Sara Korlén Schalling
I am a post doc researcher currently engaged in a research project exploring the balance between national and regional governance and professional autonomy in the de-implementation of low-value practices in health care. The project is managed by the PROCOME research group, at the Medical Management Centre at the department of LIME, KI.
My thesis project focused on how health care professionals experience the economic governance of health care in daily practice.
Beyond my research experience I have a professional background working as a licensed psychologist in the field of occupational health.
My research is concerned with bringing together the micro and macro levels of health care systems, by exploring what implications health care governance has on the provider level and for health care professionals working close to patients.
In my thesis project my main empirical focus was the subjective experiences of health care professionals. In my current post doc project I will learn more about the roles of stakeholders involved in national and regional governance, with a particular focus on de-implementation of low-value care. Still, the implications for health care providers and the role of professionals will be considered.
Methodologically, I represent a pragmatic approach with a fondness for combining and mixing both qualitative and quantitative methodology. My qualitative experience comes mainly from interview studies. My quantitative experience is mainly anchored in the field of developing and using self-assessment scales.
Exploring economic governance through the eyes of health care professionals (thesis project)
The thesis explores professionals’ experiences of two empirical settings, representing different applications of economic governance but also sharing similarities by including health care providers in specialized care, operating in two large urban areas in Sweden.
Case 1 (represented in Studies I and II) illustrates the more recent trend of introducing patient choice in specialized care. This manifests in a regional patient choice model for elective orthopedics that includes increased provider competition, specialization of providers and a reimbursement model designed to provide incentives for quality and economic efficiency. Case 2 (represented in Studies III and IV) illustrates a more traditional approach to economic governance, by the use of annual budgets in a university hospital setting experiencing substantial economic pressure. This case specifically focuses on the Department of Rehabilitation Medicine.
The thesis can be downloaded at the KI website: https://openarchive.ki.se/xmlui/handle/10616/46651
To do or not to do – balancing governance and professional autonomy to abandon low-value care (post doc project)
My current post doc project addresses the fact that many interventions used in health care lack evidence of effectiveness and may be unnecessary or even harmful, and should therefore be de-implemented. Lists of such ineffective, low-value practices are common, but these lists have little chance of leading to improvements without sufficient knowledge regarding how de-implementation can be governed and carried out. The project aims at exploring the governance of de-implementation of low-value practices from the perspectives of national and regional governments and senior management at provider organizations.
The project is described in more detail in the published study protocol “To do or not to do—balancing governance and professional autonomy to abandon low-value practices: a study protocol” that can be found in the publication list below.
2019 - PhD in Medicine, Karolinska Institutet
2012 - Licensed Psychologist
2010 - Master of Science in Psychology, Department of Psychology, Stockholm University.