Transcript 5th International Conference “Health Insurance in Transition”

Status of Emergency Medicine
SWEDEN
Dr. Thomas Arnhjort
South Stockholm General Hospital
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Sweden
Scandinavia, Nordic
countries and EU
Population 8,9 mil
Immigration 10%
GDP 28,28 US per
head
Public health
service
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Burden of disease
 Life
expectancy
 men
77,5
 women 82,1
 Major
causes of morbidity and
mortality are heart and circulation
diseases
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Health care organisation
75 public hospitals
950 primary care
units (GP)
3,8/1000 beds,
higher number in
the North
Few private units
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Medical education
Medical degree after 5,5 yrs at
university. ( 6)
1,5 yrs internship before licence to
practice
Residency 5-7 yrs  Speciality
Optional exam
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EM specialty status
Growing unofficial recognition,
legislative decision in progress
Pre-hospital EM provided by
ambulance (paramedic/ nurse)
In-hospital EM care provided by on
call doctors (various specialities)
Currently 4 EM-”residency” programs
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Pre-hospital emergency care






Supervised public ambulances and “Emergency
cars”
Paramedics, anesthetic nurses, (doctors)
“Paramedics” 15 week training + additional
courses (PhTLS)
Some ambulances equipped for thrombolysis
and direct contact with ICU/ ER
112/ national dispatch organization, 20 SOS
stations
Tax paid system, some private entrepreneurs.
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Challenges
 To
provide state of the art
emergency care for all patients
 To create a better working
environment for all ER staff
 To establish a consistent group of
doctors in the ER
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Strategies
Establishing EM as a medical speciality
 1999/
2000 two now 4 hospitals
employing “ER doctors”
 SweSEM founded 1999
 Core curriculum (2002) based on
EuSEM and SAEM
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Most successful strategies
Courage
Role modelling for other hospitals
Aiming for enthusiasts
Considering the impact of group
dynamics
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Most difficult
To get acceptance from other
specialities (internal medicine)
Economy - Investing is a cost not
initially an income
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Summary
EM in Sweden challenges traditional
system
EM doctors, an answer to three basic
needs in emergency care
Legislative decision in progress
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Dr Thomas Arnhjort
South Stockholm General Hospital
[email protected]
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