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Integrative health care systems: From vision to implementation in Sweden—An example from the County Council in Östergötland County
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Abstract / European Journal of Integrative Medicine 2 (2010) 217–265
PP-038 Integrative health care systems: From vision to implementation in Sweden—An example from the County Council in Östergötland County W. Doerfler a,∗ , A. Kullberg a , T. Falkenberg b,c a County Council of Östergötland, Management board, Linköping, Sweden b Karolinska Institutet, Department of Neurobiology, Care Sciences and Society. Research unit for Studies of Integrative Health Care, Stockholm, Sweden c The Vidar Clinic Foundation Sweden, Research Unit, Järna, Sweden
Background and aim: Patients increasing demand of access to Integrative Health Care (IHC) services within the publicly funded health care systems challenge health sector reform globally. The Östergötland County Council, the fourth largest in Sweden, has a pioneering role in Sweden with the aim to improve knowledge and acceptance of evidence based IHC among medical staff and health care organisations. Various means of information, education and communication (IEC) and implementation strategies have been applied to resolve some of the controversial issues and power struggles inherent in most IHC developments. We also aim to share and engage in exchange and cooperation between other European Health Care Regions in the field of IHC. Results and methods: Implementing IHC in the Swedish health care system will be presented along four different public health system dimensions: (A) Political: As spokespersons for the citizens and buyers of health care, the politicians initiated the discussion of integrative health care in Östergötland County. The Balanced Scorecard as formulated by the County Council delegates in Östergötland state that: Patients who so desire, should be offered some evidence-based complementary health care as a complement to the provision of regular health care; (B) Knowledge dissemination: The health care sector is knowledge-intensive and the demand for evidence is imperative. We have arranged a number of seminars, conferences and higher educational courses to gain more knowledge about different integrative methods, how they work and when they are most useful. Increasing theoretical and practical knowledge is essential in terms of gaining acceptance and support from the professionals; (C) Health promotion: The Swedish National Board of Health and Welfare approves of integrative health care to be used to a much greater extent for health promotion purposes than for curative ones. Many integrative methods are already part of health promotion. If we align IHC with health promotion, we achieve a much larger health care arena to act on; (D) Networking: In Östergötland County, we have established a Network for Integrative Medicine. There are currently only a few professionals within the health care sector who are formally interested in the integrative field. Hence, IEC initiatives including seminars and meetings to discuss possibilities and problems and how to solve are important. In addition, establishing networking beyond the boarders of the county council is very important to encourage
health care personnel to consider developing and implementing IHC. Conclusions: In this poster we focus on various aspects from the IHC development within the county council. We describe health economical aspects as well as lessons learned from the IEC interventions. Our lessons learned may serve as a guiding example towards improving integrative health care reform. doi:10.1016/j.eujim.2010.09.129 PP-039 Health care professionals’ attitudes and opinions regarding the vaccination of measles—A systematic review C. Raak ∗ , S. Schmidt-Troschke, T. Ostermann University of Witten/Herdecke, Center for Integrative Medicine, Herdecke, Germany Objective: Vaccination of measles is a part of almost every health care system. However, the question how information and knowledge transfer on vaccination for measles is handled between patient and health care professionals is still a challenging controversy. One important factor in the culture of communication is given by the attitudes and opinions of the health care professionals towards this topic. Aim: We aimed at reviewing surveys/studies on Health care professionals’ attitudes and opinions on vaccination of measles. Method: A systematic search has been performed in Medline, EMBASE, CAMbase, AMED and Google Scholar. Keywords and their combination were (Attitudes OR Opinions OR Views OR Beliefs) in combination with (Vaccination AND Measles) and (Physicians OR Nurses OR Practitioners). We also cross checked the references of articles found that way. Studies on parental attitudes were excluded. Results: We found a total of 12 papers from 1990 to 2009 matching our inclusion and exclusion criteria originated in Europe (n = 7), USA (n = 4) and Australia (n = 1) from a total of 4383 health care professionals (mean response rate 72%, mainly family physicians and pediatricians). Opinions on safety and efficacy profiles were heterogeneous. In most surveys the wish for further training and professional support was raised by the health care professionals. Main reasons were concerns regarding side effects and the felt difficulty of being up to date with recent developments in vaccination. Discussion: Vaccination of measles is a highly important topic which according to this review is still a matter of discussion between patients and health care professionals. We were able to show that there are different views and opinions and that there is the need to develop a culture of informed decision making. Supportive tools for patients, physicians and nurses should be a major part of this process. The dependency of opinions on sociocultural background and the underlying health care system and its legal aspects has to be further discussed. doi:10.1016/j.eujim.2010.09.130
Abstract / European Journal of Integrative Medicine 2 (2010) 217–265
PP-038 Integrative health care systems: From vision to implementation in Sweden—An example from the County Council in Östergötland County W. Doerfler a,∗ , A. Kullberg a , T. Falkenberg b,c a County Council of Östergötland, Management board, Linköping, Sweden b Karolinska Institutet, Department of Neurobiology, Care Sciences and Society. Research unit for Studies of Integrative Health Care, Stockholm, Sweden c The Vidar Clinic Foundation Sweden, Research Unit, Järna, Sweden
Background and aim: Patients increasing demand of access to Integrative Health Care (IHC) services within the publicly funded health care systems challenge health sector reform globally. The Östergötland County Council, the fourth largest in Sweden, has a pioneering role in Sweden with the aim to improve knowledge and acceptance of evidence based IHC among medical staff and health care organisations. Various means of information, education and communication (IEC) and implementation strategies have been applied to resolve some of the controversial issues and power struggles inherent in most IHC developments. We also aim to share and engage in exchange and cooperation between other European Health Care Regions in the field of IHC. Results and methods: Implementing IHC in the Swedish health care system will be presented along four different public health system dimensions: (A) Political: As spokespersons for the citizens and buyers of health care, the politicians initiated the discussion of integrative health care in Östergötland County. The Balanced Scorecard as formulated by the County Council delegates in Östergötland state that: Patients who so desire, should be offered some evidence-based complementary health care as a complement to the provision of regular health care; (B) Knowledge dissemination: The health care sector is knowledge-intensive and the demand for evidence is imperative. We have arranged a number of seminars, conferences and higher educational courses to gain more knowledge about different integrative methods, how they work and when they are most useful. Increasing theoretical and practical knowledge is essential in terms of gaining acceptance and support from the professionals; (C) Health promotion: The Swedish National Board of Health and Welfare approves of integrative health care to be used to a much greater extent for health promotion purposes than for curative ones. Many integrative methods are already part of health promotion. If we align IHC with health promotion, we achieve a much larger health care arena to act on; (D) Networking: In Östergötland County, we have established a Network for Integrative Medicine. There are currently only a few professionals within the health care sector who are formally interested in the integrative field. Hence, IEC initiatives including seminars and meetings to discuss possibilities and problems and how to solve are important. In addition, establishing networking beyond the boarders of the county council is very important to encourage
health care personnel to consider developing and implementing IHC. Conclusions: In this poster we focus on various aspects from the IHC development within the county council. We describe health economical aspects as well as lessons learned from the IEC interventions. Our lessons learned may serve as a guiding example towards improving integrative health care reform. doi:10.1016/j.eujim.2010.09.129 PP-039 Health care professionals’ attitudes and opinions regarding the vaccination of measles—A systematic review C. Raak ∗ , S. Schmidt-Troschke, T. Ostermann University of Witten/Herdecke, Center for Integrative Medicine, Herdecke, Germany Objective: Vaccination of measles is a part of almost every health care system. However, the question how information and knowledge transfer on vaccination for measles is handled between patient and health care professionals is still a challenging controversy. One important factor in the culture of communication is given by the attitudes and opinions of the health care professionals towards this topic. Aim: We aimed at reviewing surveys/studies on Health care professionals’ attitudes and opinions on vaccination of measles. Method: A systematic search has been performed in Medline, EMBASE, CAMbase, AMED and Google Scholar. Keywords and their combination were (Attitudes OR Opinions OR Views OR Beliefs) in combination with (Vaccination AND Measles) and (Physicians OR Nurses OR Practitioners). We also cross checked the references of articles found that way. Studies on parental attitudes were excluded. Results: We found a total of 12 papers from 1990 to 2009 matching our inclusion and exclusion criteria originated in Europe (n = 7), USA (n = 4) and Australia (n = 1) from a total of 4383 health care professionals (mean response rate 72%, mainly family physicians and pediatricians). Opinions on safety and efficacy profiles were heterogeneous. In most surveys the wish for further training and professional support was raised by the health care professionals. Main reasons were concerns regarding side effects and the felt difficulty of being up to date with recent developments in vaccination. Discussion: Vaccination of measles is a highly important topic which according to this review is still a matter of discussion between patients and health care professionals. We were able to show that there are different views and opinions and that there is the need to develop a culture of informed decision making. Supportive tools for patients, physicians and nurses should be a major part of this process. The dependency of opinions on sociocultural background and the underlying health care system and its legal aspects has to be further discussed. doi:10.1016/j.eujim.2010.09.130