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Margareta Kristenson, Anita Jernberger, Preben Bendtsen The Swedish Network for Health Promoting Hospitals Patient Orientation by means of Health Related Quality of Life (HRQoL) measurements in routine care
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In April 2003 the Swedish Government decided on New National Targets for Public Health n One of these is named –A more Health Oriented Health Service
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n Reorientation towards health n Health Orientation n Outcome orientation How can that be achieved? Health Promoting Hospitals
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Hospitlas shall.. n.. support the perceived health, function ability and well-being of patients with chronic disease, i.e. also where cure is not available
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The concept of health WHO 1945 A state of physical, social and mental well-being, not only the absence of disease
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Disease prevention and health promotion Disease prevention: The prevention of a specific disease Health Promotion: ” The process which helps people to gain control over their own health” ” The process which helps people to gain control over their own health”
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Health, disease and well-being perspectives
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Why measure health?
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(Outcome) measures in Hospilats n Economy n Activities-productivity n Outcomes: n Professional measures; X-ray, lab etc. n Self reported measures; satisfaction with care, access, self rated health and HRQoL.
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Quality of Life and Health related Quality of Life HRQoL effects of disease and /or handicap on individual self-rated health and on physical, mental and social wellbeing
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Measures of HRQoL n Two main instuments n SF -36 a broad profile n EuroQol one measure (utility)
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Pubic health survey 1999
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Public Health Survey 1999
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SF-36 patient with COPD
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SF-36 patients with COPD
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Experiences of pilot phase using SF-36 in a routine clinical setting on patients with COPD n The method is feasible for patients and personnel n Small correlation between SF -36 and measures of lung function n The inclusion of these measures in clinical evaluations supports a more holistic approach in the heath services
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Experiences of pilot phase (2) n Using an instrument like SF-36 starts a learning process in the organisation towards patient centred outcomes. Bendtsen P, Lerijon M, Sommer AS and Kristenson M, Measuring health-related quality of life in patients with chronic obstructive pulmonary disease in a routine hospital setting: Feasibility and perceived value. Health and Quality of Life Outcomes 2003, 1:5
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From pilot to broad use in the Swedish Network on HPH A computerised version of the SF-36 is available for all member hospitals. 10 hospitals active, patient groups are n pulmonary disease n mental disease n obesity n smoking
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Measures of HRQoL relevant indicators for HPH Outcomes in daily clinical practice and yearly “Health accounts” for patients, personnel and the population
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