Background information
A medium-sized Swedish county council wanted to create an understanding among politicians and civil servants of the development of equal care and health in the county council. Sirona was commissioned to carry out a change process with the aim of developing an action plan to stop the negative trend and to counteract healthcare-related inequalities within the county council.
Challenge
The challenge was to work with the county council to develop a package of measures to reverse the trend of increasing inequalities, including through integrated health programs. Based on this, a platform would be created to change the way the county council worked with equal care and health.
Implementation
The first part of the assignment focused on conducting a thorough mapping and current situation analysis of the development of healthcare-related inequalities in the county council. This included highlighting and investigating differences in socioeconomics, gender, psychiatric aspects, as well as care provision in the form of access and availability between different municipalities in the county within different disease groups. In connection with this, representatives of several municipalities and politicians in the county were interviewed, among other things, to create a broader understanding of the problem and create support for the approach and method in the change work. The current situation analysis was based on both public data (Statistics Sweden, National Board of Health and Welfare, quality registers, Open Comparisons, etc.) and internal healthcare data. For healthcare data, a comparison was also made between the county council and other county councils in Sweden.
In the second part of the assignment, Sirona's team conducted health economic analyses for selected and relevant patient groups. The health economic analyses identified heart failure patients and smoking pregnant women as groups in need of prioritization in the change work. For these groups, a model and methodology was developed to work with integrated health programs in the change process. Action programs for these groups were developed in close collaboration with representatives from primary care and senior management.
Outcome
The mission resulted in a common understanding among politicians and civil servants of the importance of working more systematically with equal care and health. The assignment provided a deep and fact-based picture of inequalities in care and health in terms of age, gender and level of education. The end product was a series of concrete recommendations and measures to create the conditions for further change work and to develop and implement a more knowledge-driven care that in the long run contributes to increased equality.
One effect of the project was that SKL highlighted the county council as a model county for work on equal care and health. SKL chose to initiate a collaboration with Sirona to implement further initiatives together with three other county councils to motivate extensive work in the field of public health.
