A 10-year population-based study of people with multiple sclerosis in Stockholm, Sweden: use of and satisfaction with care and the value of different factors in predicting use of care.
BACKGROUND
The national strategy for treatment of chronic diseases - including MS - and changes in the Swedish welfare system, call for analyses of the use of, and patient satisfaction with, care in a long-term perspective. The aim was therefore to explore the use of care and the predictive value of personal factors, disease-specific factors and functioning on the use of care and to explore patient satisfaction with care in a 10-year perspective.


METHODS
Information regarding personal factors, disease-specific factors, functioning and satisfaction with care was collected by home-visits; use of care was collected from the Stockholm County Council computerised register.


RESULTS
Data from 121 people with MS (PwMS) was collected. Primary care accounted for the majority of all care. Neurology and Rehabilitation Departments together accounted for two-thirds of all hospital outpatient care. Rehabilitation Departments accounted for one-third of the total number of inpatient days. Lower coping capacity, impaired manual dexterity and activity of daily living dependency at baseline, together with progress in MS disability predicted a higher use of care. Overall, patient satisfaction with care was stable over time.


CONCLUSIONS
The extensive use of care offers challenges to care coordination. Implementation of person-centred care could be a strategy to increase efficacy/outcome of care.
Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Huddinge, Sweden. charlotte.chruzander@ki.se.|Karolinska Institutet, Department of Clinical Neuroscience, Stockholm, Sweden. charlotte.chruzander@ki.se.|Department of Physiotherapy, Karolinska University Hospital, Stockholm, Sweden. charlotte.chruzander@ki.se.|Department of Neurology, R54, Karolinska University Hospital, Huddinge, SE-141 86, Stockholm, Sweden. charlotte.chruzander@ki.se.
Charlotte
C
Chruzander
Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Huddinge, Sweden.|Karolinska Institutet, Department of Clinical Neuroscience, Stockholm, Sweden.|Department of Physiotherapy, Karolinska University Hospital, Stockholm, Sweden.
Sverker
S
Johansson
Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Huddinge, Sweden.|Karolinska Institutet, Department of Clinical Neuroscience, Stockholm, Sweden.
Kristina
K
Gottberg
Department of Physiotherapy, Karolinska University Hospital, Stockholm, Sweden.
Ulrika
U
Einarsson
Karolinska Institutet, Department of Clinical Neuroscience, Stockholm, Sweden.
Jan
J
Hillert
Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Huddinge, Sweden.|Karolinska Institutet, Department of Clinical Neuroscience, Stockholm, Sweden.|Department of Physiotherapy, Karolinska University Hospital, Stockholm, Sweden.
Lotta Widén
LW
Holmqvist
Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Huddinge, Sweden.|Karolinska Institutet, Department of Clinical Neuroscience, Stockholm, Sweden.|Department of Physiotherapy, Karolinska University Hospital, Stockholm, Sweden.
Charlotte
C
Ytterberg
D000553:Ambulatory Care / Q000706:statistics & numerical data; D006233:Persons with Disabilities / Q000523:psychology / Q000706:statistics & numerical data; D004812:Epidemiologic Methods; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000706:statistics & numerical data; D013548:Sweden / Q000453:epidemiology