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R Axelsson

Publications and source records attributed to R Axelsson.

48 records · Page 3Linked to original sources

Denervation of the wrist joint--an alternative in conditions of chronic pain.

Nine patients with chronic pain in the wrist secondary to lunatomalacia and non-union of the scaphoid bone were treated by denervation of the wrist joint. This operation was first presented by Wilhelm in 1966. We have been using a modified technique. The purpose of the operation is to achieve relief of pain by selective neurotomy without impairment of hand function and with preservation of wrist mobility. Eight patients were considerably improved; one was not helped at all. No appreciable progression of the pathological changes have occurred radiographically during the period of follow-up. We find our results encouraging and the method worth trying.

Adult↗

Towards an evidence based health care management.

Inspired by the development of Evidence Based Medicine, this article introduces a new approach for health care management called Evidence Based Management. This approach promises to improve the practice of health care management, at the same time as it may stimulate research on the organization and management of health care. Evidence Based Management means that health care managers should learn to search for and critically appraise evidence from management research as a basis for their practice. This will require some new managerial skills that should be included in the education and training of health care managers. It will also require a new orientation for research on health care management. There will be a demand for more applied research, and also for research with a more positivist orientation.

Administrative Personnel↗

Effects of performance-based reimbursement on the professional autonomy and power of physicians and the quality of care.

The key question addressed in this study is whether performance-based reimbursement in health care affects the professional power and autonomy of physicians, and if so, whether this has any consequences for the quality of care. This cohort study examines the period 1994-98 in 11 Swedish county councils. Four hundred and eighteen physicians were studied in Stockholm County Council, which has a performance-based reimbursement system, and in ten councils without such a system. The results show that professional power and autonomy are considered to be very limited in all councils, and that they have decreased during the period studied. Professional autonomy is, however, more limited in Stockholm. The limitations in Stockholm are more related to financial considerations, whereas the limitations in the other councils are more due to guidelines and lists of recommended drugs. Professional autonomy and power were found to be important determinants for quality of care, and the physicians in Stockholm estimated the quality of care lower than their colleagues in the ten other councils. Thus, our study suggests that the performance-based reimbursement system might fail to reach the desired results due to its negative impact on professional power and autonomy.

Adult↗