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Privatization, Competition and Primary Health Care Utilization - A study of the Swedish Patient Choice Reform

Forsberg, Elvira LU (2018) NEKP01 20181
Department of Economics
Abstract
During the last decades, the issue of increased health care utilization and expenditures in the western world has been a highly debated topic in health economics. One potential explanation to this growth is the increased privatization and competition in the health care sector, which we have seen in many countries in the later years. In this paper, I study the impact of the Swedish Patient Choice Reform which for the first time introduced equal competition for private and public providers in the primary health care sector on health care utilization. To estimate the causal effect of the reform and hence estimate the effect of increased competition and privatization, I exploit the staggered implementation across regions over time in a... (More)
During the last decades, the issue of increased health care utilization and expenditures in the western world has been a highly debated topic in health economics. One potential explanation to this growth is the increased privatization and competition in the health care sector, which we have seen in many countries in the later years. In this paper, I study the impact of the Swedish Patient Choice Reform which for the first time introduced equal competition for private and public providers in the primary health care sector on health care utilization. To estimate the causal effect of the reform and hence estimate the effect of increased competition and privatization, I exploit the staggered implementation across regions over time in a difference-in-difference framework. The chosen outcome of interest is health care utilization, measured as primary health care visits to doctors and nurses. Additionally, other outcomes of the reform such as public trust, self-reported health, total costs and the doctor density have been investigated. The results of this paper show strong evidence that the Swedish Patient Choice Reform has increased the number of visits in the primary health care and consequently, also the primary health care utilization. Primarily, this increase comes from a surge in doctor visits. Moreover, the reform does not seem to have increased the total cost share of the primary sector and the public trust in the primary care has improved. (Less)
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author
Forsberg, Elvira LU
supervisor
organization
course
NEKP01 20181
year
type
H2 - Master's Degree (Two Years)
subject
keywords
Primary Health Care, Patient Choice Reform, Competition, Privatization, Health Care Utilization
language
English
id
8949181
date added to LUP
2018-07-03 13:37:04
date last changed
2018-07-03 13:37:04
@misc{8949181,
  abstract     = {During the last decades, the issue of increased health care utilization and expenditures in the western world has been a highly debated topic in health economics. One potential explanation to this growth is the increased privatization and competition in the health care sector, which we have seen in many countries in the later years. In this paper, I study the impact of the Swedish Patient Choice Reform which for the first time introduced equal competition for private and public providers in the primary health care sector on health care utilization. To estimate the causal effect of the reform and hence estimate the effect of increased competition and privatization, I exploit the staggered implementation across regions over time in a difference-in-difference framework. The chosen outcome of interest is health care utilization, measured as primary health care visits to doctors and nurses. Additionally, other outcomes of the reform such as public trust, self-reported health, total costs and the doctor density have been investigated. The results of this paper show strong evidence that the Swedish Patient Choice Reform has increased the number of visits in the primary health care and consequently, also the primary health care utilization. Primarily, this increase comes from a surge in doctor visits. Moreover, the reform does not seem to have increased the total cost share of the primary sector and the public trust in the primary care has improved.},
  author       = {Forsberg, Elvira},
  keyword      = {Primary Health Care,Patient Choice Reform,Competition,Privatization,Health Care Utilization},
  language     = {eng},
  note         = {Student Paper},
  title        = {Privatization, Competition and Primary Health Care Utilization - A study of the Swedish Patient Choice Reform},
  year         = {2018},
}