1. Margareta Kristenson, Anita Jernberger, Preben Bendtsen The Swedish Network for Health Promoting Hospitals Patient Orientation by means of Health Related Quality of Life (HRQoL) measurements in routine care

2. In April 2003 the Swedish Government decided on New National Targets for Public Health n One of these is named –A more Health Oriented Health Service

3. n Reorientation towards health n Health Orientation n Outcome orientation How can that be achieved? Health Promoting Hospitals

4. Hospitlas shall.. n.. support the perceived health, function ability and well-being of patients with chronic disease, i.e. also where cure is not available

5. The concept of health WHO 1945 A state of physical, social and mental well-being, not only the absence of disease

6. Disease prevention and health promotion Disease prevention: The prevention of a specific disease Health Promotion: ” The process which helps people to gain control over their own health” ” The process which helps people to gain control over their own health”

7. Health, disease and well-being perspectives

8. Why measure health?

9. (Outcome) measures in Hospilats n Economy n Activities-productivity n Outcomes: n Professional measures; X-ray, lab etc. n Self reported measures; satisfaction with care, access, self rated health and HRQoL.

10. Quality of Life and Health related Quality of Life HRQoL effects of disease and /or handicap on individual self-rated health and on physical, mental and social wellbeing

11. Measures of HRQoL n Two main instuments n SF -36 a broad profile n EuroQol one measure (utility)

15. Pubic health survey 1999

16. Public Health Survey 1999

23. SF-36 patient with COPD

24. SF-36 patients with COPD

27. Experiences of pilot phase using SF-36 in a routine clinical setting on patients with COPD n The method is feasible for patients and personnel n Small correlation between SF -36 and measures of lung function n The inclusion of these measures in clinical evaluations supports a more holistic approach in the heath services

28. Experiences of pilot phase (2) n Using an instrument like SF-36 starts a learning process in the organisation towards patient centred outcomes. Bendtsen P, Lerijon M, Sommer AS and Kristenson M, Measuring health-related quality of life in patients with chronic obstructive pulmonary disease in a routine hospital setting: Feasibility and perceived value. Health and Quality of Life Outcomes 2003, 1:5

29. From pilot to broad use in the Swedish Network on HPH A computerised version of the SF-36 is available for all member hospitals. 10 hospitals active, patient groups are n pulmonary disease n mental disease n obesity n smoking

30. Measures of HRQoL relevant indicators for HPH Outcomes in daily clinical practice and yearly “Health accounts” for patients, personnel and the population