{"id":13020,"date":"2020-09-29T09:34:33","date_gmt":"2020-09-29T07:34:33","guid":{"rendered":"https:\/\/www.vardforetagarna.se\/?p=13020"},"modified":"2020-09-29T09:58:05","modified_gmt":"2020-09-29T07:58:05","slug":"en-primarvard-i-balans","status":"publish","type":"post","link":"https:\/\/www.vardforetagarna.se\/2020\/09\/en-primarvard-i-balans\/","title":{"rendered":"En prim\u00e4rv\u00e5rd i balans?"},"content":{"rendered":"\n

Regionerna hade i \u00e5r beh\u00f6vt l\u00e4gga n\u00e4stan 1,4 miljarder kronor mer p\u00e5 v\u00e5rdvalen f\u00f6r en prim\u00e4rv\u00e5rd i balans. Det konstaterar vi i V\u00e5rdf\u00f6retagarnas femte kartl\u00e4ggning av underskotten i den regiondrivna prim\u00e4rv\u00e5rden. Ovanp\u00e5 det har prim\u00e4rv\u00e5rden en stor v\u00e5rdskuld att hantera. V\u00e5rdf\u00f6retagarna vill se l\u00e5ngsiktiga satsningar, likv\u00e4rdiga villkor och ett nationellt utformat regelverk f\u00f6r v\u00e5rdvalet f\u00f6r prim\u00e4rv\u00e5rden.<\/p>\n

De senaste m\u00e5naderna har V\u00e5rdf\u00f6retagarnas medlemsf\u00f6retag st\u00e5tt sida vid sida med den regiondrivna sjukv\u00e5rden f\u00f6r att hantera pandemin och i en pr\u00f6vande tid \u00e4nd\u00e5 f\u00f6rs\u00f6ka m\u00f6ta patienternas behov av v\u00e5rd. Pandemin \u00e4r inte \u00f6ver, men det \u00e4r viktigt att ocks\u00e5 se fram\u00e5t. M\u00e5nga av de l\u00e4ttnader och anpassningar av ers\u00e4ttningssystem f\u00f6r prim\u00e4rv\u00e5rden som regioner har gjort under pandemin beh\u00f6ver bli permanenta.<\/p>\n

Det finns en politisk samsyn om behovet av omst\u00e4llning till n\u00e4ra v\u00e5rd, d\u00e4r prim\u00e4rv\u00e5rden fungerar som nav. Inf\u00f6r de budgetdiskussioner och \u00f6verl\u00e4ggningar som nu sker s\u00e5v\u00e4l p\u00e5 riksniv\u00e5 som i m\u00e5nga regioner \u00e4r det p\u00e5 sin plats att p\u00e5minna om hur f\u00f6ruts\u00e4ttningarna s\u00e5g ut f\u00f6r den svenska prim\u00e4rv\u00e5rden n\u00e4r den gick in i pandemin.<\/p>\n

F\u00f6rra \u00e5ret var underskotten hos de regiondrivna v\u00e5rdcentralerna n\u00e4stan 685 miljoner kronor. Det visar den granskning som V\u00e5rdf\u00f6retagarna, f\u00f6r femte \u00e5ret i rad, har gjort av de ekonomiska resultaten i den regiondrivna prim\u00e4rv\u00e5rden. Den regiondrivna verksamheten motsvarar ungef\u00e4r halva prim\u00e4rv\u00e5rden och den andra halvan drivs i privat regi. Grovt r\u00e4knat hade regionerna d\u00e4rmed vid \u00e5rets ing\u00e5ng beh\u00f6vt l\u00e4gga n\u00e4stan 1,4 miljarder kronor ytterligare f\u00f6r att prim\u00e4rv\u00e5rden ens skulle vara i balans. Detta med dagens uppdrag och utan en enda ambitionsh\u00f6jning. Ovanp\u00e5 detta st\u00e5r sjukv\u00e5rden inf\u00f6r en stor, delvis dold, v\u00e5rdskuld. De eftersatta v\u00e5rdbehoven finns b\u00e5de i prim\u00e4r- och specialistv\u00e5rden.<\/p>\n

Regionerna styr prim\u00e4rv\u00e5rden genom v\u00e5rdval. F\u00f6r att prim\u00e4rv\u00e5rden ska fungera v\u00e4l m\u00e5ste ers\u00e4ttningarna vara b\u00e5de l\u00e5ngsiktigt h\u00e5llbara och likv\u00e4rdiga. V\u00e5r kartl\u00e4ggning f\u00f6r 2019 visar p\u00e5 f\u00f6ljande resultat:<\/p>\n

Klicka p\u00e5 bilden nedan f\u00f6r att f\u00f6rstora.<\/em><\/p>\n

\"\"<\/a><\/p>\n

I 18 av 21 regioner klarade inte regionens egna v\u00e5rdcentraler sin verksamhet med de resurser som de fick f\u00f6rra \u00e5ret. St\u00f6rst var problemen i Blekinge, Gotland, Norrbotten, V\u00e4sterbotten och \u00d6rebro, d\u00e4r verksamheterna gick back med s\u00e5 mycket som \u00e5tta procent eller mer.<\/p>\n

Klicka p\u00e5 bilden nedan f\u00f6r att f\u00f6rstora.<\/em><\/p>\n

\"\"<\/a><\/p>\n

Som tabellen ovan visar \u00e4r de ekonomiska underskotten hos regionernas egna v\u00e5rdcentraler ett best\u00e5ende problem i flera regioner. I samtliga regioner i Norrland, samt p\u00e5 Gotland, har den regiondrivna prim\u00e4rv\u00e5rden g\u00e5tt med underskott vart enda \u00e5r det senaste decenniet. I vissa av dessa regioner \u00e4r utvecklingen betydande negativ.<\/p>\n

Klicka p\u00e5 bilden nedan f\u00f6r att f\u00f6rstora.<\/em><\/p>\n

\"\"<\/a><\/p>\n

Tre regioner st\u00e5r f\u00f6r 45 procent av det samlade underskottet 2019. Det sammanlagda underskottet f\u00f6r Region \u00d6rebro L\u00e4n, Region V\u00e4sterbotten och Region Norrbotten \u00e5r 2019 var ungef\u00e4r minus 300 miljoner kr. Detta inneb\u00e4r att dessa tre regioner st\u00e5r f\u00f6r ungef\u00e4r 45 procent av det totala underskottet \u00e5r 2019.<\/p>\n

V\u00e5rdf\u00f6retagarna v\u00e4lkomnar f\u00f6r\u00e4ndringar i lagstiftning och regelverk som underl\u00e4ttar en omst\u00e4llning till n\u00e4ra v\u00e5rd. Men vi ser samtidigt en risk f\u00f6r besvikelse i den svenska prim\u00e4rv\u00e5rden, i b\u00e5de privat och offentlig regi, om reformarbetet inte \u00e5tf\u00f6ljs av v\u00e4sentligt st\u00f6rre resurser. Det kr\u00e4vs stora omf\u00f6rdelningar fr\u00e5n akutsjukhusens elektiva verksamhet f\u00f6r att \u00e5stadkomma n\u00f6dv\u00e4ndiga f\u00f6r\u00e4ndringar, d\u00e5 den svenska prim\u00e4rv\u00e5rden \u00e4r b\u00e5de underfinansierad och underdimensionerad.<\/p>\n

Underskotten inneb\u00e4r ocks\u00e5 att f\u00f6ruts\u00e4ttningarna f\u00f6r privat drivna och regiondrivna v\u00e5rdcentraler att m\u00f6ta sina patienters behov inte \u00e4r likv\u00e4rdiga. Det strider mot hela grundtanken med v\u00e5rdvalet.<\/span><\/p>\n

V\u00e5rdf\u00f6retagarna ger i rapporten fem rekommendationer:<\/p>\n

    \n
  1. Sk\u00e4rp Lagen om valfrihetssystem (LOV) f\u00f6r att garantera likv\u00e4rdiga villkor<\/li>\n
  2. Ett nationellt utformat regelverk f\u00f6r v\u00e5rdvalet<\/li>\n
  3. Indexera v\u00e5rdvalsers\u00e4ttningen<\/li>\n
  4. Dialog med v\u00e5rdgivarna om uppdrag och ers\u00e4ttning i v\u00e5rdvalet<\/li>\n
  5. Efterhandsreglera ers\u00e4ttningen till privata v\u00e5rdgivare<\/li>\n<\/ol>\n

     <\/p>\n

    Ta del av rapporten En prim\u00e4rv\u00e5rd i balans? i sin helhet h\u00e4r<\/a>.<\/h2>\n

    L\u00e4s debattartikeln <\/strong>Underfinansieringen av prim\u00e4rv\u00e5rden m\u00e5ste upph\u00f6ra<\/a>, publicerad i Dagens Samh\u00e4lle 29\/9 2020.<\/h2>\n\n","protected":false},"excerpt":{"rendered":"

    Regionerna hade i \u00e5r beh\u00f6vt l\u00e4gga n\u00e4stan 1,4 miljarder kronor mer p\u00e5 v\u00e5rdvalen f\u00f6r en prim\u00e4rv\u00e5rd i balans. Det konstaterar vi i V\u00e5rdf\u00f6retagarnas femte kartl\u00e4ggning av underskotten i den regiondrivna prim\u00e4rv\u00e5rden. Ovanp\u00e5 det har prim\u00e4rv\u00e5rden …<\/p>\n","protected":false},"author":21,"featured_media":8747,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[15],"tags":[],"article_type":[14,17],"agreement":[],"for-members":[],"class_list":["post-13020","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-sjukvard","type-blogginlagg","type-rapporter"],"acf":[],"yoast_head":"\nEn prim\u00e4rv\u00e5rd i balans? - V\u00e5rdf\u00f6retagarna<\/title>\n<meta name=\"description\" content=\"Regionerna hade 2019 beh\u00f6vt l\u00e4gga 1,4 miljarder kronor mer p\u00e5 v\u00e5rdvalen f\u00f6r en prim\u00e4rv\u00e5rd i balans, visar V\u00e5rdf\u00f6retagarnas kartl\u00e4ggning.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" 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