Which model of choice for citizens is best able to foster the establishments of primary health care units? Choice in primary health care was implemented in Sweden in 2009 in order to enhance service quality by means of competition between private and public health care units and to provide citizens with more alternatives. The Swedish Competition Authority commissioned Copenhagen Economics to analyse the main developments so far in Sweden given the available empirical evidence and complementary interviews.

Our conclusions are:

1.      The principles adopted for listing citizens to primary health care units, the principal basis for reimbursement, is of critical importance for entry.

2.      Attracting patients is a tremendous challenge for new units – within the first year of operation, they are only half as successful as the incumbents.

3.      The level of trust among entrepreneurs that County Councils safeguard a level playing field between publicly and privately run units is of great importance. We conclude that a level playing field is a critical determinant of how well the reform will achieve its goals in the coming years.

4.      Patients’ perception of overall quality is positively related to the diversity of both privately run and publicly run primary health care units.

The report has provided input into the inquiry by the Swedish Competition Authority on primary health care units, which was commisioned by the Swedish Government and published 23rd of February 2012. 

Swedish Competition Authority: www.kkv.se

For further information, please contact Karl Lundvall