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Practice and Policy in Promoting Health and Equity –experiences from a national project in primary health care in Sweden
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. (Equity Research)ORCID iD: 0000-0001-9059-599X
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. (Equity Research)ORCID iD: 0000-0002-3787-1040
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. (Equity Research)ORCID iD: 0000-0001-9496-4342
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. (Equity Research)ORCID iD: 0000-0003-0368-050X
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2016 (English)Conference paper, Abstract (Refereed)
Abstract [en]

Introduction: The Swedish Health Care Law requires the health system to provide good care on equal terms to all. However, several reports from different governmental agencies have revealed that health care is uneven in quality, lacking in accessibility, and not offered on equal terms to all people. Recent public health reports show that inequalities in health in the population have increased. To provide health care on equal terms has become a challenge for health care.

In order to apply methods for developing practice and policy in promoting health and equity the Swedish Association of Local Authorities and Regions developed and implemented a national project entitled Care on Equal Terms. The project began in 2011 and was completed in 2014 at seven Primary Health Care Units (PHCUs) in five regions. The aim of this study was to evaluate the outcomes of this project.

Methods: Based on a program theoretical approach an evaluation design was developed which included process, results and economical evaluation. In the data collection and analysis mixed methods were applied.

Results: According to the process evaluation, seven different strategies were applied in the process to develop primary health care on equal terms. One of the key observations was that in order to achieve health on more equal terms, health care needs to be provided on unequal terms, i. e. more needs to be done to reach those who need more assistance to access health services. Health promotion was one of the applied strategies and it was the most common strategy at some of the health care centers with the aim of developing patients' knowledge, awareness and understanding about health, care and self-care. The results evaluation showed that the PHCUs staff identified structural and organizational factors in health care as important factors for developing health promotion and equity in access. The health economic evaluation showed that the costs for implementing the activities for an improved equity were limited. Yet the majority of the PHCUs thought that the detailed regulation of their financing and reporting requirements were a limitation in their work for improved equity. Four of five county councils have recently introduced a primary care provider payment system (ACG) which may not be supportive of efforts to improve equity in access.

Conclusions: It is possible to develop and maintain practices that can contribute to more equitable care and increase health care personnel’s awareness about practice and policy in promoting health and equity.

Place, publisher, year, edition, pages
2016.
National Category
Health Sciences
Identifiers
URN: urn:nbn:se:mdh:diva-30887OAI: oai:DiVA.org:mdh-30887DiVA: diva2:898770
Conference
22nd IUHPE World Conference on Health Promotion, CURITIBA, BRAZIL
Available from: 2016-01-29 Created: 2016-01-29 Last updated: 2016-12-22Bibliographically approved

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