Region Västra Götaland (VGR) is the regional authority of West Sweden (Västra Götaland), an area with 1.6 million inhabitants or 17% of the population of Sweden. VGR as an organisation has a dual responsibility; responsibility for health care as well as societal services in areas such as public communication and culture, as well as responsibility for the regional development of this part of Sweden. VGR is thus both operating and funding hospitals and clinics using regional as well as national financing, but also funding research and development both in the health care area and in other areas of regional importance. The total annual budget of VGR is approximately 450 million €, of which a large part is personnel costs of the approximately 55.000 employees. The research part of the budget is approximately 113 million €. VGR has an important position related to health care research and industrial collaboration through its role as coordinator of clinical research and clinical trials of pharmaceuticals and medtech projects. In addition, VGR coordinates funding for regional development directed towards society and business, in the former part for instance in the form of infrastructure and in the latter part in particular related to SMEs.
In the DECI project VGR is represented by the care providers in the former Skaraborg county. Skaraborg is situated in the north-eastern part of the Western region, located between the two largest lakes in Sweden Vänern and Vättern. Healthcare services are provided by the Skaraborg hospital, the primary care units and the communities, serving a population of 260 000 inhabitants.
The Skaraborg Hospital (SHG) is the specialist hospital group in Skaraborg, consisting of four hospitals in the towns of Lidköping, Skövde, Mariestad, and Falköping. SHG has two emergency departments at the Skövde and Lidköping hospitals. SHG offers services including acute and planned care in 30 different medical specialities. The hospitals have 700 beds. During a year the services entail 45 000 inpatient episodes, 210 000 outpatient visits to physicians, 20 000 surgical procedures and 2 500 births. Furthermore, in Skaraborg there are 34 primary care units and 15 communities that together with SHG have the overall responsibility for dementia diagnosis and treatment. The prevalence of dementia in Sweden in people older than 65 years is 7%, which corresponds to more than 15000 inhabitants in Skaraborg with varying degrees of cognitive impairment.
Currently, the primary care centres are responsible for the initial investigation of patients with cognitive impairment. Basic care is then provided by the community teams with support from the general practitioner at the primary care centres. Patients with severe or complex symptoms are referred to a specialized unit at the hospital for further evaluation and support.
The role in the Project
SHG has a long tradition of research connected to the organizing of healthcare services, e.g. regarding care for patients with chronic diseases and elderly patients with multiple illnesses. Particularly, new integrated care models for these patients have been developed in West Skaraborg. The design of the care models has involved all the care providers (the hospital, the primary care centres and the communities). So far, internal as well as external assessments have shown very successful results from the patients’ perspective.
In addition, SkaS is at the forefront regarding research on patients with dementia, thus also having acces to a large cohort of these patients for many years.
SHG will lead Work Package 5 as site pilot and as a coordinator of the pilot projects. More specifically this package encompasses the activation of experimental care groups, with patient’s enrolment and involvement of the care professionals who will be involved in the experimentation in each of the four pilot cases. The package is based on a iterative action-reflection loops that aim not only to progressively achieve successful implementation and experimentation of the new care model, but also to develop—together with all the stakeholders—actionable knowledge on how to introduce the new business model in different scenarios.
Dr Svante Lifvergren
MD PhD, quality director at SHG and project manager
Dr Ulla Andin
MD PhD, senior consultant, assistant project manager
Professor Johan Svensson
MD PhD, senior consultant and project expert