As many of you know, we recently had our first experience with Sweden's medical system. So I thought I'd share the few observations we have. Keep in mind, this is completely anecdotal. I have no idea whether what we experienced here in our little town is typical or not. Also, we've never had the fun of a emergency room visit or hospital stay with one of our kids before anywhere. With those caveats, here's our experience.
Our son was playing in the park across the street on a Saturday afternoon, fell out of a tree and badly broke his arm. When he came home to us it was not a "hmmm, is it sprained or strained or broken?" type of injury but rather a horrific "that is SO broken and I'll never get this picture out of my head" experience.
We scooped him up into the car and raced to our local hospital. Luckily we did know where it was and it was only a 5 minute drive away. First problem, we didn't know the word for "emergency room" in Swedish but we figured the entry with the big red cross was a good guess. Frantic dad rushed in to make sure it was the right place and then came back for the boy.
As with everything in Sweden, there was a number machine in the waiting room. T had grabbed one on his way through, but no one ever actually made him wait for his number to be called. I guess they figured it was easier to deal with frantic American dad right away. The ER was also not very busy.
Within a few minutes they had him on a bed and were wheeling him back to an examination room with Dad in tow. Unfortunately, when they started asking for info, I'd failed to bring the one thing they needed-- the ever important Personnummer. I'd brought his passport and residence card but the magic number was in my phone which I'd left on the table in my rush out the door. So back home I ran, which was probably just as well since I'd left the oven on and we had friends coming by who we hadn't had a chance to call and warn we were gone. Called in the number, grabbed my phone and back to the hospital.
First thing we noticed, the personnummer was the only thing the emergency room ever needed-- no long forms, no waivers. In fact, the entire time we were at the hospital, the only paper I filled out was one short form giving them preferred names for the child and parents, contact phone numbers and whether he was allergic to anything or had any dietary restrictions. No medical history. No insurance forms. No liability waivers or privacy policy forms. Have I mentioned that it is very rare to sue anyone for anything in Sweden? I think that is probably the reason for most of the differences we noticed compared to American medical facilities.
Once the ER doc had taken a look, they wheeled him to x-ray, stopping in the emergency room waiting room so that M and I could come along. We waited just a few minutes for x-rays. T not only came in for the x-ray itself but helped hold the plate. :-) Then we all went along to G's hospital room. With T helping the nurse push the bed. That seemed to be standard practice. We saw other kids also being wheeled by parent and nurse.
Throughout, there was also an expectation that a parent would be present for all that went on. They did limit it to one parent for the surgery recovery room and for staying the night, but they had very open visiting hours for the rest of us. They put G in his own room with a bed for T to spend the night with him.
I've read articles in the newspapers here about overcrowding in some of the city hospitals-- patience being put in closets or hallways-- but we saw nothing of that in Kristianstad.
We had to wait quite a while for them to look at the x-rays and decide whether surgery was necessary-- 4 or 5 hours. And once they decided it was odd because no one really gave us an update, they just started getting him ready for surgery. We don't know if that is normal or because of the language issues. Everyone was great about using English with us, but it does limit what they can say. But really what are you going to do, it needs to be fixed and you have to trust that they know how to do that. But I'm sure in a US hospital they would have given us a detailed description of what they were going to do.
We did get some explanation when a nurse came in and asked G if he had any questions about what was going to happen. He said he didn't want to know. :-) She was great and just told him the parts that would be comforting-- that his dad would be there while he went to sleep and when he woke up-- left out the part about him leaving in the middle. But T and I talked to her a bit in the hall and got a little better idea of what was going on. When he went in for the surgery, we had never spoken to a doctor.
After the surgery, the surgeon did talk to T for a minute and showed him the before and after x-rays.
The children's ward was calm and comfortable. They had lots of movies you could take to watch in your room, a play room, even a playground out on the roof. They had a little kitchen/dining area for families to use. For a small amount you could eat what you wanted of the sandwich fixings they'd set out there. The next day as he started to wake up and feel better, G and T played air hockey and G enjoyed a good lunch. The nurses were all really friendly and helpful throughout. We had to wait a while for a doctor to get out of surgery and see him before he could released. That wasn't a big deal since he was comfortable.
Once again, when we left, no paperwork. No written discharge instructions (would have kind of liked more of that) just verbal from the doctor. We had to have the nurse write down for us what pain killer they said to buy for him-- it wasn't a name we knew. They said he'd need to come back in 2 weeks to have the stitches removed and said we'd receive an appointment time by letter. Sure enough, when we got back from our trip we found two letters waiting for us. One for that first appointment. Another for an appointment in 2 more weeks to have the cast off and x-rays done.
So we were back to the hospital the other day. They have one reception desk in the mail hall that handles all the offices. We checked in there--just had to show them some ID-- and went and sat in the waiting room for orthopedics. It was funny to sit in a waiting room with no receptionist around. Soon someone came and got us and they took care of him pretty quickly. We saw a different orthopedic surgeon briefly but mostly saw the nurses who took off the cast, removed the stitches and put a new cast on.
We've never seen a bill and as far as I understand we never will. There are small copays for medical care for adults but children are covered entirely. Sweden is interesting that way. They value children very highly and the care and comfort of children is a very high priority. So, for example, dental care is relatively expensive for adults, but completely free for children-- even braces if needed.
So anyway, that has been our experience so far with the medical system in Sweden. From our limited experience it seems you are given fewer choices, for example of what doctor you see. But the cultural bias against litigation really frees up the employees to be more flexible and human in how they deal with patients which is refreshing.
Oh one other thing, as soon as we were registered here with their taxing agency, we received letters assigning us to a particular clinic for our primary health care needs. I haven't had need to check that out yet. It did say that if for some reason we are unhappy with that clinic, we can change to a different one. We also received notices of dental appointments scheduled for the kids. Kind of funny to just get a letter saying, You have a dentist appointment on this day ... when you never asked for one. :-)
