Trends over time. Many indicators show results per county for two periods in order to determine whether there has been improvement or deterioration over time. The later results appear as the main bar in the figure, while the earlier results appear as a shaded bar. Breakdown by gender and socioeconomic group. The main principle for medical indicators is that data in the printed report are shown for women and men together, while the presentation is broken down by gender when there are extraordinary reasons for doing so. Diagrams broken down by gender are available on the websites of the two organisations whenever such data are available. The outcomes for some indicators are also broken down by educational level. Municipal or health centre level. A number of indicators are highly relevant at the municipal or health centre level, but such a breakdown is beyond the scope of this report. The presentation of certain indicators, however, includes the gaps between local authorities and between health centres as a means of stressing that they are particularly wide. Selection of time period. Current data are always preferable and the most germane. How well the healthcare system functioned 50 years ago is of little interest in this connection. Indicators should be designed such that improvements are detected quickly. Favourable outcomes generated by changes to the routines of a hospital or clinic should show up clearly instead of being diluted by previous data. Data from 2011 are used when available and useful. Longer time periods are more appropriate when it comes to indicators for which there are few cases or events (death, infection, reoperation, etc.). Any other approach would lead to statistical unreliability and random fluctuations from year to year. In other words, the benefits of being up-to-date and accurate must be weighed against each other. Furthermore, some indicators measure long-term effects, such as whether a hip prosthesis is still in place and working after 10 years. Surgery performed a number of years earlier is essential to such comparisons.
Comparisons, including county rankings and descriptions of the indicators Every indicator is accompanied by a diagram and brief description. Each diagram is a horizontal bar chart on which the counties appear in descending order. The national average is also presented in a separate colour. Generally speaking, the counties at the top of the diagram have performed best. Occasionally that position may be a sign of overtreatment. The results for some indicators, such as the frequency of Caesarean section, are difficult to evaluate. The counties are ranked even when data quality is poorer, differences between them are small or statistical unreliability is large.
QUALITY AND EFFICIENCY IN SWEDISH HEALTH CARE 2012
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