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HOSPITAL

‘Lean hospital a sign of Swedish welfare reform’

A Stockholm hospital saved from closure by private health care providers has been hailed by the Economist as one of modern's Sweden public-private success stories.

'Lean hospital a sign of Swedish welfare reform'

In a 14-page Nordics special, The Economist noted already in February that many notions once cemented in the Swedish conscience had been laid bare and dissected, or, as its correspondent noted, “the streets of Stockholm are awash with the blood of holy cows”.

One such holy cow, was, of course an ingrained suspicion toward private enterprise operating in state-funded industries, including health care.

Yet in 1999 the reigns of St. Göran’s hospital in western Stockholm were taken over by Capio, a Swedish healthcare management company owned by private equity firms. Today, 20 percent of hospital care across Sweden is run by private outfits in Sweden, a number that rises to 30 percent in the primary care sector.

“St. Göran’s is the medical equivalent of a budget airline,” The Economist wrote last week.

“The aim is to give taxpayers value for money. Hospitals should not be in the hotel business, the argument goes.”

Capio’s reform has, among other things, made the working relationship between doctors and nurses less hierarchical, the Economist explained. Small teams of medical staff work together. They make not only medical decisions together, but discuss work flow and how to manage everyday affairs – for example where the defibrilators should be kept so no one runs around looking for one while a patient flatlines in another room.

The term for focusing on work flow and quality in healthcare is “lean” and the liberal Economist is a key cheerleader for its virtues. A main aim at St. Göran was to cut short the amount of time patients spend in-house, a target that Sweden seems to be good at implementing nationally.

The Economist reported that the average length of a hospital stay in Sweden was 4.5 days. In France, it is 5.2 days, while Germans spend on average 7.5 days in hospital.

Sweden also has about half as many hospital beds per capita as France does, yet Swedes live to be a bit older than their French peers.

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STATISTICS

Norway saw fewer hospital patients in 2020 despite pandemic

Fewer patients were treated in hospital in 2020 than in 2019, with Covid-19 being the reason for the drop, according to Statistics Norway.

Norway saw fewer hospital patients in 2020 despite pandemic
Illustration photo by Audun Braastad / AFP)

The decline in patients has been largest for those awaiting planned treatments, but the number of people requiring immediate attention also dropped too, according to Statistics Norway figures.

Due to the coronavirus pandemic, hospitals had to prioritise differently in 2020 as a result of the increased need for intensive care units.

“2020 was a year marked by pandemics and restrictions. In many places hospitals have had to prioritise differently due to the coronavirus, and perhaps particularly as the result of the increased need for intensive care,” the report said.

This has contributed to a decrease in the number of patients in hospitals at all levels of care.

The number of patients with 24-hour stays decreased by 7 percent. The total number of days spent in hospital fell by 11 percent or 380,000 fewer days in a hospital bed in 2020 compared to 2019.

Hospital stays lasting at least 24 hours include both planned and unplanned visits. In 2020 planned visits accounted for 29 percent of all visits, which is a decrease of 16 percent from the previous year, while visits for immediate appointments decreased by 3 percent.

READ ALSO: Norwegian senior medic calls for geographical division of Covid-19 restrictions

The figures show a decline for almost all diagnostic groups, but cancer patients had a smaller decline than other groups.

Planned treatment of various forms of cancer decreased by 8 percent, but acute help for tumours saw an increase of 11 percent.

This reverses a trend of numbers of patients in hospitals increasing year on year. The increases had primarily been driven by patients at outpatient clinics.

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