This study examined the use of telemedicine as a means to follow up infants discharged from a Swe... more This study examined the use of telemedicine as a means to follow up infants discharged from a Swedish neonatal intensive care unit to home health care. Methods: Families were randomised to either a control group receiving standard home health care (n = 42 families) or a telemedicine group receiving home health care with telemedicine support (n = 47 families) after discharge from the hospital. Both groups had follow-up hospital appointments with the neonatal nurse. In the telemedicine group, appointments were supplemented by the use of a specially designed web page and video calls. Results: The use of the web page and video calls decreased the number of emergency visits to the hospital (p = 0.047). In the telemedicine group, 26% of the families felt they had more scheduled appointments than necessary, whereas only 6% of the families in the control group thought so (p = 0.037). The parents were highly satisfied with the use of telemedicine. Although the nurses were favourable to using telemedicine, the rigid organisation of the home healthcare programme and the nurses' schedules and work routines prevented its optimal use. Conclusion: The use of telemedicine decreased the need of hospital visits. Organisational adaptations would be necessary to make the best use of telemedicine.
Hemodynamic measurements were performed in 10 healthy women undergoing elective laparoscopy for t... more Hemodynamic measurements were performed in 10 healthy women undergoing elective laparoscopy for the investigation of infertility. A standardized anesthetic technique which included the application of positive end–expiratory pressure (PEEP), 0.49 kPa (3.7 mmHg) was utilized. The following variables were studied: cardiac output, stroke volume and left ventricular ejection time (determined non–invasively with impedance cardiography), heart rate, blood pressure, total peripheral vascular resistance and end–tidal carbon dioxide (ET–CO2). The combination of 25 head–down tilt and PEEP ventilation during laparoscopy was associated with a pressure response that restored arterial pressures to essentially pre–anesthetic levels. Net cardiac effects were small. With this regime low pressure 0.7–1.1 kPa (5–8 mmHg) intra–abdominal insufflation with CO2 was associated with only minor cardiovascular changes. There were no indications that 0.49 kPa PEEP during laparoscopy produced adverse cardiovascular effects. The application of PEEP reduced (P < 0.001) ET–CO2. There was no net increase in ET–CO2 after CO2–insufflation compared to the measurement after induction of anesthesia. This is in contrast to earlier studies without PEEP where a significant net increase in ET–CO2 was reported after CO2–insufflation.
The project Mobimed started in 1988. The purpose of the project was to develop a telemedicine sys... more The project Mobimed started in 1988. The purpose of the project was to develop a telemedicine system where patient information text as well as data reflecting the status of various physiological parameters could be transmitted from a mobile terminal to a resident terminal at a hospital or similar place. The information transmitted was to be so comprehensive that a physician at the hospital together with the personnel attending the patient could make a diagnosis and suggest therapy. At the hospital all transmitted data should be stored automatically. Since September 1989 a prototype system is running in Sweden with one ambulance connected to two hospitals. This system is using the Mobitex* and speech transmission system for data transmission. As a first step the project is oriented towards ECG-monitoring. Mobimed has also been developed for laptop computers using the ordinary telephone network. In this case Mobimed can be used at home or anyplace where wireless transmission is not required. 1.
Thoracic trauma is one of the most common and lethal types of injury, causing over a quarter of t... more Thoracic trauma is one of the most common and lethal types of injury, causing over a quarter of traumatic deaths. Severe thoracic injuries are often occult and difficult to diagnose in the field. There is a need for a point-of-care diagnostic device for severe thoracic injuries in the prehospital setting. Electrical bioimpedance (EBI) is non-invasive, portable, rapid and easy to use technology that can provide objective and quantitative diagnostic information for the prehospital environment. Here, we evaluated the performance of EBI to detect thoracic injuries. In this open study, EBI resistance (R), reactance (X) and phase angle (PA) of both sides of the thorax were measured at 50 kHz on patients suffering from thoracic injuries (n = 20). In parallel, a control group consisting of healthy subjects (n = 20) was recruited. A diagnostic mathematical algorithm, fed with input parameters derived from EBI data, was designed to differentiate patients from healthy controls. Ratios between the X and PA measurements of both sides of the thorax were significantly different (p < 0.05) between healthy volunteers and patients with left- and right-sided injuries. The diagnostic algorithm achieved a performance evaluated by leave-one-out cross-validation analysis and derived area under the receiver operating characteristic curve of 0.88. A diagnostic algorithm that accurately discriminates between patients suffering thoracic injuries and healthy subjects was designed using EBI technology. A larger, prospective and blinded study is thus warranted to validate the feasibility of EBI technology as a prehospital tool.
Studies in health technology and informatics, May 18, 2023
Many digital health projects often stop in the pilot or test phase. Realisation of new digital he... more Many digital health projects often stop in the pilot or test phase. Realisation of new digital health services is often challenging due to lack of guidelines for the step-by-step roll-out and implementation of the systems when changing work processes and procedures are needed. This study describes development of the Verified Innovation Process for Healthcare Solutions (VIPHS)-a stepwise model for digital health innovation and utilisation using service design principles. A multiple case study (two cases) involving participant observation, role play, and semi-structured interviews were conducted for the model development in prehospital settings. The model might be helpful to support realisation of innovative digital health projects in a holistic, disciplined, and strategic way.
BACKGROUNDTo reduce the effects of a traffic accident it is essential to transport the casualties... more BACKGROUNDTo reduce the effects of a traffic accident it is essential to transport the casualties to the right care facility with minimal delay. For (single) accidents involving Vulnerable Road Use ...
IEEE Transactions on Intelligent Transportation Systems, May 1, 2022
Driver sleepiness constitutes a well-known traffic safety risk. With the introduction of automate... more Driver sleepiness constitutes a well-known traffic safety risk. With the introduction of automated driving systems, the chance of getting sleepy and even falling asleep at wheel could increase further. Conventional sleepiness detection methods based on driving performance and behavior may not be available under automated driving. Methods based on physiological measurements such as heart rate variability (HRV) becomes a potential solution under automated driving. However, with reduced task load, HRV could potentially be affected by automated driving. Therefore, it is essential to investigate the influence of automated driving on the relation between HRV and sleepiness. Data from real-road driving experiments with 43 participants were used in this study. Each driver finished four trials with manual and partial automated driving under normal and sleep-deprived condition. Heart rate was monitored by consumer wearable chest bands. Subjective sleepiness based on Karolinska sleepiness scale was reported at five min interval as ground truth. Reduced heart rate and increased overall variability were found in association with severe sleepy episodes. A binary classifier based on the AdaBoost method was developed to classify alert and sleepy episodes. The results indicate that partial automated driving has small impact on the relationship between HRV and sleepiness. The classifier using HRV features reached area under curve (AUC) = 0.76 and it was improved to AUC = 0.88 when adding driving time and day/night information. The results show that Manuscript
International journal of gynaecology and obstetrics, Dec 1, 1994
The rapid developments that have occurred in telecommunications, computer and information technol... more The rapid developments that have occurred in telecommunications, computer and information technology affects all of us in our day-today lives regardless of profession. We live in a world where
In Sweden, as in many other countries, paramedics or nurses constitute the majority of prehospita... more In Sweden, as in many other countries, paramedics or nurses constitute the majority of prehospital personnel. If tasks usually performed by doctors are to be performed by these personnel, there is a need for guidelines and triage in the handling of medical emergencies. We describe an information management system used in ambulances for data communication, documentation, triaging and presentation of checklists. In most cases, data are input while the patient is being cared for. The information is collected and stored together with data automatically received from the dispatch centre. The latter date are transferred by a mobile radio network to the ambulance. Medical date (e.g. electrocardiograms) are transferred from the ambulance over the data network to the receiving medical facility. All transferred data are finally collected in a database for statistical analysis and follow-up.
BMC Medical Informatics and Decision Making, Aug 9, 2014
Background: Errors in the decision-making process are probably the main threat to patient safety ... more Background: Errors in the decision-making process are probably the main threat to patient safety in the prehospital setting. The reason can be the change of focus in prehospital care from the traditional "scoop and run" practice to a more complex assessment and this new focus imposes real demands on clinical judgment. The use of Clinical Guidelines (CG) is a common strategy for cognitively supporting the prehospital providers. However, there are studies that suggest that the compliance with CG in some cases is low in the prehospital setting. One possible way to increase compliance with guidelines could be to introduce guidelines in a Computerized Decision Support System (CDSS). There is limited evidence relating to the effect of CDSS in a prehospital setting. The present study aimed to evaluate the effect of CDSS on compliance with the basic assessment process described in the prehospital CG and the effect of On Scene Time (OST). Methods: In this time-series study, data from prehospital medical records were collected on a weekly basis during the study period. Medical records were rated with the guidance of a rating protocol and data on OST were collected. The difference between baseline and the intervention period was assessed by a segmented regression. Results: In this study, 371 patients were included. Compliance with the assessment process described in the prehospital CG was stable during the baseline period. Following the introduction of the CDSS, compliance rose significantly. The post-intervention slope was stable. The CDSS had no significant effect on OST. Conclusions: The use of CDSS in prehospital care has the ability to increase compliance with the assessment process of patients with a medical emergency. This study was unable to demonstrate any effects of OST.
This checklist has been adapted for use with protocol submissions to Systematic Reviews from Tabl... more This checklist has been adapted for use with protocol submissions to Systematic Reviews from Table 3 in Moher D et al: Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic Reviews 2015 4:1 Section/topic # Checklist item Information reported Line number(s) Yes No ADMINISTRATIVE INFORMATION Title Identification 1a Identify the report as a protocol of a systematic review Page 1, Line 4 Update 1b If the protocol is for an update of a previous systematic review, identify as such Registration 2 If registered, provide the name of the registry (e.g., PROSPERO
Objective: Driver fatigue is considered to be a major contributor to road traffic crashes. Cardia... more Objective: Driver fatigue is considered to be a major contributor to road traffic crashes. Cardiac monitoring and heart rate variability (HRV) analysis is a candidate method for early and accurate detection of driver sleepiness. This study has 2 objectives: to evaluate the (1) suitability of different preprocessing strategies for detecting and removing outlier heartbeats and spectral transformation of HRV signals and their impact of driver sleepiness assessment and (2) relation between common HRV indices and subjective sleepiness reported by a large number of drivers in real driving situations, for the first time. Methods: The study analyzed >3,500 5-min driving epochs from 76 drivers on a public motorway in Sweden. The electrocardiograph (ECG) data were recorded in 3 studies designed to evaluate the physiological differences between awake and sleepy drivers. The drivers reported their perceived level of sleepiness according to the Karolinska Sleepiness Scale (KSS) every 5 min. Two standard methods were used for identifying outlier heartbeats: (1) percentage change (PC), where outliers were defined as interbeat intervals deviating >30% from the mean of the four previous intervals and (2) standard deviation (SD), where outliers were defined as interbeat interval deviating >4 SD from the mean interval duration in the current epoch. Three standard methods were used for spectral transformation, which is needed for deriving HRV indices in the frequency domain: (1) Fourier transform; (2) autoregressive model; and (3) Lomb-Scargle periodogram. Different preprocessing strategies were compared regarding their impact on derivation of common HRV indices and their relation to KSS data distribution, using box plots and statistical tests such as analysis of variance (ANOVA) and Student's t test. Results: The ability of HRV indices to discriminate between alert and sleepy drivers does not differ significantly depending on which outlier detection and spectral transformation methods are used. As expected, with increasing sleepiness, the heart rate decreased, whereas heart rate variability overall increased. Furthermore, HRV parameters representing the parasympathetic branch of the autonomous nervous system increased. An unexpected finding was that parameters representing the sympathetic branch of the autonomous nervous system also increased with increasing KSS level. We hypothesize that this increment was due to stress induced by trying to avoid an incident, because the drivers were in real driving situations. Conclusions: The association of HRV indices to KSS did not depend on the preprocessing strategy. No preprocessing method showed superiority for HRV association to driver sleepiness. This was also true for combinations of methods for frequency domain HRV indices. The results prove clear relationships between HRV indices and perceived sleepiness. Thus, HRV analysis shows promise for driver sleepiness detection.
The number of elderly people in the society is increasing, and with that the expected the health ... more The number of elderly people in the society is increasing, and with that the expected the health care costs. One reason for this is that the probability of contracting a chronic illness increases with age. Congestive heart failure (CHF) is a typical such illness and it affects ...
Allt eftersom antalet äldre och långtidssjuka ökar i samhället, förväntas också kostnaderna för s... more Allt eftersom antalet äldre och långtidssjuka ökar i samhället, förväntas också kostnaderna för sjuk-och hälsovård att öka. Hjärtsvikt är en sjukdom som drabbar omkring 2 % av befolkningen i västvärden, och de flesta patienter är över 60 år. Denna sjukdom spelar därför ...
This study examined the use of telemedicine as a means to follow up infants discharged from a Swe... more This study examined the use of telemedicine as a means to follow up infants discharged from a Swedish neonatal intensive care unit to home health care. Methods: Families were randomised to either a control group receiving standard home health care (n = 42 families) or a telemedicine group receiving home health care with telemedicine support (n = 47 families) after discharge from the hospital. Both groups had follow-up hospital appointments with the neonatal nurse. In the telemedicine group, appointments were supplemented by the use of a specially designed web page and video calls. Results: The use of the web page and video calls decreased the number of emergency visits to the hospital (p = 0.047). In the telemedicine group, 26% of the families felt they had more scheduled appointments than necessary, whereas only 6% of the families in the control group thought so (p = 0.037). The parents were highly satisfied with the use of telemedicine. Although the nurses were favourable to using telemedicine, the rigid organisation of the home healthcare programme and the nurses' schedules and work routines prevented its optimal use. Conclusion: The use of telemedicine decreased the need of hospital visits. Organisational adaptations would be necessary to make the best use of telemedicine.
Hemodynamic measurements were performed in 10 healthy women undergoing elective laparoscopy for t... more Hemodynamic measurements were performed in 10 healthy women undergoing elective laparoscopy for the investigation of infertility. A standardized anesthetic technique which included the application of positive end–expiratory pressure (PEEP), 0.49 kPa (3.7 mmHg) was utilized. The following variables were studied: cardiac output, stroke volume and left ventricular ejection time (determined non–invasively with impedance cardiography), heart rate, blood pressure, total peripheral vascular resistance and end–tidal carbon dioxide (ET–CO2). The combination of 25 head–down tilt and PEEP ventilation during laparoscopy was associated with a pressure response that restored arterial pressures to essentially pre–anesthetic levels. Net cardiac effects were small. With this regime low pressure 0.7–1.1 kPa (5–8 mmHg) intra–abdominal insufflation with CO2 was associated with only minor cardiovascular changes. There were no indications that 0.49 kPa PEEP during laparoscopy produced adverse cardiovascular effects. The application of PEEP reduced (P < 0.001) ET–CO2. There was no net increase in ET–CO2 after CO2–insufflation compared to the measurement after induction of anesthesia. This is in contrast to earlier studies without PEEP where a significant net increase in ET–CO2 was reported after CO2–insufflation.
The project Mobimed started in 1988. The purpose of the project was to develop a telemedicine sys... more The project Mobimed started in 1988. The purpose of the project was to develop a telemedicine system where patient information text as well as data reflecting the status of various physiological parameters could be transmitted from a mobile terminal to a resident terminal at a hospital or similar place. The information transmitted was to be so comprehensive that a physician at the hospital together with the personnel attending the patient could make a diagnosis and suggest therapy. At the hospital all transmitted data should be stored automatically. Since September 1989 a prototype system is running in Sweden with one ambulance connected to two hospitals. This system is using the Mobitex* and speech transmission system for data transmission. As a first step the project is oriented towards ECG-monitoring. Mobimed has also been developed for laptop computers using the ordinary telephone network. In this case Mobimed can be used at home or anyplace where wireless transmission is not required. 1.
Thoracic trauma is one of the most common and lethal types of injury, causing over a quarter of t... more Thoracic trauma is one of the most common and lethal types of injury, causing over a quarter of traumatic deaths. Severe thoracic injuries are often occult and difficult to diagnose in the field. There is a need for a point-of-care diagnostic device for severe thoracic injuries in the prehospital setting. Electrical bioimpedance (EBI) is non-invasive, portable, rapid and easy to use technology that can provide objective and quantitative diagnostic information for the prehospital environment. Here, we evaluated the performance of EBI to detect thoracic injuries. In this open study, EBI resistance (R), reactance (X) and phase angle (PA) of both sides of the thorax were measured at 50 kHz on patients suffering from thoracic injuries (n = 20). In parallel, a control group consisting of healthy subjects (n = 20) was recruited. A diagnostic mathematical algorithm, fed with input parameters derived from EBI data, was designed to differentiate patients from healthy controls. Ratios between the X and PA measurements of both sides of the thorax were significantly different (p < 0.05) between healthy volunteers and patients with left- and right-sided injuries. The diagnostic algorithm achieved a performance evaluated by leave-one-out cross-validation analysis and derived area under the receiver operating characteristic curve of 0.88. A diagnostic algorithm that accurately discriminates between patients suffering thoracic injuries and healthy subjects was designed using EBI technology. A larger, prospective and blinded study is thus warranted to validate the feasibility of EBI technology as a prehospital tool.
Studies in health technology and informatics, May 18, 2023
Many digital health projects often stop in the pilot or test phase. Realisation of new digital he... more Many digital health projects often stop in the pilot or test phase. Realisation of new digital health services is often challenging due to lack of guidelines for the step-by-step roll-out and implementation of the systems when changing work processes and procedures are needed. This study describes development of the Verified Innovation Process for Healthcare Solutions (VIPHS)-a stepwise model for digital health innovation and utilisation using service design principles. A multiple case study (two cases) involving participant observation, role play, and semi-structured interviews were conducted for the model development in prehospital settings. The model might be helpful to support realisation of innovative digital health projects in a holistic, disciplined, and strategic way.
BACKGROUNDTo reduce the effects of a traffic accident it is essential to transport the casualties... more BACKGROUNDTo reduce the effects of a traffic accident it is essential to transport the casualties to the right care facility with minimal delay. For (single) accidents involving Vulnerable Road Use ...
IEEE Transactions on Intelligent Transportation Systems, May 1, 2022
Driver sleepiness constitutes a well-known traffic safety risk. With the introduction of automate... more Driver sleepiness constitutes a well-known traffic safety risk. With the introduction of automated driving systems, the chance of getting sleepy and even falling asleep at wheel could increase further. Conventional sleepiness detection methods based on driving performance and behavior may not be available under automated driving. Methods based on physiological measurements such as heart rate variability (HRV) becomes a potential solution under automated driving. However, with reduced task load, HRV could potentially be affected by automated driving. Therefore, it is essential to investigate the influence of automated driving on the relation between HRV and sleepiness. Data from real-road driving experiments with 43 participants were used in this study. Each driver finished four trials with manual and partial automated driving under normal and sleep-deprived condition. Heart rate was monitored by consumer wearable chest bands. Subjective sleepiness based on Karolinska sleepiness scale was reported at five min interval as ground truth. Reduced heart rate and increased overall variability were found in association with severe sleepy episodes. A binary classifier based on the AdaBoost method was developed to classify alert and sleepy episodes. The results indicate that partial automated driving has small impact on the relationship between HRV and sleepiness. The classifier using HRV features reached area under curve (AUC) = 0.76 and it was improved to AUC = 0.88 when adding driving time and day/night information. The results show that Manuscript
International journal of gynaecology and obstetrics, Dec 1, 1994
The rapid developments that have occurred in telecommunications, computer and information technol... more The rapid developments that have occurred in telecommunications, computer and information technology affects all of us in our day-today lives regardless of profession. We live in a world where
In Sweden, as in many other countries, paramedics or nurses constitute the majority of prehospita... more In Sweden, as in many other countries, paramedics or nurses constitute the majority of prehospital personnel. If tasks usually performed by doctors are to be performed by these personnel, there is a need for guidelines and triage in the handling of medical emergencies. We describe an information management system used in ambulances for data communication, documentation, triaging and presentation of checklists. In most cases, data are input while the patient is being cared for. The information is collected and stored together with data automatically received from the dispatch centre. The latter date are transferred by a mobile radio network to the ambulance. Medical date (e.g. electrocardiograms) are transferred from the ambulance over the data network to the receiving medical facility. All transferred data are finally collected in a database for statistical analysis and follow-up.
BMC Medical Informatics and Decision Making, Aug 9, 2014
Background: Errors in the decision-making process are probably the main threat to patient safety ... more Background: Errors in the decision-making process are probably the main threat to patient safety in the prehospital setting. The reason can be the change of focus in prehospital care from the traditional "scoop and run" practice to a more complex assessment and this new focus imposes real demands on clinical judgment. The use of Clinical Guidelines (CG) is a common strategy for cognitively supporting the prehospital providers. However, there are studies that suggest that the compliance with CG in some cases is low in the prehospital setting. One possible way to increase compliance with guidelines could be to introduce guidelines in a Computerized Decision Support System (CDSS). There is limited evidence relating to the effect of CDSS in a prehospital setting. The present study aimed to evaluate the effect of CDSS on compliance with the basic assessment process described in the prehospital CG and the effect of On Scene Time (OST). Methods: In this time-series study, data from prehospital medical records were collected on a weekly basis during the study period. Medical records were rated with the guidance of a rating protocol and data on OST were collected. The difference between baseline and the intervention period was assessed by a segmented regression. Results: In this study, 371 patients were included. Compliance with the assessment process described in the prehospital CG was stable during the baseline period. Following the introduction of the CDSS, compliance rose significantly. The post-intervention slope was stable. The CDSS had no significant effect on OST. Conclusions: The use of CDSS in prehospital care has the ability to increase compliance with the assessment process of patients with a medical emergency. This study was unable to demonstrate any effects of OST.
This checklist has been adapted for use with protocol submissions to Systematic Reviews from Tabl... more This checklist has been adapted for use with protocol submissions to Systematic Reviews from Table 3 in Moher D et al: Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic Reviews 2015 4:1 Section/topic # Checklist item Information reported Line number(s) Yes No ADMINISTRATIVE INFORMATION Title Identification 1a Identify the report as a protocol of a systematic review Page 1, Line 4 Update 1b If the protocol is for an update of a previous systematic review, identify as such Registration 2 If registered, provide the name of the registry (e.g., PROSPERO
Objective: Driver fatigue is considered to be a major contributor to road traffic crashes. Cardia... more Objective: Driver fatigue is considered to be a major contributor to road traffic crashes. Cardiac monitoring and heart rate variability (HRV) analysis is a candidate method for early and accurate detection of driver sleepiness. This study has 2 objectives: to evaluate the (1) suitability of different preprocessing strategies for detecting and removing outlier heartbeats and spectral transformation of HRV signals and their impact of driver sleepiness assessment and (2) relation between common HRV indices and subjective sleepiness reported by a large number of drivers in real driving situations, for the first time. Methods: The study analyzed >3,500 5-min driving epochs from 76 drivers on a public motorway in Sweden. The electrocardiograph (ECG) data were recorded in 3 studies designed to evaluate the physiological differences between awake and sleepy drivers. The drivers reported their perceived level of sleepiness according to the Karolinska Sleepiness Scale (KSS) every 5 min. Two standard methods were used for identifying outlier heartbeats: (1) percentage change (PC), where outliers were defined as interbeat intervals deviating >30% from the mean of the four previous intervals and (2) standard deviation (SD), where outliers were defined as interbeat interval deviating >4 SD from the mean interval duration in the current epoch. Three standard methods were used for spectral transformation, which is needed for deriving HRV indices in the frequency domain: (1) Fourier transform; (2) autoregressive model; and (3) Lomb-Scargle periodogram. Different preprocessing strategies were compared regarding their impact on derivation of common HRV indices and their relation to KSS data distribution, using box plots and statistical tests such as analysis of variance (ANOVA) and Student's t test. Results: The ability of HRV indices to discriminate between alert and sleepy drivers does not differ significantly depending on which outlier detection and spectral transformation methods are used. As expected, with increasing sleepiness, the heart rate decreased, whereas heart rate variability overall increased. Furthermore, HRV parameters representing the parasympathetic branch of the autonomous nervous system increased. An unexpected finding was that parameters representing the sympathetic branch of the autonomous nervous system also increased with increasing KSS level. We hypothesize that this increment was due to stress induced by trying to avoid an incident, because the drivers were in real driving situations. Conclusions: The association of HRV indices to KSS did not depend on the preprocessing strategy. No preprocessing method showed superiority for HRV association to driver sleepiness. This was also true for combinations of methods for frequency domain HRV indices. The results prove clear relationships between HRV indices and perceived sleepiness. Thus, HRV analysis shows promise for driver sleepiness detection.
The number of elderly people in the society is increasing, and with that the expected the health ... more The number of elderly people in the society is increasing, and with that the expected the health care costs. One reason for this is that the probability of contracting a chronic illness increases with age. Congestive heart failure (CHF) is a typical such illness and it affects ...
Allt eftersom antalet äldre och långtidssjuka ökar i samhället, förväntas också kostnaderna för s... more Allt eftersom antalet äldre och långtidssjuka ökar i samhället, förväntas också kostnaderna för sjuk-och hälsovård att öka. Hjärtsvikt är en sjukdom som drabbar omkring 2 % av befolkningen i västvärden, och de flesta patienter är över 60 år. Denna sjukdom spelar därför ...
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Papers by Bengt Sjöqvist