Helsebibliotekets Research Archive
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Barn innlagt sammen med foreldre som er i behandling for rusmiddelproblemer
No full textNORSK SAMMENDRAG: Dette er den første av to delrapporter om tilbud til barn av foreldre med rusmiddelproblemer som SIRUS har skrevet på oppdrag av Barne- og familiedepartementet. Denne rapporten tar for seg barn innlagt sammen med foreldre i behandling. Den andre rapporten omhandler hele spekteret av støtte- og behandlingstilbud i Norge for barn av rusmiddelbrukende foreldre (SIRUS rapport 1/2006).\ud
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Det var innlagt 161 barn på 11 institusjoner som gir tilbud om innleggelse av barn sammen med foreldre i løpet av 2004; 93 % av disse var under tre år og 64 % var under ett år. Tjuefem prosent ble født under mors opphold på institusjonen. Kun to prosent av barna var over seks år. Institusjonene oppgir at de prioriterer de yngste barna, eller helst gravide kvinner så tidlig i svangerskapet som mulig.\ud
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Rapporten konkluderer med at tendensen til i økende grad å prioritere behandling allerede under svangerskapet og tidligst mulig i barnas liv synes faglig velbegrunnet og kan være svært viktige forebyggende tiltak. Dilemmaene ved å inkludere barn i voksnes rusmiddelbehandling bør imidlertid ha løpende oppmerksomhet.\ud
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Rapporten peker avslutningsvis på flere områder der det er behov for fagutvikling og forskning.ENGLISH SUMMARY: The Ministry wanted SIRUS to ascertain which inpatient treatment units include admissions of children in their treatment of parents for substance abuse problems, how many children are involved, what assistance is given to the children, the kind/amount of professions working with them, routines for co-operation with welfare officials (including kindergartens/schools), how these children are followed up after their parents complete treatment and whether the institutions have evaluated their work.\ud
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There was no readily accessible overview of Norwegian institutions providing admission to children along with their parents. Through various sources, nine inpatient treatment units were found that offered such assistance. Two childcare and parent-children centres that play central roles in related work were also included. Information was acquired through a questionnaire sent to these 11.\ud
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In 2004 there were 161 children admitted to the institutions and 93 % of them were under the age of three, 64 % under age one. About a quarter of the children were born during their mothers’ institutional residence. For preventive reasons, priority was given to admitting children from an early age and mothers from an early pregnancy. The length of stays in treatment units varied widely. Half of the institutions reported using standard tools for making assessments of the children. Those who used such tools were more likely to report negative effects and dysfunctions among the children. However, a high frequency of functional and developmental problems appeared to be linked to prenatal and early-years exposure to substances.\ud
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High professional competence prevails in most of the institutions but there is a considerable need for specific initiatives to train and instruct in observation and clarification of children’s developmental damage and relationship difficulties. The competence of external specialists in child psychiatry and child habilitation service is emphasised.\ud
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The institutions report comprehensive co-operation with others in the field. The public childcare service is nearly always involved, often prior to admissions. However, it would be advisable for these juvenile authorities to follow up families even more during inpatient treatment and for a long time after release so that the children’s care can be evaluated on a regular basis.\ud
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No major evaluation studies have been made by the institutions that include children along with parents undergoing treatment. A couple of minor investigations have been made and they report reaching their objectives.\ud
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To evaluate the need for further research and development, the report reflects on issues such as: What is the purpose of admitting children together with parents undergoing inpatient treatment? What professional/theoretical considerations are such initiatives based on? How can treatment of parents be combined with ensurance of the children’s needs?\ud
The report points out possible areas for professional development and research:\ud
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- Evaluation strategies and standards for evaluation should be considered.\ud
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- Extensions of prospective follow-up investigations of children and parents are proposed. Contextual factors and prerequisites must be included in such studies, including socio-economic matters, social network, ethnicity and culturally relevant information.\ud
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- Information about treatment availabilities must be improved.\ud
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- A decision is recommended regarded whether children should be given independent patient status when admitted along with their parents.\ud
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- A professional network should be established among all the relevant institutions - a forum for discussing dilemmas and problems linked to treatment of children with parents and initiating competence-enhancing measures.\ud
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- Models for systematic follow-ups of children and parents should be developed as part of an evaluation strategy.\ud
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The report includes an overview of tools that can be utilised for registration and diagnostics at the treatment units
What do we know about how to do audit and feedback? Pitfalls in applying evidence from a systematic review.
No full textBACKGROUND: Improving the quality of health care requires a range of evidence-based activities. Audit and feedback is commonly used as a quality improvement tool in the UK National Health Service [NHS]. We set out to assess whether current guidance and systematic review evidence can sufficiently inform practical decisions about how to use audit and feedback to improve quality of care. METHODS: We selected an important chronic disease encountered in primary care: diabetes mellitus. We identified recommendations from National Institute for Clinical Excellence (NICE) guidance on conducting audit and generated questions which would be relevant to any attempt to operationalise audit and feedback in a healthcare service setting. We explored the extent to which a systematic review of audit and feedback could provide practical guidance about whether audit and feedback should be used to improve quality of diabetes care and, if so, how audit and feedback could be optimised. RESULTS: National guidance suggests the importance of securing the right organisational conditions and processes. Review evidence suggests that audit and feedback can be effective in changing healthcare professional practice. However, the available evidence says relatively little about the detail of how to use audit and feedback most efficiently. CONCLUSION: Audit and feedback will continue to be an unreliable approach to quality improvement until we learn how and when it works best. Conceptualising audit and feedback within a theoretical framework offers a way forward
Narkotikasituasjonen i kommunene. Resultater fra årene 2002 og 2003
No full textNORSK SAMMENDRAG: Hovedtyngden av kommunene, rundt 50 %, oppga i 2002 og 2003 at det ikke har skjedd noen endring i narkotikasituasjonene fra året før. Men andelen kommuner med stabil situasjon varierer for de ulike typer stoff. Andelen kommuner som rapporterer om en økning i antall misbrukere i forhold til året før var lavere i 2003 enn i 2002 for nesten alle stoffer.\ud
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Cannabis, amfetamin og beroligende midler ser ut til å bli vanligere. Bruk av kokain og løsemidler har lavest vekst og for en relativt stor andel kommuner rapporteres at disse stoffer ikke kan påvises i kommunen. Bruk av opiater og ecstasy øker også i en del kommuner, men det er også en relativt stor andel kommuner hvor det rapporteres om færre brukere eller at slike stoffer ikke finnes. Politiet og helse- og sosialetatene vurderer tendensene i utviklingen ganske likt for de fleste stoffer.\ud
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Rapporten gir i tillegg helse- og sosialetatenes og politiets vurdering av antall misbrukere, aldersforskjeller i bruk av narkotiske stoffer og personer på venteliste for LAR i kommunene. Den gir også oversikt over kommunenes arbeid med å utarbeide rusmiddelpolitisk handlingsplan.\ud
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I over halvparten av kommunene oppga helse- og sosialetaten at alkohol var det største problemet for både voksne og ungdom. Politiet vurderer narkotikabruk som mer alvorlig enn sosialetatene.ENGLISH SUMMARY: This report presents results from surveys in 2002 and 2003 regarding several aspects of illegal drug use in the 434 Norwegian municipalities. The respondents were the local health- and social services, the local police authorities and for some municipalities, street outreach services.\ud
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The general response rate from the health- and social services and the police was good, yielding coverage of 77 % and 80 % respectively in 2002 and 88 % and 91 % in 2003. Due to item non-response the coverage was not as good for each aspect under study. The number of municipalities covered is shown in the tables. Only 8 % of the municipalities had carried out a local survey which the figures were based on.\ud
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The respondents were asked whether the drug scene had changed during the year. Approximately 50 % of the municipalities reported no change in the use of drugs. However this figure varied with the type of drug and the year of reporting; figures for stability in the use of drugs ranged from 40 % to 64 %. Cannabis, amphetamine and tranquilizers have been the drugs most common in use. Almost 50 % of the municipalities reported an increase in the use of such drugs in 2002 and 40 % in 2003. Cocaine and solvents had the least increase and were the types of drugs most frequently reported as not present in the municipalities. Opiates did increase in approximately 20 % of the municipalities and decreased in or were not present in 20-30 % of them. The figures varied with the year of reporting and the respondent (social services, police). Ecstasy may have become less common to use; the reported proportion of municipalities with no users almost doubled to 23 % from 2002 to 2003.\ud
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The respondents were asked to report figures for the number of users of illegal drugs and injecting drug users, based on local knowledge. Such figures must be appreciated with caution. For the country as a whole, an interval from 18 to 30 per 1000 inhabitants 16-64 years of age would cover the true number of users of illegal drugs. Injecting drug use was far less common. In 2003 the survey yielded an average of 2 per 1000 persons 16-64 years in small municipalities (less than 5000 inhabitants), up to 9.4 per 1000 in the two largest municipalities with more than 160.000 inhabitants. No increase in such figures could be established from 2002 till 2003.\ud
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The type of drug used varied with age. Few reports of amphetamine and opiates were given for those younger than 18 years of age and few reports of GHB for those older than 40 years of age. Cannabis was the most common drug for all age groups. The second most common drug was solvents for those younger than 15 years of age, ecstasy/ tranquilizers for those 15-17 years, amphetamine for those 18-25 years, opiates/amphetamine for those 26-40 years and opiates for those more than 40 years of age. When two drugs are mentioned, the social services and the police reported differently. Heroin, the most used opiate, was commonly injected and so was amphetamine.\ud
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In 2003 14 % of the municipalities had an outreach service, 26 % had special housing projects for drug users and 18 % offered a low threshold service. In 2002 18 municipalities reported that they had a program for easy access to needles and syringes and so did 22 municipalities in 2003. Needles and syringes can otherwise be bought in pharmacies in Norway.\ud
The survey will continue on a yearly basis and thus it will be possible to compare longer time series with other indicators of the increase or decrease of illegal drug use and the kind of drugs used
Rusmiddelmisbrukernes helseproblemer og helsetjenestetilbud i et overordnet tilsynsperspektiv. En vurdering av sentrale datakilder
No full textNORSK SAMMENDRAG: I rapporten presenteres en oversikt over sentrale datakilder om rusmiddelmisbrukeres helsetilstand, det helsetjenestetilbudet disse pasientene mottar og tilgjengeligheten av tjenestetilbudet. Hovedvekten har vært lagt på tunge alkohol- og narkotikamisbrukere. En målsetning med rapporten har vært å vurdere om tilgjengelige datakilder på rusfeltet gir et tilfredsstillende grunnlag for tilsynsmyndighetens løpende overvåkning av området. Et annet mål med kunnskapsinnhentingen har vært å vurdere om det er områder hvor det er stor risiko for svikt, sett på bakgrunn av helsepolitiske målsetninger og myndighetskrav på området.\ud
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Kunnskapsgrunnlaget som er innhentet viser at:\ud
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Tilgjengelige kartleggingssystem, registre og annen statistikk er mangelfulle for å kunne gjennomføre en løpende tilsynsmessig overvåkning av rusfeltet. \ud
Det materialet som er blitt utledet fra tilsynsarbeid sentralt og regionalt, fra ulike forskningsrapporter, publikasjoner, osv, kan ikke sies å være tilfredsstillende når det gjelder tilsynsmessige vurderinger av rusmiddelmisbrukeres helsetilstand og det tjenestetilbudet de mottar. \ud
Det er et hovedinntrykk at mange rusmiddelmisbrukere ikke får de tjenestene de har behov for. Særlig bekymringsfullt er manglene i tjenestetilbudet til de tunge rusmiddelmisbrukerne, sett på bakgrunn av deres helseproblemer, de til dels alvorlige psykiske og somatiske lidelsene og den høye mortaliteten som preger denne gruppen.\ud
I den videre tilsynsmessige overvåkningen av rusområdet vil Helsetilsynet særlig ha fokus på tilgjengeligheten til tjenestene, forsvarligheten i behandlingstilbudene, samhandlingen innen og mellom behandlingsnivåene, og hvordan tjenestene tilrettelegger for medvirkning, informasjon og samtykke.SUMMARY IN ENGLISH: In this report, a review of central references about the health status of alcohol and drug abusers, the health services received by these people, and the availability of health services for them, is presented. The main emphasis is on alcohol and drug abusers with serious addiction. One aim of the report was to evaluate whether available references in this area give an adequate knowledge base for continuous surveillance of the area by the supervision authorities. Another aim has been to evaluate whether there are areas with a large risk of deficiency in provision of health services, according to health policy aims or requirements from the authorities in this area.\ud
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The Administrative alcohol and drug treatment reform was implemented on 1 January 2004. The reform transferred responsibility for treatment of alcohol and drug abusers from the county councils to the regional health authorities on behalf of the state. The regional health authorities’ new responsibility is defined as “interdisciplinary, specialised treatment of alcohol and drug abuse”. It forms part of the specialised health services on a par with the somatic and psychiatric services. The overriding objective of the reform is that alcohol and drug abusers with complex problems shall receive improved and more coordinated services, and that the results of treatment should be better. The changes have been made in order to make it easier for alcohol and drug abusers to receive the specialist health services that they need to improve their somatic and mental health. The reform has not entailed any changes in the responsibilities and tasks of the municipal authorities. The social services retain overall responsibility for provision and coordination of measures to help alcohol and drug abusers.\ud
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An important future task for the supervision authorities is to monitor whether the intentions of the alcohol and drug treatment reform are fulfilled, and whether the legislation is followed.\ud
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The review of available knowledge in this area has shown that statistics from surveys, registers and other sources are inadequate for the purpose of carrying out continuous monitoring of the alcohol and drug field. The general databases on municipal and specialist health services are organised in such a way that it is difficult to identify alcohol and drug abusers as a separate group. In addition, the national documentation systems in the alcohol and drug field have little data on patient flow, treatment methods and treatment results.\ud
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The information gained from central and regional supervision, from research reports, publications, studies etc., cannot be regarded as satisfactory to meet the needs of the supervisory authorities for evaluation of alcohol and drug abusers’ health status and their use of available health services.\ud
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However, the main impression gained from the available data and information is that many alcohol and drug users do not receive the services they require. In particular, the health problems, the level of physical and mental illness and the high mortality among alcohol and drug abusers with serious addiction give special cause for concern. However, the threshold for receiving help from the specialist health services is often high. Supply of specialist health services, both acute medical help and long-term treatment, is often inadequate. But in addition, general health services, such as regular general medical practitioner services, dental services, nursing and care services and health services in prisons, often function inadequately for alcohol and drug abusers. Lack of coordination between different levels, such as between health and social services, often acts as a barrier to achieving the aims of the treatment programme.\ud
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Based on the knowledge that has been collected, the conclusion is that there are clear indications that many alcohol and drug abusers do not receive their right to be provided with essential health care. In planning supervision of the alcohol and drug field in 2006 on a country-wide basis, the Norwegian Board of Health will take into account the areas identified in this report where there is a risk that deficiencies in provision of health services can occur. When monitoring the alcohol and drug field in the future, we will particularly focus on availability of services, professional standards, cooperation between and within treatment levels, and how services are organized to ensure adequate patient participation, information and consent
Ungdoms etterspørsel etter alkohol. En empirisk analyse basert på intervjudata 1990-2004
No full textNORSK SAMMENDRAG: I rapporten studeres ungdoms forbruk av alkohol. Forhold som påvirker om og eventuelt hvor mye ungdommer drikker blir analysert. Sammenhengen mellom ungdommers alkoholforbruk og priser, og mellom forbruk og aldersgrenser blir studert spesielt.\ud
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Undersøkelsen bygger på svar fra 32 000 ungdommer fra 15 til 20 år samlet inn fra 1990 til 2004. I denne perioden har ikke andelen som noen gang har drukket alkohol endret seg. Debutalderen har også vært stabil på ca 15 år. Alkoholbruken blant ungdom som har drukket har imidlertid økt betydelig. Det samlede konsumet har økt med 50 prosent, fra et gjennomsnitt på 0,18 liter ren alkolhol per måned i 1990 til 0,27 liter ren alkohol i 2004.\ud
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Rapporten konkluderer med at både aldersgrensen og avgiftspolitikken ser ut å virke inn på ungdoms alkoholforbruk. Prisen har sannsynligvis større betydning for hvor mye som drikkes enn om ungdom velger å drikker i det hele tatt. Aldersgrensen ser ut til å ha sterkest effekt for kjøp av øl og vin, og der er også for øl at man finner klare effekter av avgiftspolitikken.ENGLISH SUMMARY: Official policy in Norway seeks to restrict the consumption of alcohol, especially by young people. This report looks at youth consumption patterns with regard to beer, wine and spirits. We probe factors affecting the decision to drink over the past month and how much is drunk. We also investigated other aspects of young people’s drinking patterns, such as changes in the proportion claiming to have touched alcohol at some time; whether there was an increase in the number of young people claiming to have been drunk; whether alcopop’s share of young people’s total consumption had grown; dealings with moonshining etc.\ud
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There has been little scientific focus on the impact of excise duties on youth drinking patterns either by the Norwegian or indeed international research community. But given that alcohol taxes are considered a prime policy instrument because they directly affect retail prices, we were particularly interested to explore the relationship between the price of alcohol and youth alcohol consumption patterns. We investigated the importance of price changes on young people reporting having drunk in the past month; the extent to which alcohol consumption of those who drink is affected by price changes; we studied drinking patterns in relation to age limits enacted by the authorities on the purchase of different alcoholic beverages. Age limits make it more difficult to obtain alcohol, and represents for potential under-age shoppers an added transaction cost.\ud
The body of the data used in this analysis was collected by SIRUS. Between 1990 and 2004 a total of 32,000 young people (15–20), resident in Norway, were questioned about drugs and drink. The surveys included questions about tobacco, alcohol and drug use, as well as obtaining information on standard variables like sex, age, education, domicile etc.\ud
We found no change in the period covered by this study (1990–2004) in the number of respondents reporting having ever drunk alcohol, but we did discover a change in young people’s drinking preferences. The number reporting having ever drunk beer, wine or spirits fell; we found however high alcopop consumption levels in 2003–04 (the years for which we have data on alcopop), significantly higher in fact than for the other types of drink. The alcohol debut age remained stable over the period (at about fifteen), whether the drink in question was beer, wine or spirits.\ud
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On the other hand, alcohol consumption by youngsters who drink rose significantly, as much as 50 per cent overall, and ranging from an average 0.18 litres pure alcohol per month in 1990 to 0.27 litres pure alcohol in the past couple of years. Spirits and alcopop saw a particularly steep rise. Those reporting having drunk wine, spirits and alcopop recently increased in number, as did the frequency of drinking events. The percentage reporting having drunk in the past four weeks rose from about 60 per cent at the start of the period to about 66 per cent by 2003/04.\ud
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Alcopop was introduced to the Norwegian market in 1998, but did not really take off until high street retailers were allowed to sell it over the counter. By 2004, alcopop represented 40 per cent of young girls’ (eighteen) reported alcohol consumption; the percentage was lower for slightly older girls and boys in the same age-group. Beer was the most popular drink among boys by a good margin. About 75 per cent of our respondents had been drunk at least once (68 per cent within the past six months), and nearly 20 per cent more than fifty times. Frequency of drunkenness reported by the girls in our sample is no different from the boys.\ud
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As expected, the data show a rise in the average consumption of beer, wine, spirits and alcopop with age. We find the sharpest rise in beer, wine and alcopop consumption when the youngsters turn eighteen; beer consumption increases most. Beyond the age of eighteen, alcohol consumption continues to rise, but not as rapidly as with the lower age-groups. The over-eighteens drank on average twice as much beer as the under-eighteens. Surprisingly, we found the sharpest rise in the consumption of spirits across the fifteen–sixteen divide.\ud
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Two methods are used in the report to analyse the data. We wanted separate analyses of whether the youngsters had drunk over the past month and how much they (i.e. those reporting having drunk at all) had drunk. As expected, several variables, such as sex and age for instance, were shown by the two methods to affect both the decision to drink beer, wine and spirits, and quantities, and in the same direction. One factor which influences the decision to drink then also affects how much alcohol is consumed. The effects of other variables – such as place of residence – were not as transparent.\ud
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We used method 1 to analyse factors affecting the decision to drink beer, wine and spirits in the month before completing the questionnaire. The data do not include information on every factor known to influence decisions to drink (we lack data on, for instance, peer pressure, disposable income etc.), and for that reason we used an analytical method (multivariate probit) which takes at least some account of such non-observed factors. The impact of price on the likelihood of drinking is not very great according to our findings. The low effect of price could mean other factors play a greater role in young people’s decisions to drink, or that the prices provided by outlets and the Vinmonopol failed to represent the prices young people actually pay. We did find a positive correlation between high price and decreased likelihood of beer drinking, but it was not significant. We also found a positive correlation between the likelihood of drinking wine and the price of wine, probably explained by Norway’s changing drinking habits in recent years, giving wine an increasingly dominant place despite increasing prices. In the model for spirits, the relationship between price and likelihood of drinking spirits was not significant. This is probably because many of our respondents were not paying normal Vinmonopol prices for the spirits they consumed. There is evidence to suggest that a significant share of the spirits consumed by young people is either paid for by others, purloined from parental stocks or illegally manufactured/traded.\ud
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From the range of available alcohol beverages, boys are most likely to drink beer and spirits, while girls tend to prefer wine. Respondents with part-time work were more likely to drink beer, wine and spirits than those without a paid job. And respondents holding a full-time job were more likely to consume spirits. Living with one or both parents resulted in a lower likelihood of drinking beer, wine and spirits, in contrast to living apart from their parents.\ud
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Using method 2 we analysed alcohol consumption of respondents claiming to have consumed alcohol during the month prior to the questionnaire. We made allowances for the fact that these respondents make up a distinct sub-group of the sample per se, and adopted an analytical approach (Heckman’s two stage estimation procedure) which allowed us to generalise our findings across the entire youth population. The estimates on price sensitivity and our reading of them differ according to the type of beverage in question
Pasienterfaringer ved poliklinikker for voksne i det psykiske helsevernet i Norge – Institusjonsvise resultater
No full textNasjonalt kunnskapssenter for helsetjenesten har i 2004 gjennomført en pasienterfaringsundersøkelse ved somatiske poliklinikker og dagavdelinger i Helse Øst, Helse Sør og Helse Midt-Norge. Det er utarbeidet tre rapporter fra undersøkelsen; hovedresultater, institusjonsvise resultater og metodedokumentasjon.\ud
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Til sammen 12 443 pasienter som var til konsultasjon i perioden 1.-14. september 2004 har svart på spørreskjema om pasienterfaringer. Svarprosenten i undersøkelsen er på 53. Det er skjevheter i utvalget etter sykehus og alder, og det er grunn til å tro at de sykeste, de med størst funksjonssvikt, de som ikke forstår norsk godt nok og de som ikke har fast bopel er underrepresentert i undersøkelsen. Polikliniske pasienter er i stor grad fornøyde med tjenestene de har mottatt. Mest fornøyd er de med tilgjengeligheten og standarden ved poliklinikkene, minst fornøyd er de med opplevelser i forkant av besøket og informasjon. Menn og kvinner er like fornøyde med poliklinikkene, mens eldre pasienter er mer tilfredse enn yngre pasienter. Pasienter som opplever sin helsetilstand som dårlig er i mindre grad fornøyde enn pasienter som opplever helsetilstanden sin som bra.\ud
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Pasienter som hadde behov for å endre time og opplevde at dette var lett å få til, er mer fornøyde enn de som mener det var vanskelig å endre time. Pasienter som erfarte at timen ble utsatt/flyttet uten at de ba om det er mindre fornøyde enn pasienter som ikke opplevde dette. Videre er pasientene mer fornøyde dersom de har hatt time med samme behandler tidligere, enn om de treffer en ny behandler. Pasienter som mener at de har blitt feilbehandlet er logisk nok mer misfornøyd enn pasienter som ikke opplever seg som feilbehandlet.\ud
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Pasientene er fornøyde med de polikliniske tjenestene i alle helse-regionene. Hovedområdene standard og tilgjengelighet får best tilbakemelding fra pasientene i alle regionene, mens erfaringer før besøket og informasjon kommer dårligst ut. Vi finner små forskjeller i pasienttilfredshet mellom helseforetak og institusjoner innad i hver helseregion.\ud
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I Helse Øst er det liten variasjon mellom helseforetakene og institusjonene. De største forskjellene finner vi når det gjelder tilgjengelighet, standard og erfaringer før besøket. Ullevål universitetssykehus og Akershus Universitetssykehus har signifikant dårligere resultater enn gjennomsnittet for hele materialet på de fleste hovedområder, mens de private spesialsykehusene kommer bedre ut enn gjennomsnittet. I Helse Sør er det også liten variasjon mellom helseforetakene og institusjonene.\ud
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De største forskjellene finner vi på tilgjengelighet, informasjon og erfaringer før besøket. Sørlandet sykehus HF og Ringerike sykehus HF har signifikant bedre resultater enn totalsnittet på majoriteten av hovedområdene. Det er også små forskjeller mellom helseforetak og institusjoner i Helse Midt-Norge. De største forskjellene finner vi på områdene tilgjengelighet, standard og erfaringer før besøket. St.Olavs Hospital HF har signifikant dårligere resultat enn totalsnittet på halvparten av hovedområdene
Pasienterfaringer ved poliklinikker for voksne i det psykiske helsevernet i Norge – Hovedresultater
No full textMeldesentralen – årsrapport 2003
No full textNORSK SAMMENDRAG: For 2003 er det registrert 1810 uønskede hendelser som utløste meldeplikt til Helsetilsynet i fylket. Antall meldinger om pasientskade i 2003 har økt noe sammenliknet med de siste par år. \ud
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Det fremgår i for liten grad av materialet hva virksomhetene iverksetter av tiltak for å hindre at uønskede hendelser oppstår, og gjentar seg. Det understrekes at det i tråd med det lovpålagte kravet om internkontroll er et lokalt ansvar å følge opp uønskede hendelser i helsetjenesten. Helsetilsynet finner det bekymringsfullt at antall meldinger tyder på at det fortsatt bare er toppen av isfjellet som avdekkes når det gjelder skade på pasienter i spesialisthelsetjenesten. \ud
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Helsetilsynet er av den oppfatning at de helseinstitusjoner som melder flest uønskede hendelser i større grad har et kvalitetssystem som fungerer enn de institusjoner som melder lite eller ingenting.SUMMARY IN ENGLISH: In 2003, 1 810 adverse events were registered, that involved a duty to report to the Norwegian Board of Health in the counties. The number of reports of injuries to patients in 2003 has increased slightly, compared to the number during the last few years.\ud
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The material does not provide adequate information about what measures were taken by the organizations to prevent adverse events happening and being repeated. It is pointed out that, according to the legal requirements on internal control, responsibility for following up adverse events in the health services lies with the institution where the event occurred.\ud
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The Norwegian Board of Health is concerned that the reports represent only the tip of the iceberg, with regard to the occurrence of injuries to patients in specialist health services. The Norwegian Board of Health believes that the health institutions that send in the most reports of adverse events are those institutions that have better-functioning quality control systems than those institutions who report few or no events