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Wisell, Kristin
Publications (6 of 6) Show all publications
Wisell, K., Winblad, U. & Kälvemark Sporrong, S. (2019). Diversity as salvation?: A comparison of the diversity rationale in the Swedish pharmacy ownership liberalization reform and the primary care choice reform. Health Policy, 123(5), 457-461
Open this publication in new window or tab >>Diversity as salvation?: A comparison of the diversity rationale in the Swedish pharmacy ownership liberalization reform and the primary care choice reform
2019 (English)In: Health Policy, ISSN 0168-8510, E-ISSN 1872-6054, Vol. 123, no 5, p. 457-461Article in journal (Refereed) Published
Abstract [en]

Widespread liberalizing reform of the Swedish community pharmacy and primary care sectors took place in 2009–2010, including opening the market to private providers. One important rationale for the reforms was to increase diversity in the health-care system by providing more choices for individuals. The aim of this study was to increase the understanding how policy makers understood and defined diversity as a concept, and as a rationale for the reforms. The method used was document analysis of preparatory work and plenary parliament debate protocols. The results show that policy makers held vague and unclear definitions of diversity, which complicated its implementation. Diversity was sometimes seen as an effect of competition–a goal–while in other cases it was seen as a condition to be met in order to achieve competition–a means. Thus, policy makers viewed diversity both as a goal and as a means, making the underlying mechanisms unclear. The findings also revealed that policy makers failed to consistently demonstrate how the introduction of competition would lead to diversity.

Keywords
Community pharmacy, Community health care, Regulations, Liberalization, Sweden, Diversity
National Category
Pharmaceutical Sciences
Research subject
Social Pharmacy
Identifiers
urn:nbn:se:uu:diva-380072 (URN)10.1016/j.healthpol.2019.03.005 (DOI)000468719700003 ()30890380 (PubMedID)
Available from: 2019-03-23 Created: 2019-03-23 Last updated: 2019-06-24Bibliographically approved
Wisell, K., Winblad, U. & Sporrong, S. K. (2016). Stakeholders’ expectations and perceived effects of the pharmacy ownership liberalization reform in Sweden: a qualitative interview study. BMC Health Services Research, 16, Article ID 379.
Open this publication in new window or tab >>Stakeholders’ expectations and perceived effects of the pharmacy ownership liberalization reform in Sweden: a qualitative interview study
2016 (English)In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 16, article id 379Article in journal (Refereed) Published
Abstract [en]

Background: Reforms in the health-care sector, including the pharmacy sector, can have different rationales. The Swedish pharmacies were prior to 2009 organized in a state-owned monopoly. In 2009, a liberalization of the ownership took place, in which a majority of the pharmacies were sold to private owners. The rationales for this liberalization changed profoundly during the preparatory work, making it probable that other rationales than the ones first expressed existed. The aim of this study was to explore the underlying rationales (not stated in official documents) for the liberalization in the Swedish pharmacy sector, and also to compare the expectations with the perceived outcomes.

Methods: Semi-structured interviews were conducted with representatives from key stakeholder organizations; i.e., political, patient, and professional organizations. The analysis was performed in steps, and themes were developed in an inductive manner.

Results: One expectation among the political organization participants was that the ownership liberalization would create opportunities for ideas. The competition introduced in the market was supposed to lead to a more diversified pharmacy sector. After the liberalization, the participants in favor of the liberalization were surprised that the pharmacies were so similar.

Among the professional organization participants, one important rationale for the liberalization was to get better use of the pharmacists’ knowledge. However, all the professional, and some of the patient organization participants, thought that the counseling in the pharmacies had deteriorated after the liberalization.

As expected in the interviews, the post-liberalization pharmacy sector consists of more pharmacies. However, an unexpected perceived effect of the liberalization was, among participants from all the stakeholder groups, less access to prescription medicines in the pharmacies.

Conclusions: This study showed that the political organization participants had an ideological basis for their opinion. The political stakeholders did not have a clear view about what the liberalization should lead to, apart from abolishing the monopoly. The perceived effects are quite similar in the different stakeholder groups, and not as positive as were expected.

Keywords
community pharamcy, regulation, pharmacy policy, Sweden
National Category
Social and Clinical Pharmacy
Research subject
Social Pharmacy
Identifiers
urn:nbn:se:uu:diva-301433 (URN)10.1186/s12913-016-1637-6 (DOI)000381258500001 ()27519573 (PubMedID)
Projects
The monopoly experiment
Available from: 2016-08-23 Created: 2016-08-23 Last updated: 2019-03-24Bibliographically approved
Wisell, K. & Kälvemark-Sporrong, S. (2016). The Raison D’être for the Community Pharmacy and the Community Pharmacist in Sweden: A Qualitative Interview Study. Pharmacy, 4(1), Article ID 3.
Open this publication in new window or tab >>The Raison D’être for the Community Pharmacy and the Community Pharmacist in Sweden: A Qualitative Interview Study
2016 (English)In: Pharmacy, ISSN 2226-4787, Vol. 4, no 1, article id 3Article in journal (Refereed) Published
Abstract [en]

Community pharmacies are balancing between business (selling medicines and other products) and healthcare (using the pharmacists’ knowledge in order to improve drug utilization). This balance could be affected by regulations decided upon by politicians, but also influenced by others. The aim of this study was to explore important stakeholders’ views on community pharmacy and community pharmacists in Sweden. The method used was that of semi-structured qualitative interviews. Political, professional, and patient organization representatives were interviewed. The results show that informants who are pharmacists or representatives of a professional pharmacist organization generally have a healthcare-centered view on community pharmacy/pharmacists. However, different views on how this orientation should be performed were revealed, ranging from being specialists to dealing with uncomplicated tasks. Political organization representatives generally had a more business-oriented view, where competition in the market was believed to be the main driving force for development. A third dimension in which competition was not stressed also emerged; that community pharmacies should primarily distribute medicines. This dimension was most prevalent among the political and patient organization representatives. One conclusion to be drawn is that no stakeholder seemed to have a clear vision or was willing to take the lead for the development of the community pharmacy sector.

Keywords
community pharmacy; regulation; pharmacy policy; pharmacy reform; legislation; Sweden
National Category
Pharmaceutical Sciences
Identifiers
urn:nbn:se:uu:diva-279193 (URN)10.3390/pharmacy4010003 (DOI)000374049100003 ()
Available from: 2016-02-29 Created: 2016-02-29 Last updated: 2018-01-10Bibliographically approved
Wisell, K. & Sporrong, S. K. (2016). The Raison D’être for the Community Pharmacy and the Community Pharmacist in Sweden:: A Qualitative Interview Study. Pharmacy, 4(1)
Open this publication in new window or tab >>The Raison D’être for the Community Pharmacy and the Community Pharmacist in Sweden:: A Qualitative Interview Study
2016 (English)In: Pharmacy, ISSN 2226-4787, Vol. 4, no 1Article in journal (Refereed) Published
Abstract [en]

Community pharmacies are balancing between business (selling medicines and other products) and healthcare (using the pharmacists’ knowledge in order to improve drug utilization). This balance could be affected by regulations decided upon by politicians, but also influenced by others. The aim of this study was to explore important stakeholders’ views on community pharmacy and community pharmacists in Sweden. The method used was that of semi-structured qualitative interviews. Political, professional, and patient organization representatives were interviewed.

The results show that informants who are pharmacists or representatives of a professional pharmacist organization generally have a healthcare-centered view on community pharmacy/pharmacists. However, different views on how this orientation should be performed were revealed, ranging from being specialists to dealing with uncomplicated tasks. Political organization representatives generally had a more business-oriented view, where competition in the market was believed to be the main driving force for development. A third dimension in which competition was not stressed also emerged; that community pharmacies should primarily distribute medicines. This dimension was most prevalent among the political and patient organization representatives. One conclusion to be drawn is that no stakeholder seemed to have a clear vision or was willing to take the lead for the development of the community pharmacy sector.

Keywords
community pharmacy; regulation; pharmacy policy; pharmacy reform; legislation; Sweden
National Category
Social and Clinical Pharmacy Pharmaceutical Sciences
Research subject
Social Pharmacy
Identifiers
urn:nbn:se:uu:diva-380060 (URN)10.3390/pharmacy4010003 (DOI)
Available from: 2019-03-23 Created: 2019-03-23 Last updated: 2019-09-05Bibliographically approved
Wisell, K., Winblad, U. & Sporrong, S. K. (2015). Reregulation of the Swedish pharmacy sector: A qualitative content analysis of the political rationale. Health Policy, 119(5), 648-653
Open this publication in new window or tab >>Reregulation of the Swedish pharmacy sector: A qualitative content analysis of the political rationale
2015 (English)In: Health Policy, ISSN 0168-8510, E-ISSN 1872-6054, Vol. 119, no 5, p. 648-653Article in journal (Refereed) Published
Abstract [en]

In 2009, a reregulation of the Swedish pharmacy sector took place, and a fundamental change in ownership and structure followed. The reregulation provides an opportunity to reveal the politicians' views on pharmacies. The aim of thiS study was to explore and analyze the political arguments for the reregulation of the Swedish pharmacy sector in 2009. The method used was a qualitative content analysis of written political documents regarding the reregulation. The primary rationales for the reregulation were better availability, efficiency, price pressure, and safe usage of medicines. During the preparatory work, the rationales of diversity on the market and entrepreneurship were added, while the original rationales of efficiency, price pressure, and better usage of medicines were abandoned. The reform can be seen as a typical New Public Management reform influenced by the notion that private actors are better equipped to perform public activities. The results point to that the reform was done almost solely in order to introduce private ownership in the pharmacy sector, and was not initiated in order to solve any general problems, or to enhance patient outcomes of medicine use.

Keywords
Pharmacy policy, Regulation, Community pharmacy, Sweden
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:uu:diva-256851 (URN)10.1016/j.healthpol.2015.03.009 (DOI)000355031900011 ()25841749 (PubMedID)
Available from: 2015-06-26 Created: 2015-06-26 Last updated: 2019-03-24Bibliographically approved
Wisell, K., Sporrong, S. K. & Winblad Spångberg, U. (2015). The innovation that never came true: stakeholders views of the perceived effects of the reregulation of the Swedish pharmacies. Paper presented at Nordic Social Pharmacy and Health Services Research Conference & The Nordic Networking Group of Clinical Pharmacy, June 3–5, 2015, Tartu, Estonia. International Journal of Clinical Pharmacy, 37, 15-15
Open this publication in new window or tab >>The innovation that never came true: stakeholders views of the perceived effects of the reregulation of the Swedish pharmacies
2015 (English)In: International Journal of Clinical Pharmacy, ISSN 2210-7703, E-ISSN 2210-7711, Vol. 37, p. 15-15Article in journal, Meeting abstract (Other academic) Published
National Category
Pharmaceutical Sciences
Identifiers
urn:nbn:se:uu:diva-266043 (URN)10.1007/s11096-015-0121-4 (DOI)000361489300028 ()
Conference
Nordic Social Pharmacy and Health Services Research Conference & The Nordic Networking Group of Clinical Pharmacy, June 3–5, 2015, Tartu, Estonia
Available from: 2015-11-05 Created: 2015-11-05 Last updated: 2018-01-10Bibliographically approved
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