Hej hej!
This high-pitched greeting was the single most heard Swedish expression during our study trip in Stockholm. The Swedish would greet us this way in the supermarket and cafés, but also at official meetings. We soon integrated the ‘hej hej!’ in our own conversations, which made them sound so much more cheerful.
A short introduction: I’m a Dutch (basic) physician and master student at Leyden Academy, participating in the one-year international master’s programme ‘Vitality and Ageing’ in Leiden, the Netherlands. After a trimester on gerontology (social and biological aspects of aging) and geriatrics (medical aspects of aging), we had a spring break before entering our third and final trimester on healthcare structure. As a delegation from China, Mexico and the Netherlands, we travelled to Sweden during this break to learn about their health care system and compare it to our own. The timing of the trip made it a perfect introduction to our upcoming courses ‘structure and financing health care’, ‘models of care’ and ‘governance’. The only minor drawback was the fact that we travelled north at the end of winter…
So what did we learn about Swedish health care?
Swedish registries
We gained knowledge on their health care structure when visiting Social Styrelsen and Vårdanalys: two government agencies, the former collects, compiles and analyzes data from national registries and develops standards with the information gathered. The latter is doing more or less the same, but then from a patient and citizen’s perspective, aiming at strengthening their position. As we got to know, the Swedish have many registries. This is possible since every citizen has an identity card with a PIN (personal identity number). Showing this PIN card is obligatory before you can make use of health services and this way, all actions are automatically registered and saved in databases. Their health data registers include the ‘national patient’ (on hospital admissions), cancer, medical births and pharmaceutical registers.
Visits
We also visited the Ministry of Health and Social Affairs, where we learned about current problems in the Swedish system and developments in for instance technology. We were welcomed in the Aging Research Center, where we were updated on pharmaceuticals in dementia and multimorbidity. Our lasts visits were more clinically orientated. We received an inspiring tour in Silviahemmet, a day care and education institute for people with dementia, where, amongst others, we were introduced to different ways in which you can (and should) approach a demented person.
Lastly, we visited two academic hospitals, the Akademiska sjukhuset in Uppsala and the Karolinska hospital in Stockholm. During these visits, we learned about the ‘physical activity on prescription’ program, which literally makes people move on doctor’s orders. We also learned about the Uppsala initiative ‘doctors on wheels’, where a physician and nurse visit elderly at home when acute care is needed, to prevent many hospital admissions. Striking were also the ‘doctor’ tags, and the special ward for people with confusion.
Stockholm sightseeing
The Swedish are extremely nice and friendly people: their hospitality was without boundaries, and we were welcomed with fika (coffee and sweets) at every visit. Of course, we saw some of Stockholm too; we visited the beautiful Stadhuset (city hall), took nice walks (during which small pebbles – which were on the streets to prevent icy slips- would always end up in our shoes), had lunch in a greenhouse on one of the islands, and went to a Jazz club to enjoy live music. Our hotel was a boat, so the soft rocking made up for the somewhat uncomfortable beds after a couple of (very expensive!) beers. And we sampled traditional foods (oh yes, we tried elk, cooked beetroots and pickled herring). Thanks to my great group of fellow students, this trip, besides being educational, was a lot of fun.
In summary: a broad vision of Swedish health care and culture, and although winter was still showing its tail, the sun was with us the whole time, which made it a great, inspiring trip!
Hiltsje Heemskerk