Experiences of introducing a quasi-market in Swedish primary care:

Fulfilment of overall objectives and assessment of provider activities

Authors

  • Anna Häger Glenngård Lund University, School of Economics and Management

Keywords:

Health care reform, Sweden, Quasi-market, Choice, Accountability, Primary care

Abstract

Health care as any other public service is subject to many potentially conflicting objectives and many actors. Over time, the traditional goal of health care systems of distributive justice has been accompanied by other objectives and health care reforms have developed accordingly. One type of reform in countries with publicly funded health care has evolved around replacing monopolistic state providers with competition among providers and choice for individuals: quasi-markets have been introduced. This new structure of governance, involving a mix of mechanisms for corrective action, seems to be appropriate for achieving a mix of objectives. New accountability relationships between providers and citizens are appropriate for holding providers to account for new objectives related to accessibility, quality as perceived by patients and responsiveness of services towards individuals. These objectives are visible to individuals at their point of contact with the provider. Such accountability relationships are not enough to achieve all overall objectives. It is necessary to establish and maintain dual accountability relationships with providers. Accountability relationships between providers and governments have to be maintained to achieve traditional objectives related to other aspects of quality, efficient management of resources and equitable distribution of services. 

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Author Biography

Anna Häger Glenngård, Lund University, School of Economics and Management

Anna Häger Glenngård (PhD) has more than 10 years of experience of applied research within the fields of health policy, health economics and health management and governnace in the context of the Swedish health care system as well as in low-income-countries. She also has experience of academic and short-course teaching including development of course material. Current areas of research include different aspects of quality in Swedish primary care, studies related to governance and accountability, including the design of provider payment systems, and coordination of care among different care providers.

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Published

2016-03-15

How to Cite

Glenngård, A. H. (2016). Experiences of introducing a quasi-market in Swedish primary care:: Fulfilment of overall objectives and assessment of provider activities. Scandinavian Journal of Public Administration, 21(1), 71–86. Retrieved from https://publicera.kb.se/sjpa/article/view/14980

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Section

Original Articles

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