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Choice and privatisation in Swedish primary care
1Institute of Economic Research and Department of Business Administration, Lund University School of Economics and Management, Lund, Sweden. anders.anell@fek.lu.se
Health Economics, Policy, and Law
|August 13, 2010
Summary
Swedish primary care reforms introduced patient choice and provider privatization. Financial incentives may risk under-provision of care, requiring careful governance to ensure quality and competition.
Area of Science:
- Healthcare Management
- Public Policy
- Health Economics
Background:
- Swedish primary care underwent significant local reforms in 2007, emphasizing patient choice and provider privatization.
- These reforms aimed to enhance the role of primary care and improve service access and responsiveness.
Purpose of the Study:
- To compare the characteristics of newly implemented primary care models in Sweden.
- To analyze changes in financial incentives for healthcare providers.
- To discuss governance challenges faced by county councils under the new system.
Main Methods:
- Comparative analysis of primary care models across 21 Swedish county councils.
- Examination of financial incentive structures, including fixed payments and comprehensive provider responsibility.
- Assessment of factors influencing informed patient choice and market entry barriers for providers.
Main Results:
- Most models combined comprehensive provider responsibility with significant patient choice.
- Fixed payments and full financial responsibility for providers may incentivize under-provision of care.
- Facilitating competition is challenging due to difficulties in ensuring informed patient choices and the tendency for models to favor large, integrated providers.
Conclusions:
- County councils must balance provider autonomy with governance to prevent monopolistic behavior and ensure quality care.
- Effective implementation requires addressing challenges in informed patient choice and market competition.
- Further governance over clinical practice may be necessary to counteract potential negative incentives.
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