Advanced

General practice in the Nordic countries

Olsen, Kim Rose; Anell, Anders LU ; Häkkinen, Unto; Iversen, Tor; Ólafsdóttir , Thorhildur and Sutton, Matt (2016) In Nordic Journal of Health Economics 4(1). p.56-67
Abstract
Background: General practice systems in the Nordic countries share certain common features. The sector is based on the Nordic model of a tax-financed supply of services with a political objective of equal access for all. The countries also share the challenges of increased political expectations to deliver primary prevention and increased workload as patients from hospital care are discharged earlier. However, within this common framework, primary care is organized differently. This is particularly in relation to the private-public mix, remuneration systems and the use of financial and non-financial incentives.

Objective: The objective of this paper is to compare the differences and similarities in primary care among the Nordic... (More)
Background: General practice systems in the Nordic countries share certain common features. The sector is based on the Nordic model of a tax-financed supply of services with a political objective of equal access for all. The countries also share the challenges of increased political expectations to deliver primary prevention and increased workload as patients from hospital care are discharged earlier. However, within this common framework, primary care is organized differently. This is particularly in relation to the private-public mix, remuneration systems and the use of financial and non-financial incentives.

Objective: The objective of this paper is to compare the differences and similarities in primary care among the Nordic countries, to create a mapping of the future plans and reforms linked to remuneration and incentives schemes, and to discuss the pros and cons for these plans with reference to the literature. An additional objective is to identify gaps in the literature and future research opportunities.

Results/Conclusions: Despite the many similarities within the Nordic health care systems, the primary care sectors function under highly different arrangements. Most important are the differences in the gate-keeping function, private versus salaried practices, possibilities for corporate ownership, skill-mix and the organisational structure. Current reforms and political agendas appear to focus on the side effects of the individual countries’ specific systems. For example, countries with salaried systems with geographical responsibility are introducing incentives for private practice and more choices for patients. Countries with systems largely based on private practice are introducing more monitoring and public regulation to control budgets. We also see that new governments tends to bring different views on the future organisation of primary care, which provide considerable political tension but few actual changes. Interestingly, Sweden appears to be the most innovative in relation to introducing new incentive schemes, perhaps because decisions are made at a more decentralised level. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
general practice, remuneration, primary care, incentives, Nordic countries
in
Nordic Journal of Health Economics
volume
4
issue
1
pages
56 - 67
publisher
University of Oslo
ISSN
1892-9729
DOI
10.5617/njhe.2801
language
English
LU publication?
yes
id
1bb72af4-13c9-4360-9673-9129da915c48
date added to LUP
2016-06-28 13:36:08
date last changed
2016-09-29 12:13:57
@misc{1bb72af4-13c9-4360-9673-9129da915c48,
  abstract     = {Background: General practice systems in the Nordic countries share certain common features. The sector is based on the Nordic model of a tax-financed supply of services with a political objective of equal access for all. The countries also share the challenges of increased political expectations to deliver primary prevention and increased workload as patients from hospital care are discharged earlier. However, within this common framework, primary care is organized differently. This is particularly in relation to the private-public mix, remuneration systems and the use of financial and non-financial incentives.<br/><br/>Objective: The objective of this paper is to compare the differences and similarities in primary care among the Nordic countries, to create a mapping of the future plans and reforms linked to remuneration and incentives schemes, and to discuss the pros and cons for these plans with reference to the literature. An additional objective is to identify gaps in the literature and future research opportunities.<br/><br/>Results/Conclusions: Despite the many similarities within the Nordic health care systems, the primary care sectors function under highly different arrangements. Most important are the differences in the gate-keeping function, private versus salaried practices, possibilities for corporate ownership, skill-mix and the organisational structure. Current reforms and political agendas appear to focus on the side effects of the individual countries’ specific systems. For example, countries with salaried systems with geographical responsibility are introducing incentives for private practice and more choices for patients. Countries with systems largely based on private practice are introducing more monitoring and public regulation to control budgets. We also see that new governments tends to bring different views on the future organisation of primary care, which provide considerable political tension but few actual changes. Interestingly, Sweden appears to be the most innovative in relation to introducing new incentive schemes, perhaps because decisions are made at a more decentralised level.},
  author       = {Olsen, Kim Rose and Anell, Anders and Häkkinen, Unto and Iversen, Tor and Ólafsdóttir  , Thorhildur and Sutton, Matt},
  issn         = {1892-9729},
  keyword      = {general practice,remuneration,primary care,incentives, Nordic countries},
  language     = {eng},
  number       = {1},
  pages        = {56--67},
  publisher    = {ARRAY(0xacca678)},
  series       = {Nordic Journal of Health Economics},
  title        = {General practice in the Nordic countries},
  url          = {http://dx.doi.org/10.5617/njhe.2801	},
  volume       = {4},
  year         = {2016},
}