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Choice and privatisation in Swedish primary care.

Anell, Anders LU (2011) In Health Economics, Policy and Law 6. p.549-569
Abstract
In 2007, a new wave of local reforms involving choice for the population and privatisation of providers was initiated in Swedish primary care. Important objectives behind reforms were to strengthen the role of primary care and to improve performance in terms of access and responsiveness. The purpose of this article was to compare the characteristics of the new models and to discuss changes in financial incentives for providers and challenges regarding governance from the part of county councils. A majority of the models being introduced across the 21 county councils can best be described as innovative combinations between a comprehensive responsibility for providers and significant degrees of freedom regarding choice for the population.... (More)
In 2007, a new wave of local reforms involving choice for the population and privatisation of providers was initiated in Swedish primary care. Important objectives behind reforms were to strengthen the role of primary care and to improve performance in terms of access and responsiveness. The purpose of this article was to compare the characteristics of the new models and to discuss changes in financial incentives for providers and challenges regarding governance from the part of county councils. A majority of the models being introduced across the 21 county councils can best be described as innovative combinations between a comprehensive responsibility for providers and significant degrees of freedom regarding choice for the population. Key financial characteristics of fixed payment and comprehensive financial responsibility for providers may create financial incentives to under-provide care. Informed choices by the population, in combination with reasonably low barriers for providers to enter the primary care market, should theoretically counterbalance such incentives. To facilitate such competition is indeed a challenge, not only because of difficulties in implementing informed choices but also because the new models favour large and/or horizontally integrated providers. To prevent monopolistic behaviour, county councils may have to accept more competition as well as more governance over clinical practice than initially intended. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Health Economics, Policy and Law
volume
6
pages
549 - 569
publisher
Cambridge University Press
external identifiers
  • wos:000295304600007
  • pmid:20701829
  • scopus:77955393590
ISSN
1744-134X
DOI
10.1017/S1744133110000216
language
English
LU publication?
yes
id
539dffde-6c1d-47ed-93c8-d20d102972f3 (old id 1665345)
date added to LUP
2010-09-08 16:00:06
date last changed
2017-01-01 03:26:03
@article{539dffde-6c1d-47ed-93c8-d20d102972f3,
  abstract     = {In 2007, a new wave of local reforms involving choice for the population and privatisation of providers was initiated in Swedish primary care. Important objectives behind reforms were to strengthen the role of primary care and to improve performance in terms of access and responsiveness. The purpose of this article was to compare the characteristics of the new models and to discuss changes in financial incentives for providers and challenges regarding governance from the part of county councils. A majority of the models being introduced across the 21 county councils can best be described as innovative combinations between a comprehensive responsibility for providers and significant degrees of freedom regarding choice for the population. Key financial characteristics of fixed payment and comprehensive financial responsibility for providers may create financial incentives to under-provide care. Informed choices by the population, in combination with reasonably low barriers for providers to enter the primary care market, should theoretically counterbalance such incentives. To facilitate such competition is indeed a challenge, not only because of difficulties in implementing informed choices but also because the new models favour large and/or horizontally integrated providers. To prevent monopolistic behaviour, county councils may have to accept more competition as well as more governance over clinical practice than initially intended.},
  author       = {Anell, Anders},
  issn         = {1744-134X},
  language     = {eng},
  pages        = {549--569},
  publisher    = {Cambridge University Press},
  series       = {Health Economics, Policy and Law},
  title        = {Choice and privatisation in Swedish primary care.},
  url          = {http://dx.doi.org/10.1017/S1744133110000216},
  volume       = {6},
  year         = {2011},
}