Awareness and opinions on healthcare decommissioning in a Swedish region

Fredriksson, Mio; Moberg, Linda

doi:10.1016/j.healthpol.2020.05.016

Cited by 1 publication

(2 citation statements)

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“…The main argument in support of these principles in contemporary health governance is that directly elected leaders with a mandate to adjust national policies to specific local circumstances will be better suited to making policy adjustments based on the unique conditions in different parts of the country. The national government plays an important role in monitoring and evaluating the health services provided by the counties so that they are of equal quality and accessible on equal terms by the population (Fredriksson, 2012). Until the 1990s, primary care centres in Sweden were almost exclusively public and operated directly by the county councils, which also decided if and where any new providers could establish themselves within the region.…”

Section: Case Study Context: the Primary Care Choice Reform In Swedenmentioning

confidence: 99%

“…These early evaluations thus identify several ways of preventing risk selection behaviour among the counties. They are also reflective of the fact that concerns regarding risk selection and a resulting decrease in equity was one of the most discussed issues when the primary care choice reform was introduced, particularly by the left (Fredriksson, 2012).…”

Section: Case Study Context: the Primary Care Choice Reform In Swedenmentioning

confidence: 99%

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Preserving social equity in marketized primary care: strategies in Sweden

Winblad

Isaksson

Blomqvist

2020

HEPL

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A primary care choice reform launched in Sweden in 2010 led to a rapid growth of private providers. Critics feared that the reform would lead to an increased tendency among new, profit-driven, providers, to select patients with lower health risks. Even if open risk selection is prohibited, providers can select patients in more subtle ways, such as establishing their practices in areas with higher health status. This paper investigates to what extent strategies were employed by local governments to avoid risk selection and whether there were any differences between left- and right-wing governments in this regard. Three main strategies were used: risk adjustment of the financial reimbursements on the basis of health and/or socio-economic status of listed patients; design of patient listing systems; and regulatory requirements regarding the scope and content of the services that had to be offered by all providers. Additionally, left-wing local governments were more prone than right-wing governments to adopt risk adjustment strategies at the onset of the reform but these differences diminished over time. The findings of the paper contribute to our understanding of how social inequalities may be avoided in tax-based health care systems when market-like steering models such as patient choice are introduced.

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Section: Case Study Context: the Primary Care Choice Reform In Swedenmentioning

confidence: 99%

Section: Case Study Context: the Primary Care Choice Reform In Swedenmentioning

confidence: 99%