The Effects of the Healthcare Choice System in the Swedish Primary Healthcare (스웨덴 일차의료 영역에서 진료선택제도(vårdval) 도입의 효과)

Shin Jeongwan (신정완)

The Effects of the Healthcare Choice System in the Swedish Primary Healthcare

Journal of the Scandinavian Society of Korea
Abbr : JSSK
2023, (31), pp.45-81
Publisher : The Scandinavian Society of Korea
Research Area : Social Science > Area Studies > North Europe(Scandinavian)
Received : May 11, 2023
Accepted : June 7, 2023
Published : June 30, 2023

Shin Jeongwan ¹

¹경북대학교

Accredited

ABSTRACT

Sweden has long been an exemplary country having NHS(National Health Service) type health security system. The Swedish health security system, however, has been much changed since 1990s by the policies marketizing healthcare. The introduction of the healthcare choice system(vårdval) is a pronounced case of the market-oriented healthcare reforms. This system enables patients to choose medical institutions where they would receive treatment and register themselves there. The county councils, responsible for healthcare, then reimburse each medical institution for the medical costs incurred, according to the number of registered patients of each medical institution. Some county councils voluntarily introduced this system since 2007. Since 2010, the introduction of the system in the primary healthcare became obligatory for all county councils. The system has produced good results such as the enhanced rights of patients, the improved responsiveness of the primary care centers to patients’ demands, the increase of the number of primary care centers, and the increased diversity of healthcare providers. But bad results also have been produced such as the widening gap of healthcare accessibility between population densed areas and population thin areas, and between patients with mild cases and patients with serious cases, and the fact that patients with complex diseases can not receive well-integrated treatment as before. We can say that the healthcare choice system brought out results violating the healthcare egalitarianism, the traditional value of the Swedish healthcare, in that the patients with stronger healthcare needs came to be in worse situation. The main causes of these bad results are as follows. Firstly, the system brought out results that healthcare providers choose patients, rather than patients choose medical institutions as intended. Secondly, the principle of equal treatment for all healthcare providers made it difficult for county councils to selectively support the medical institutions in the backward areas in healthcare.

KEYWORDS

healthcare choice system(vårdval), market-oriented healthcare reforms, healthcare accessibility gap, healthcare egalitarianism, county councils

Citation status

* References for papers published after 2023 are currently being built.

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