University affiliation
Linköping University
Main supervisor
Katarina Hedin, MD, PhD, Adjunct Professor
PhD project participating in the National Research School in General Medicine.
Health in Sweden is improving, but not for everyone. Equal health brings great benefits for both the individual and society. We need to know more about the extent to which health care contributes to health equity. Our project will study how contacts with health care look over time in different groups in the population and evaluate a population-oriented intervention, "Health Center". Through the project, we want to find strategies that contribute to care on equal terms according to need.
However, knowledge about how well the health care system lives up to this goal is limited. There is also a lack of a scientific systematic study of how the COVID-19 pandemic has affected access to Swedish healthcare in both primary and secondary care in different groups and over time. With the goal of health equity, primary care collaborates in an increasing number of population-oriented health promotion initiatives, but the contribution of the interventions to health equity is less often studied.
The overall aim of the doctoral projects is to study the extent to which Swedish health care is provided on equal terms according to need and how it is affected by a major event in society such as the COVID-19 pandemic, and whether an intervention aimed at the population in the form of health centers can promote health equity.
Paper 1-3 are longitudinal register-based studies covering the time period 2018-01-01 – 2025-12-31 and include all individuals registered in Region Halland, Region Jönköping, Region Kronoberg and Region Skåne.
Paper 1 studies the relationship between contacts with health care in both primary and secondary care, diagnosis panorama, prescription/collection of drugs and socioeconomic position, age, gender, pre-existing morbidity, geographical distances and country of birth. In addition to a basic description of the population's contacts with health care, regression models are used to understand which factors are associated with different contact patterns.
Paper 2 uses regression and multilevel analysis to analyze the changes that occurred during the COVID-19 pandemic in terms of contact with health care, diagnostic panorama and prescription/collection of medicines. The change is analyzed in different groups such as age, gender, socioeconomic position, existing morbidity, geographical distance and country of birth.
Paper 3 studies how the contacts with health care have changed over time for patients with multimorbidity, and how this relates to socioeconomic position, age, gender, geographical distance and country of birth.
In paper 4, a survey is conducted to investigate which groups in the population are reached by the Health Center's activities and what the participants' expectations of and experiences of the Health Center ́s activities look like.
In order to develop strategies for how health care can better contribute to health equity, a clearer picture is required of the extent to which care is currently provided on equal terms according to need, and how this is affected by major events, such as the COVID-19 pandemic. A common group in health care that generally has great needs is people with multimorbidity. It is
therefore particularly important to know what the contact pattern with health care looks like for his group. In order to know whether initiatives such as health centers contribute to a more health equity, it is crucial that these are evaluated from an equity perspective.
Linköping University
Katarina Hedin, MD, PhD, Adjunct Professor