title: Priority dilemmas in psoriasis care and visions of a future care in a group of administrators, politicians and professionals in northern Sweden.
abstract: During the 1990s priority discussions were actualized in Sweden due to increased demands on health care and limited resources. In the county of Västerbotten in northern Sweden, with large rural areas, the decision makers faced special challenges due to distances and cost. Despite discussions striving for fairness in priorities, decision makers are still dealing with limited resources and difficult priority decisions regarding different diseases and treatments. In this study we aimed at describing views on priorities in public psoriasis care and visions of a future care among politicians, administrators and professionals in the county of Västerbottten in northern Sweden. Qualitative research interviews were performed with 23 key-persons. The findings revealed priority dilemmas about issues on organization, accessibility and ethics. Visions of a future care appeared as ambitions of a more effective care with good accessibility, continued research, information and a holistic approach in priorities. We conclude that dilemmas revealed in this study were a reflection of a gap between intentions and practice. In efforts to reduce these dilemmas we suggest methods with fairness in economic planning and priority setting, with concrete, official statements about the dominating views on which the priorities are based, and public information about these statements.
authors.affiliation: Section of Dermatology and Venereology, Department of Public Health and Clinical Medicine, Umeå University, SE-901 85 Umeå, Sweden. margaretha.uttjek@dermven.umu.se
authors.forename: Margaretha
authors.initials: M
authors.lastname: Uttjek
authors.forename: Mona
authors.initials: M
authors.lastname: Dufåker
authors.forename: Berndt
authors.initials: B
authors.lastname: Stenberg
authors.forename: Lennart
authors.initials: L
authors.lastname: Nygren
mesh_terms: D001294:Attitude to Health; D005544:Forecasting; D006287:Health Planning Guidelines; D006292:Health Priorities / Q000145:classification* / Q000941:ethics; D006297:Health Services Accessibility / Q000941:ethics / Q000592:standards*; D006801:Humans; D033182:Intention; D007407:Interviews as Topic; D011050:Policy Making; D011565:Psoriasis / Q000191:economics / Q000628:therapy*; D036301:Qualitative Research; D012040:Regional Health Planning / Q000941:ethics*; D040841:Resource Allocation / Q000941:ethics*; D019035:Rural Health Services / Q000600:supply & distribution*; D012935:Social Justice; D012941:Social Responsibility; D013222:State Medicine; D013548:Sweden