Reflections from the perspective of Head of Research Skåne University Hospital Professor Ingemar Petersson Stab forskning och utbildning SUS
Lessons from the past and visions for the future Systematic learning Systematic development Systematic evaluation Systematic planning
Swedish Research in International Comparison
Lessons from the past and visions for the future
Lessons from the past and visions for the future
Lessons from the past and visions for the future
Lessons from the past and visions for the future Systematic learning Systematic development Systematic evaluation Systematic planning
Sources for knowledge
Externa Ärenden Riktlinjer Standardized Implementation/HTA Regionala frågor Regionala frågor Ärende eller Fråga Nominering SUS övriga styrgrupper Styrgrupp Styrgrupp Styrgrupp Styrgrupp FoOI AU ärendeberedning Ledningsgrupp Förvaltningschef SUS Sakkunn iga (för aktuell fråga) Beslut SUS Kliniker Institutioner Nominering sakkunniga Stödprocesser HTA Bibliotek Bygg/lokal Ekonomi Epicentrum Etiskt råd FoU-centrum Investeringsgrupp Läkemedelsråd Regionala grupper Registercentrum Ordnat införande 1. Rutinsjukvård 2. Utveckling 3. Forskning
Routine health care New methods- strong evidence
Development/Implementation New methods- limited evidence
Research New methods- insufficient evidence- To Research!
HTA (Health Technology Assessment) systematic methodology to evaluate the scientific background and evidence Archie Cochrane
systematic methodology to evaluate the scientific evidence Structured question Literature search Evaluations Evidence grading HTA-report and systematic review
Lessons from the past and visions for the future Systematic learning Systematic development Systematic evaluation Systematic planning
A case study from Sweden 3-4 % of the adult population are seeking health care at least once per year for Low Back Pain (LBP). Population based figures, population 1.3 million, south Sweden, period 2004-2008 Jöud A, Petersson IF, Englund M. Low Back Pain - Epidemiology of Consultations. Arthritis Care Res (Hoboken). 2012 Feb 15. doi: 10.1002/acr.21642. [Epub ahead of print]
Inflammatory Back Pain- Spondylarthritides (AS/SpA/PsA) in south Sweden. Overall prevalence 0,45% 0.8 0.7 0.6 Women Men Percent 0.5 0.4 0.3 0.2 0.1 0.0 15-29 30-44 45-59 60-74 75- Age Haglund, Bremander, Petersson et al. Annals of the Rheumatic Diseases 2011 Jun;70(6):943-8. Epub 2011 Feb 2
Inflammatory Back Pain- Spondylarthritides (AS/SpA/PsA) in south Sweden. Results from a Population-Based Health Care Register Study Emma Haglund, Ann Bremander, Ingemar F Petersson, Britta Strömbeck, Stefan Bergman, Lennart TH Jacobsson, Aleksandra Turkiewicz, Pierre Geborek, Martin Englund Ann Rheum Dis. 2011 Feb 2. [Epub ahead of print]
Cases had an increased risk for sick leave compared with controls with a relative risk of 1.8; 95% CI 1.5, 2.1 Cases had more days with sick leave than controls (median number of more days per year 30; 95% CI 2, 72). Rheumatology (Oxford). 2009 Mar;48(3):289-92 Strömbeck B, Englund E, Bremander A, Jacobsson L, Kedza L, Kobelt G, Petersson IF. Cost of illness from the public payers perspective in patients with ankylosing spondylitis. J Rheumatol. 2010 Nov;37(11):2348-55.
Sick Leave in patients with Ankylosing Spondylitis (AS) treated with TNF blockers 2004-2007 in south Sweden as compared to controls Sick leave in patients with ankylosing spondylitis before and after anti-tnf therapy: a population-based cohort study. Kristensen LE, Petersson IF, Geborek P, Jöud A, Saxne T, Jacobsson LTH, Englund M. Rheumatology (Oxford). 2012 Feb;51(2):243-9. Epub 2011 May 12
Lessons from the past and visions for the future Systematic learning Systematic development Systematic evaluation Systematic planning
Challenges for the future Health Care Needs Ökat och förändrat vårdbehov till följd av Resources Demografisk utveckling Medicinsk och medicinsk teknisk utveckling Förändrat sjukdomspanorama Ökade förväntningar Kompentesförsörjning Ekonomi
Changes in the population in Region Skåne 2015-2025 40% 35% 36% 30% 25% 20% 15% 10% 11% 12% 9% 8% 17% 7% 7% Skåne Riket 5% 5% 3% 0% 0-19 20-64 65-79 80 totalt
Increased health care consumption 2015-2025 for SUS Antal Inpatient care 600 000 500 000 400 000 300 000 200 000 403 410 489 384 100 000 0 85 283 102 450 Vårdtillfällen 2015 Vårdtillfällen 2025 Vårddagar 2015 Vårddagar 2025 Beräkning baserad på uppgifter om vård-konsumtion per invånare i ettårsklasser hämtade från RSVD (Region Skånes vårddatabas) för 2014. Antar en procentenhets ökad vårdkonsumtion per år utöver demografisk förändring.
0,14 Outpatient healthcare visits in different medical diagnostic areas (ICD 10) 0,12 0,1 Antal besök 0,08 0,06 0,04 2009 2010 2011 2012 2013 2014 0,02 0
The future for register research and epidemiology (Genotyping) Phenotyping Sociotyping Eco -typing Geo -typing Progno -typing Combo -typing
Thanks Juan Miro, Fondation Maeght, Nice