uu.seUppsala University Publications
Change search
Link to record
Permanent link

Direct link
BETA
Alternative names
Publications (3 of 3) Show all publications
Kullberg, L., Blomqvist, P. & Winblad, U. (2018). Market-orienting reforms in rural health care in Sweden: how can equity in access be preserved?. International Journal for Equity in Health, 17, Article ID 123.
Open this publication in new window or tab >>Market-orienting reforms in rural health care in Sweden: how can equity in access be preserved?
2018 (English)In: International Journal for Equity in Health, ISSN 1475-9276, E-ISSN 1475-9276, Vol. 17, article id 123Article in journal (Refereed) Published
Abstract [en]

Background: Health care provision in rural and urban areas faces different challenges. In Sweden, health care provision has been predominantly public and equitable access to care has been pursued mainly through public planning and coordination. This is to ensure that health needs are met in the same manner in all parts of the country, including rural or less affluent areas. However, a marketization of the health care system has taken place during recent decades and the publicly planned system has been partially replaced by a new market logic, where private providers guided by financial concerns can decide independently where to establish their practices. In this paper, we explore the effects of marketization policies on rural health care provision by asking how policy makers in rural counties have managed to combine two seemingly contradictory health policy goals: to create conditions for market competition among health care providers and to ensure equal access to health care for all patients, including those living in rural and remote areas. Methods: A qualitative case study within three counties in the northern part of Sweden, characterized by vast rural areas, was carried out. Legal documents, the "accreditation documents" regulating the health care quasi-markets in the three counties were analyzed. In addition, interviews with policy makers in the three county councils, representing the political majority, the opposition, and the political administration were conducted in April and May 2013. Results: The findings demonstrate the difficulties involved in introducing market dynamics in health care provision in rural areas, as these reforms not only undermined existing resource allocation systems based on health needs but also undercut attempts by local policy makers to arrange for care provision in remote locations through planning and coordination. Conclusion: Provision of health care in rural areas is not well suited for market reforms introducing competition, as this may undermine the goal of equity in access to health care, even in a publicly financed health care system.

Keywords
Rural health care, Marketization, Patient choice, Health care planning, Health governance, Sweden
National Category
Public Health, Global Health, Social Medicine and Epidemiology Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:uu:diva-362645 (URN)10.1186/s12939-018-0819-8 (DOI)000441946700002 ()30119665 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, Dnr 2011-01137
Available from: 2018-10-09 Created: 2018-10-09 Last updated: 2018-10-09Bibliographically approved
Masterton, M., Boström, L. & Winblad, U. (2015). Patientcentrerade vårdmöten: förutsättningar och begränsningar i svensk hälso- och sjukvård.
Open this publication in new window or tab >>Patientcentrerade vårdmöten: förutsättningar och begränsningar i svensk hälso- och sjukvård
2015 (Swedish)Report (Other academic)
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:uu:diva-270567 (URN)
External cooperation:
Projects
Forum för Health Policy i samarbete med LIF - de forskande läkemedelsföretagen
Note

Linn Boström heter numera Linn Kullberg

Available from: 2015-12-30 Created: 2015-12-30 Last updated: 2016-08-26Bibliographically approved
Winblad, U., Blomqvist, P. & Boström, L. (2015). Patientcentrering i Sverige: aktuella initiativ. Stockholm: Forum för Health Policy
Open this publication in new window or tab >>Patientcentrering i Sverige: aktuella initiativ
2015 (Swedish)Report (Other academic)
Place, publisher, year, edition, pages
Stockholm: Forum för Health Policy, 2015
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:uu:diva-270569 (URN)
External cooperation:
Note

Linn Boström heter numera Linn Kullberg

Available from: 2015-12-30 Created: 2015-12-30 Last updated: 2016-08-26Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-7869-408x

Search in DiVA

Show all publications