Search our website:

The Esther approach to healthcare in Sweden: A business case for radical improvement

Outcomes and performance indicators

The Esther Network for re-designing patient care has been crucial in delivering improved patients outcomes, whilst delivering resource savings. The success of the project became obvious very early. A total system wide redesign took place, from 2000-2001 onwards  to focus energy and funds on caring for the patient at home. This resulted in a 20% reduction in hospital admissions. In 2003, the Esther Network won the ‘GotaPriset, Swedish national award for quality improvement. This was because the project exhibited outcomes such as:

  • Hospital admissions fell from approximately 9,300 in 1998 to an estimated 7,300 in 2003.

  • Hospital days for heart failure patients decreased from approximately 3,500 in 1998 to 2,500 in 2000.

  • Waiting times for referral appointments with neurologists decreased from 85 days in 2000 to 14 days in 2003.

  • Waiting times for referral appointments with gastroenterologists fell from 48 days in 2000 to 14 days in 2003.

  • The number of unnecessary days in hospital decreased from 1113 in 1999 to 62 in 2011. 

Unnecessary days in hospital:

The measurement here is the amount of days the patient remains still in hospital although they no longer have a medical need for specialist care. This can occur for example if the homecare service or primary care  does not have the capacity to look after the patient at home.

Esther resulted in the following changes:



About this case study
Main Contact

Nicoline Vackerberg
Director of the Esther Network


Nicoline Vackerberg wrote this case study for Governance International in January 2013.

Copyright © Governance International ®, 2010 -2021. All rights reserved