Empowering patients to need less care and do better in Highland Hospital, South Sweden

Outcomes

Overall, the outcomes can be summarised as better access to information and treatment for all patients, high quality care for those patients in need of immediate treatement, lower morbidity for patients with flare-ups in their disease, satisfied patients and satisfied staff, and lower use of health care system resources. In many ways, these outcomes were unplanned – the original intentions were essentially to treat patients more in line with our values and give them a greater role in their care, while also getting down the waiting lists. We believed that we could achieve these things while maintaining the quality of patients’ care. In practice, quality has improved considerably, a much better result than we expected.

The number of hospitalizations of patients with inflammatory bowel disease decreased 48% during the period 1998-2005, compared to the nationwide decrease of 4% reported by the National Board of Health. Our clinic has moved from above the national average of in-patients per 100,000 residents to being almost half the national average during this period.

Moreover, we have seen a substantial improvement in adherence to recommended drug regimes: 68% of patients with total ulcerative colitis have taken out from the pharmacy more than 70% of their prescribed dose, and for left-sided colitis the figure is  58%. These rates of adherence are considerably higher than those found in other investigations, where the adherence rates are as low as 30-50%.

The number of unscheduled visits of patients with flare-ups in their condition decreased from a day in 2001 to a week in 2005, mainly, we believe, because patients are taking more responsibility for their own care and therefore are contacting us much earlier when there is a flare-up in their condition, before they become really ill.