974, E-ISSN 1536-5964, Vol. 101, nr 45, artikel-id e31772Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Background: The shift towards home-based care has resulted in increased provision of home healthcare and home help to older adults. Infections acquired in older adults while receiving home care have increased too, resulting in unplanned yet avoidable hospitalizations. In recent years, several studies have reported an array of factors associated with risk of infection; however, no previous systematic review has compiled such evidence, which is important to better protect older adults. Therefore, we have outlined the work of a systematic review that aims to identify risk factors for infection in older adults receiving home healthcare and/or home help.

    Methods: Searches for relevant studies will be conducted in five databases [MEDLINE, EMBASE (Excerpta Medica Database), Web of Science Core Collection, Cinahl (Cumulative Index to Nursing & Allied Health Literature) and Sociological Abstracts]. All types of studies will be included. Exposures considered refer to medical, individual, social/behavioral and environmental risk factors for infection (outcome). Two researchers will independently go through the records generated. Eligible studies will be assessed for risk of biases using the Cochrane risk of bias assessment tool and an overall interpretation of the biases will be provided. If the data allow, a meta-analysis will be conducted. It is possible that both quantitative and qualitative studies will be identified and eligible. Therefore, for the analysis, the Joanna Briggs Institute Reviewers’ Manual for mixed methods systematic reviews will be used as it allows for two or more single method reviews (e.g., one quantitative and one qualitative) to be conducted separately and then combined in a joint overarching synthesis.

    Results: The findings of the planned systematic review are of interest to healthcare professionals, caregivers, older adults and their families, and policy- and decisions makers in the health and social care sectors as the review will provide evidence-based data on multiple factors that influence the risk of infection among older adults receiving care in their homes.

    Conclusion: The results could guide future policy on effective infection control in the home care sector.

  • 10. Liljas, Ann E. M.
    et al.
    Brattström, Fanny
    Burström, Bo
    Schön, Pär
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Agerholm, Janne
    Impact of Integrated Care on Patient-Related Outcomes Among Older People - A Systematic Review2019Ingår i: International Journal of Integrated Care, ISSN 1568-4156, E-ISSN 1568-4156, Vol. 19, nr 3, artikel-id UNSP 6Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Introduction: The growing number of older adults with multiple needs increases the pressure to reform existing healthcare systems. Integrated care may be part of such reforms. The aim of this systematic review was to identify important patient-related outcomes of integrated care provided to older adults. Methods: A systematic search of 5 databases to identify studies comprising older adults assessing hospital admission, length of hospital stay, hospital readmission, patient satisfaction and mortality in integrated care settings. Retrieved literature was analysed employing a narrative synthesis. Results: Twelve studies were included (2 randomised controlled trials, 7 quasi-experimental design, 2 comparison studies, 1 survey evaluation). Five studies investigated patient satisfaction, 9 hospital admission, 7 length of stay, 3 readmission and 5 mortality. Findings show that integrated care tends to have a positive impact on hospital admission rates, some positive impact on length of stay and possibly also on readmission and patient satisfaction but not on mortality. Conclusions: Integrated care may reduce hospital admission rates and lengths of hospital stay. However due to lack of robust findings, the effectiveness of integrated care on patient-related outcomes in later life remain largely unknown. Further research is needed to establish the effect of integrated care on these patient-related outcomes.

  • 11.
    Naseer, Mahwish
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Dalarna University, Sweden.
    Dahlberg, Lena
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Dalarna University.
    Ehrenberg, Anna
    Schön, Pär
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Calderón-Larrañaga, Amaia
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Stockholm Gerontology Research Center, Sweden.
    The role of social connections and support in the use of emergency care among older adults2023Ingår i: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 111, artikel-id 105010Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: Limited and inconsistent findings have been reported on the link between social connections and support and emergency department (ED) visits in older populations. Moreover, the adequacy of informal care for older adults has rarely been considered. This study explored the associations of social connections, social support, and informal care with ED visits in younger-old (<78 years) and oldest-old (≥78 years) adults.

    Methods: This is a prospective cohort study based on community-living adults ≥60 years old participating in the Swedish National Study on Aging and Care in Kungsholmen (N=3066 at wave 1, 2001-2004; N=1885 at wave 3, 2007-2010; N=1208 at wave 5, 2013-2016). Standardised indexes were developed to measure social connections, social support, and informal care. The outcome variable was hospital-based ED visits within 4 years of the SNAC-K interview. Associations between exposure variables and ED visits were assessed through negative binomial regressions using generalised estimating equations.

    Results: Medium (IRR 0.77; 95% CI 0.59–0.99) and high (IRR 0.77; 95% CI 0.56–0.99) levels of social support were negatively associated with ED visits compared to low levels of social support, but only in oldest-old adults. No statistically significant associations were observed between social connections and ED visits. Higher ED visit rates were seen in oldest-old adults with unmet informal care needs, even if the differences did not reach statistical significance.

    Conclusions: ED visits were associated with social support levels among adults aged ≥78 years. Public health interventions to mitigate situations of poor social support may improve health outcomes and reduce avoidable ED visits in oldest-old adults.

  • 12.
    Naseer, Mahwish
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Dalarna University, Sweden.
    McKee, Kevin J.
    Ehrenberg, Anna
    Schön, Pär
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Dahlberg, Lena
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Dalarna University, Sweden.
    Individual and contextual predictors of emergency department visits among community-living older adults: a register-based prospective cohort study2022Ingår i: BMJ Open, E-ISSN 2044-6055, Vol. 12, nr 2, artikel-id e055484Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives To examine the extent to which contextual factors explain emergency department (ED) visits and ED revisits, additional to that explained by individual factors.

    Design A register-based prospective cohort study.

    Setting Swedish region of Dalarna.

    Participants Participants were 16 543 community-living adults aged 80 or older who were residents of the Dalarna region of Sweden, excluding older adults who moved out of Dalarna or into residential care during the study period.

    Outcome measures Dependent variables were initial ED visit, and at least one ED revisit within 30 days of an initial ED visit.

    Results Approximately 36% of the participants visited the ED during the study period with 18.9% returning to the ED within 30 days. For both initial ED visits and ED revisits, the addition of contextual factors to models containing individual factors significantly improved model fit (p<0.001; p<0.022) and the amount of variance explained in the outcome. In the final models, initial ED visit was significantly associated with older age, number of chronic diseases, receipt of home help, number of primary care visits, proportion of 80+ in the population and shorter distance to the ED; while an ED revisit was significantly associated with greater use of social care, number of hospital admissions and disposition (discharged; admitted to hospital) at initial ED visit.

    Conclusion Contextual factors explain variance in initial ED visit, additional to that explained by individual factors alone, which indicates inequitable access to ED care. These findings suggest considering local variations in contextual factors in order to improve health-related outcomes among older adults.

  • 13.
    Schön, Pär
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Gender Matters: Differences and change in disability and health among our oldest women and men2011Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    This thesis investigates gender differences in health and how they have changed between 1992 and 2002 among very old people. It explores gender differences in the association between disability and health, and gender differences in care utilization among our oldest old people. The studies are based on nationally representative data of the population in Sweden aged 77 and older (SWEOLD).

     Results from Study I showed that women generally had more health problems than men. Analyses of change between 1992 and 2002 showed increased prevalence rates for both sexes, especially women. However, women’s reporting of poor global self-rated health did not increase. There were no gender differences and there was no change over time in activities of daily living (ADL). Several health indicators seem to be developing differently for women and men.

     Study II showed that associations between ADL disability and other health indicators changed between 1992 and 2002, with several health problems and functional limitations becoming less disabling over time. This trend was especially true for women, while for men, the findings were mixed.

     Study III found no gender differences in physician visits and dental visits, despite women’s worse health and dental status. Marriage was associated with more physician visits for men and dentist visits for women. Results imply that women and unmarried older adults may have unmet health-care needs.

     Study IV examined whether the increase in life expectancy at age 65 observed between 1992 and 2002 consisted of years with or without musculoskeletal pain. Results showed that total years without pain decreased for both women and men, but more so for women. Women also had more years with pain added to life.

     The results of this thesis suggest an increase of health problems, but not disability, in the oldest Swedish population. However, gender variations in the findings highlight the importance of analyzing health trends separately for women and men.

    Ladda ner fulltext (pdf)
    FULLTEXT01
  • 14.
    Schön, Pär
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Agahi, Neda
    Karolinska Institutet, Aging Research Center .
    Thorslund, Mats
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Kåreholt, Ingemar
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Parker, Marti G.
    Karolinska institutet, Aging Research Center.
    The pains of a longer life: Gender differences in life expectancy free from musculoskeletal pain at age 65 in SwedenManuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    Background. Life expectancy (LE) has increased. Health expectancy studies divide LE into life spent in different health conditions.

    Objective. To describe the number of years spent with musculoskeletal pain in relation to total LE at age 65 in 1991/1992 and 2000/2002 and to examine the change in the proportion of LE spent free from musculoskeletal pain (pain-free life expectancy, PFLE) among men and women. Do the years added to life consist of years with or without musculoskeletal pain?

    Methods. PFLE was calculated using Sullivan’s method by combining prevalence rates of musculoskeletal pain from two nationally representative population-based studies in Sweden (LNU and SWEOLD) from 1991/1992 and 2000/2002 and life tables from Statistics Sweden.

    Results. In 1991/1992, both men and women aged 65 could expect to live 12 years free from musculoskeletal pain. However, the proportion of PFLE among men (75%) and women (60%) differed significantly (p = 0.000). Ten years later, both men and women could expect significantly more years with pain. PFLE among women had decreased to 51% (p = 0.059; 10.6 pain-free years, 10.0 years with pain); among men it had decreased to 68% (p = 0.152; 11.7 pain-free years, 5.5 years with pain). 

    Conclusions. The estimated proportion of pain-free LE at age 65 decreased between 1991/1992 and 2000/2002. For men, the number of pain-free years remained unchanged, but years with pain increased. For women, there was both a decrease in pain-free years and an increase in years with pain.  Results suggest an expansion of morbidity in the older population.

  • 15.
    Schön, Pär
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Parker, M. G.
    Kåreholt, Ingemar
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Thorslund, Mats
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Gender differences in associations between ADL and other health indicators in 1992 and 20022011Ingår i: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 23, nr 2, s. 91-98Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background and aims: Research has shown increased prevalence rates over time in several health indicators in the older population. These increases have not been accompanied by corresponding increases in ADL and IADL disability. Given that disability and other health indicators follow different trends, the associations between them may change. Since both health and disability appear to follow different trends for men and women, we can also expect gender differences in the associations. We examined gender differences in how objective tests of function as well as self-reported health and function indicators were associated with ADL/IADL in 1992 and 2002.

    Methods: Data were from the Swedish Panel Study of Living Conditions among the Oldest Old (SWEOLD), a nationally representative interview survey of persons aged 77+.

    Results: Compared to men, women had significantly higher prevalence rates for most health indicators both survey years, but there were no significant gender differences in ADL/IADL limitations. Prevalence rates increased significantly between 1992 and 2002 for all health indicators, but not for ADL/IADL. Most of the associations between ADL/IADL and other health indicators were stronger for men than for women. The overall pattern was that associations have become weaker for women over time; for men, the picture was mixed.

    Conclusions: The changing associations between ADL/IADL and other health indicators may reflect a complex interplay between changes in a range of social and environmental factors, some of which may be modifiable. ADL/IADL appear to reflect different dimensions of health and different kinds of needs for men and women.

  • 16.
    Schön, Pär
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Parker, Marti G.
    Karolinska institutet, Aging Research Center.
    Sex differences in health in 1992 and 2002 among very old Swedes2008Ingår i: Journal of Population Ageing, ISSN 0167-5923, Vol. 1, nr 1, s. 107-123Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background. Despite their longer life spans, women show higher morbidity rates compared to men at all ages. The gender gap in mortality has decreased over the past twenty years, but few studies have examined sex differences in morbidity over time. This study examines sex differences in health and changes in sex differences between 1992 and 2002.

    Methods. SWEOLD is a nationally representative interview survey of persons aged 77+. Outcomes include self-reported and objective health indicators.

    Results. Women had significantly higher prevalence rates for most health problems. Analyses of change over time showed that women had greater increases in, e.g., hypertension and poor lung function, and men had greater increases in poor self-rated health (SRH) and myocardial infarction (MI). The sex difference decreased significantly for SRH due to men’s increased reporting of poor health and increased for MI due to increased prevalence among men.

    Conclusions. Several health indicators seem to be developing differently for men and women. The gender gap has narrowed for poor SRH and widened for MI.

  • 17.
    Schön, Pär
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Parker, Marti G.
    Karolinska institutet, Aging Research Center.
    Thorslund, Mats
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Gender differences in physician and dental visits among very old personsManuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    Objectives. To analyze gender differences in care utilization and correlates to utilization among very old people for visits to physicians and dentists.

    Methods. Based on non-institutionalized respondents in SWEOLD, a nationally represen­tative interview survey of persons aged 77+ (n=529).

    Results: There were no gender differences in physician visits but men were more likely to have visited the dentist than women. Marriage was positively associated with visits to the physician and the dentist for men. Higher education was positively associated with physician visits for men and with dentist visits for women. Men with impaired mobility were less likely to report physician visits than men without mobility problems.

    Discussion: Unmarried men may be at a disadvantage for both dental and physician care. Given women’s poorer physical and dental health status, they may be disadvantaged both regarding visits to physician and dentist.

  • 18. Tynkkynen, Liina-Kaisa
    et al.
    Pulkki, Jutta
    Tervonen-Gonçalves, Leena
    Schön, Pär
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Burström, Bo
    Keskimäki, Ilmo
    Health system reforms and the needs of the ageing population-an analysis of recent policy paths and reform trends in Finland and Sweden2022Ingår i: European Journal of Ageing, ISSN 1613-9372, E-ISSN 1613-9380, Vol. 19, nr 2, s. 221-232Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Population ageing with an increasing number of people experiencing complex health and social care needs challenges health systems. We explore whether and how health system reforms and policy measures adopted during the past two decades in Finland and Sweden reflect and address the needs of the older people. We discuss health system characteristics that are important to meet the care needs of older people and analyse how health policy agendas have highlighted these aspects in Finland and Sweden. The analysis is based on most similar cases. The two countries have rather similar health systems and are facing similar challenges. However, the policy paths to address these challenges are different. The Swedish health system is better resourced, and the affordability of care better ensured, but choice and market-oriented competition reforms do not address the needs of the people with complex health and social care needs, rather it has led to increased fragmentation. In Finland, the level of public funding is lower which may have negative impacts on people who need multiple services. However, in terms of integration and care coordination, Finland seems to follow a path which may pave the way for improved coordination of care for people with multiple care needs. Intensified monitoring and analysis of patterns of health care utilization among older people are warranted in both countries to ensure that care is provided equitably.

1 - 18 av 18
RefereraExporteraLänk till träfflistan
Permanent länk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf