From European to national guidelines on heart disease.
OBJECTIVE
Guidelines from the European Society of Cardiology are important tools for defining and establishing current standards of care for various heart diseases. The aim of the present paper is to describe the process of how these international guidelines may be transformed and implemented at a national level in Sweden.


RESULTS
The structure and process behind the national guidelines for heart diseases in Sweden and their relationship to the underlying European guidelines are described and differences between the national and European levels highlighted. We also give examples of how the scientific values of health care measures are weighted against health economic perspectives and integrated in a prioritization process. Compared to the European guidelines, the Swedish national guidelines have a broader economic perspective and aim to ensure that health care is cost effective and provided to all Swedish citizens on equal terms.


CONCLUSIONS
When certain health care measures are implemented, the national process can result in other priorities than could be expected from the European guidelines alone. On the other hand, a forceful implementation may be facilitated by the societal context in which these national guidelines are produced.
Institute of Medicine, University of Gothenburg, Gothenburg, Sweden. lars.grip@vgregion.se
Lars
L
Grip
Bertil
B
Lindahl
Lars-Åke
LÅ
Levin
Christina
C
Kärvinge
Kristina
K
Eklund
Lars
L
Wallentin
D005060:Europe; D017048:Health Care Costs; D006292:Health Priorities / Q000191:economics / Q000458:organization & administration; D006331:Heart Diseases / Q000628:therapy*; D006801:Humans; D017410:Practice Guidelines as Topic; D013548:Sweden