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Swedish healthcare under pressure

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  • Anders Anell

Abstract

Swedish healthcare, run by local governments at both the regional (county) and the municipal levels, has been under pressure during the last 15 years, following increased scrutiny of performance and demand for cost‐containment. Health‐care expenditures per capita and levels of resource inputs have grown, but more slowly than in other EU countries. At the same time, the number of elderly people has increased, as have options for medical treatment. In the late 1980s, several local governments referred to long waiting‐lists for elective treatment and anecdotal evidence of inefficiency and poor responsiveness when arguing for market‐oriented reforms. A purchaser–provider split followed, and so did changes in the payment systems for health‐care providers. According to the available evidence, these reforms yielded an increased volume of services in the short run; but traditional hierarchical management soon replaced the new incentives. Moreover, evidence suggests that changes introduced by the national government, and the deteriorating funding conditions together with a continued use of new medical technology, have had more far‐reaching effects on health‐care output and outcome than local‐government reforms. Copyright © 2005 John Wiley & Sons, Ltd.

Suggested Citation

  • Anders Anell, 2005. "Swedish healthcare under pressure," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages 237-254, September.
    • Handle: RePEc:wly:hlthec:v:14:y:2005:i:s1:p:s237-s254
    DOI: 10.1002/hec.1039
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    1. Forsberg, Ewa & Axelsson, Runo & Arnetz, Bengt, 2001. "Financial incentives in health care. The impact of performance-based reimbursement," Health Policy, Elsevier, vol. 58(3), pages 243-262, December.
    2. U.‐G. Gerdtham & M. Löthgren & M. Tambour & C. Rehnberg, 1999. "Internal markets and health care efficiency: a multiple‐output stochastic frontier analysis," Health Economics, John Wiley & Sons, Ltd., vol. 8(2), pages 151-164, March.
    3. Wagstaff, Adam & van Doorslaer, Eddy & van der Burg, Hattem & Calonge, Samuel & Christiansen, Terkel & Citoni, Guido & Gerdtham, Ulf-G & Gerfin, Mike & Gross, Lorna & Hakinnen, Unto, 1999. "Equity in the finance of health care: some further international comparisons1," Journal of Health Economics, Elsevier, vol. 18(3), pages 263-290, June.
    4. van Doorslaer, Eddy & Wagstaff, Adam & van der Burg, Hattem & Christiansen, Terkel & De Graeve, Diana & Duchesne, Inge & Gerdtham, Ulf-G & Gerfin, Michael & Geurts, Jose & Gross, Lorna, 2000. "Equity in the delivery of health care in Europe and the US," Journal of Health Economics, Elsevier, vol. 19(5), pages 553-583, September.
    5. Harrison, Michael I. & Calltorp, Johan, 2000. "The reorientation of market-oriented reforms in Swedish health-care," Health Policy, Elsevier, vol. 50(3), pages 219-240, January.
    6. Ulf‐G. Gerdtham & Pravin K. Trivedi, 2001. "Equity in Swedish health care reconsidered: new results based on the finite mixture model," Health Economics, John Wiley & Sons, Ltd., vol. 10(6), pages 565-572, September.
    7. Anell, Anders, 1996. "The monopolistic integrated model and health care reform: the Swedish experience," Health Policy, Elsevier, vol. 37(1), pages 19-33, July.
    8. Elofsson, Stig & Undén, Anna-Lena & Krakau, Ingvar, 1998. "Patient charges -- a hindrance to financially and psychosocially disadvantage groups seeking care," Social Science & Medicine, Elsevier, vol. 46(10), pages 1375-1380, March.
    9. Diderichsen, Finn, 1995. "Market reforms in health care and sustainability of the welfare state: lessons from Sweden," Health Policy, Elsevier, vol. 32(1-3), pages 141-153.
    10. Hanning, Marianne, 1996. "Maximum waiting-time guarantee -- an attempt to reduce waiting lists in Sweden," Health Policy, Elsevier, vol. 36(1), pages 17-35, April.
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    Cited by:

    1. Stefan Meyer, 2015. "Payment schemes and cost efficiency: evidence from Swiss public hospitals," International Journal of Health Economics and Management, Springer, vol. 15(1), pages 73-97, March.
    2. Hjelmgren, Jonas & Anell, Anders, 2007. "Population preferences and choice of primary care models: A discrete choice experiment in Sweden," Health Policy, Elsevier, vol. 83(2-3), pages 314-322, October.
    3. Toth, Federico, 2010. "Healthcare policies over the last 20 years: Reforms and counter-reforms," Health Policy, Elsevier, vol. 95(1), pages 82-89, April.
    4. d'Andria, Diego, 2008. "The Debate on the Sustainability of Social Spending," MPRA Paper 11745, University Library of Munich, Germany.
    5. Ulf-G Gerdtham & Philip Clarke & Alison Hayes & Soffia Gudbjornsdottir, 2009. "Estimating the Cost of Diabetes Mellitus-Related Events from Inpatient Admissions in Sweden Using Administrative Hospitalization Data," PharmacoEconomics, Springer, vol. 27(1), pages 81-90, January.
    6. Kristian Bolin & Anna Lindgren & Björn Lindgren & Petter Lundborg, 2009. "Utilisation of physician services in the 50+ population: the relative importance of individual versus institutional factors in 10 European countries," International Journal of Health Economics and Management, Springer, vol. 9(1), pages 83-112, March.
    7. Samantha Smith, 2010. "The Irish ‘health basket’: a basket case?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(3), pages 343-350, June.
    8. Joan Costa-Font & Valentina Zigante, 2016. "The choice agenda in European health systems: the role of middle-class demands," Public Money & Management, Taylor & Francis Journals, vol. 36(6), pages 409-416, September.
    9. Cecilia Gardsten & Kerstin Blomqvist & Mikael Rask & Åse Larsson & Agneta Lindberg & Gith Olsson, 2018. "Challenges in everyday life among recently diagnosed and more experienced adults with type 2 diabetes: A multistage focus group study," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(19-20), pages 3666-3678, October.
    10. Wettermark, Björn & Godman, Brian & Neovius, Martin & Hedberg, Niklas & Mellgren, Tor-Olov & Kahan, Thomas, 2010. "Initial effects of a reimbursement restriction to improve the cost-effectiveness of antihypertensive treatment," Health Policy, Elsevier, vol. 94(3), pages 221-229, March.
    11. Joan Costa-i-Font & Valentina Zigante, 2014. "The Choice Agenda' in European Health Systems: The Role of 'Middle Class Demands," LEQS – LSE 'Europe in Question' Discussion Paper Series 82, European Institute, LSE.

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