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Getting Better Value for Money from Sweden's Healthcare System

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  • David Rae

Abstract

This paper reviews the strengths and weaknesses of the Swedish healthcare system and the challenges that it will face in the future. It discusses ways to improve access to primary care, including different methods for paying GPs, whether access is less equitable than in other countries and the role of patient fees. The maximum waiting time guarantee for elective surgery is reviewed, along with ways of reducing regional variations in quality. The extent of decentralisation is questioned, as that may be affecting the quality of care and value for money in some areas, including elderly and psychiatric care. Mechanisms for improving the hospital sector are also examined including fee-for-service (DRG) payment mechanisms and whether for-profit hospitals would help. Finally, it considers ways to make financing more stable and sustainable. Soins de santé en Suède: comment en avoir plus pour son argent ? Cette communication étudie les forces et les faiblesses du système de santé suédois et les défis qui le guettent. Elle examine plusieurs pistes pour améliorer l'accès aux soins de premier recours, notamment différentes manières de rémunérer les médecins généralistes; elle s'efforce également de déterminer si l'accès aux soins est plus ou moins équitable qu'à l'étranger et traite du rôle des honoraires payés par les patients. L'étude s'attache ensuite au temps maximum d'attente pour les actes de chirurgie non vitale et à la manière de réduire les disparités de qualité entre régions. L'étendue de la décentralisation est mise en question dans la mesure où elle pourrait avoir une incidence sur la qualité des soins et sur l'efficacité de la dépense tout particulièrement en gériatrie et en psychiatrie. L'étude examine des mécanismes pour améliorer le fonctionnement du secteur hospitalier y compris l'introduction du paiement à l'acte et la création d'hopitaux à but lucratif. Enfin, l'étude réfléchit à la manière d'assurer la stabilité et la pérennité des ressources financières du secteur.

Suggested Citation

  • David Rae, 2005. "Getting Better Value for Money from Sweden's Healthcare System," OECD Economics Department Working Papers 443, OECD Publishing.
  • Handle: RePEc:oec:ecoaaa:443-en
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    File URL: http://dx.doi.org/10.1787/082725005676
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    Citations

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    Cited by:

    1. János Kornai, 2009. "The soft budget constraint syndrome in the hospital sector," International Journal of Health Economics and Management, Springer, vol. 9(2), pages 117-135, June.
    2. Joanne Castonguay & Claude Montmarquette & Claude Castonguay & Iain Scott, 2007. "Analyse comparative sur le financement de la santé," CIRANO Project Reports 2007rp-04, CIRANO.
    3. Kornai, János, 2008. "A puha költségvetési korlát szindrómája a kórházi szektorban
      [The soft budget constraint syndrome in the hospital sector]
      ," Közgazdasági Szemle (Economic Review - monthly of the Hungarian Academy of Sciences), Közgazdasági Szemle Alapítvány (Economic Review Foundation), vol. 0(12), pages 1037-1056.

    More about this item

    Keywords

    gestion publique; health care; public sector efficiency; santé;

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • H73 - Public Economics - - State and Local Government; Intergovernmental Relations - - - Interjurisdictional Differentials and Their Effects
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets

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