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Choice policies in Northern European health systems
AKF Danish Institute of Governmental Studies, Denmark.
The Commonwealth Fund, USA.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
Erasmus University, The Netherlands.
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2012 (English)In: Health Economics, Policy and Law, ISSN 1744-1331, E-ISSN 1744-134X, Vol. 7, no 1, 47-71 p.Article in journal (Refereed) Published
Abstract [en]

This paper compares the introduction of policies to promote or strengthen patient choice in four Northern European countries – Denmark, England, the Netherlands and Sweden. The paper examines whether there has been convergence in choice policies across Northern Europe. Following Christopher Pollitt's suggestion, the paper distinguishes between rhetorical (discursive) convergence, decision (design) convergence and implementation (operational) convergence (Pollitt, 2002). This leads to the following research question for the article: Is the introduction of policies to strengthen choice in the four countries characterised by discursive, decision and operational convergence? The paper concludes that there seems to be convergence among these four countries in the overall policy rhetoric about the objectives associated with patient choice, embracing both concepts of empowerment (the intrinsic value) and market competition (the instrumental value). It appears that the institutional context and policy concerns such as waiting times have been important in affecting the timing of the introduction of choice policies and implementation, but less so in the design of choice policies. An analysis of the impact of choice policies is beyond the scope of this paper, but it is concluded that further research should investigate how the institutional context and timing of implementation affect differences in how the choice policy works out in practice.

Place, publisher, year, edition, pages
2012. Vol. 7, no 1, 47-71 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-163772DOI: 10.1017/S1744133111000302ISI: 000307172800007OAI: oai:DiVA.org:uu-163772DiVA: diva2:464826
Available from: 2011-12-14 Created: 2011-12-14 Last updated: 2012-10-01Bibliographically approved

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Winblad, Ulrika
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