Internett over alt. Online hele tiden
Avanserte datamaskiner i lommen
Omgang via sosiale medier
Akkurat nå mange som sjekker hva som skjer rundt omrkring.
Ikke noe galt med det – kun et bevis på de radikale enringen som har skjedd siden årtusenskiftet!
Et annet eksempel som viser den radikale utviklingen
It bølgen har altså endret mye – men hva har hendt med eldrebølgen? Ut over at den har kommet 15 år nærmere.
Mer oppmerksom. Alle snakker om den. Enige om at det er positivt at folk blir eldre
Samtidig forstår vi at den vil gi store utfordringer innen helse og omsorg.
Til tross for at vi forstår – utreder vi mye og utvikler lite.
IT er blitt allemannseie privat, men ikke innenfor helse og omsorg. Der sliter vi med «Jävla skitsystem».
For snart 15 år siden var milleiumksiftet – om 15 år, i 2030 vil eldrebølgen slå inn over oss med full kraft.
Heavy users of social and health care services in the city of Oulu
Background
The costs of social and health care services accumulate to a small minority of the population. This study analyses the customer groups within the group of high cost users in the city of Oulu, Finland. The focus of the analysis is on the identification of the groups and the differences in their usage of services compared to the rest of the population. The implications of the results for the provision of services and the structure of the health care and social care system are discussed.
Methods
The study is a retrospective registry study. The data were drawn from different electronic patient records and consisted of patient level information on service usage and costs with regard to both health care and social care services. The period covered was from 1 January 2011 to 31 December 2011. The population under study consisted of 152 494 individuals. The data were analyzed with statistical methods.
Results
The most expensive 10% of the population cause 81% of the costs of social and health care services funded by the city of Oulu. Of the costs of the most expensive 10% of the population, 62% are caused by people who are customers of at least one social service and 38% by people using only health care services. The most expensive 10% of the population use on average four different service types whereas the remaining 90% of the population use on average one type of service. The most expensive 10% of the population are the main users of primary care ward services, psychiatric care services, and secondary and tertiary health care services while the costs of other health care services (primary care outpatient services, emergency care and dental care services) are mainly caused by the remaining 90% of the population.
Conclusions
Because a small portion of the population causes the majority of the costs, the structure of the health care system and the service network should focus on the management of this group and the prevention of becoming a member of the group. The current system based on separate organizations for each service serves well the 90% of the population who use at most one type of service. However, it cannot respond to the needs of the high-cost 10% of the population. Because the expensive customers use many different services, the service combination should be individually planned, and there should be one party responsible for the coordination. Patient information should flow to and from the coordinator and between service providers.
»Den sjuka vården 2.0 – från nollvision till patientrevolution« Fokuserar boken bland annat på hur sjukvården bör möta den pågående IT-drivna »patientrevolutionen«.– Vi ser framför oss en utveckling där patienter ibland kan få bättre diagnoser på sin iPhone eller dator än vad de kan få på vårdcentralen, säger Stefan Fölster, i dag chef för tankesmedjan Reforminstitutet.
Stefan Fölster med flera ser en lösning i begreppet »flippad sjukvård«, som går ut på att vända på det traditionella och invanda. Han drar en parallell till skolan där det talats om »det flippade klassrummet«. Det innebär att eleverna exempelvis får i hemläxa att titta på en webbaserad föreläsning. Dagen efter kan lektionen i stället för en vanlig lärarledd föreläsning ägnas åt fördjupning, analys och feedback.
Inom sjukvården skulle det, enligt författarna, kunna innebära att patienten beskriver sina symtom hemma via ett datoriserat diagnosstöd. Därefter överför diagnosstödet automatiskt informationen till patientjournalen och ger diagnosförslag som ibland kan räcka för att en remiss ska skickas till labb eller specialist direkt.
– Patienten väljer att tillgängliggöra informationen för sin vårdcentral som responderar, säger Stefan Fölster som menar att det underlättar vid själva patientbesöket – om ett sådant rekommenderas – genom att vårdcentralen redan har informationen.