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Measuring competition in primary care-Evidence from Sweden
Sofie Vengberg1, Mio Fredriksson1, Ulrika Winblad1
1Health Services Research, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
Plos One
|July 15, 2024
Summary
Defining local healthcare markets is key for competition reforms. A new variable shape method better captures Swedish primary care competition, revealing many monopolies needing policy attention.
Area of Science:
- Health economics
- Healthcare market analysis
- Primary care policy
Background:
- Healthcare reforms often aim to boost quality and efficiency through provider competition.
- Spatial definitions of local healthcare markets (e.g., fixed radius circles) may not accurately reflect actual market conditions.
- Limited research exists on competition within primary care markets, a critical healthcare component.
Purpose of the Study:
- To refine geographical definitions of local markets for healthcare competition analysis.
- To investigate the level of provider competition in Swedish primary care settings.
Main Methods:
- A cross-sectional study utilized comprehensive data on individuals and primary care providers in Sweden.
- Local markets were defined using fixed radii (1km, 3km), variable radii, and a novel variable shape approach.
- Competition was quantified using the Herfindahl-Hirschman index and competitor counts.
Main Results:
- Fixed radius market definitions inadequately represent geographical variations in competition.
- Variable radius and variable shape methods showed similarities but identified different competitors and competition levels.
- Swedish primary care exhibits substantial variation in competition, with numerous monopolies and highly competitive markets.
Conclusions:
- The variable shape market definition shows promise for accurately identifying actual markets and competitors, warranting further investigation.
- Swedish policymakers must determine the future of promoting competition and address conditions in monopolistic primary care markets.
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