Institute of Economic Research, Lund University School of Economics and Management, Lund, Sweden.
Health Policy. 2011 Nov;103(1):31-7. doi: 10.1016/j.healthpol.2011.05.014. Epub 2011 Jun 24.
Recent reforms in Swedish primary care have involved choice of provider for the population combined with freedom of establishment and privatisation of providers. This study focus to what extent individuals feel they have exercised a choice of provider, why they exercise choice and where they search for information, based on a population survey in three Swedish counties. The design of the study enabled for studying behaviour with respect to differences in time since introduction of the reform and differences in number of alternative providers and establishments of new providers in connection with the reform. About 60% of the population in the three counties felt that they had made a choice of provider in connection with or after the introduction of a reform focusing on choice and privatisation. Establishments of new providers and having enough information increased the likelihood whereas preferences for direct access to a specialist decreased the likelihood of making a choice. The data further suggests that individuals were rather passive in their search for information and tended to choose providers that they previously had been in contact with. This is in line with results from previous studies and poses challenges for county councils governance of reforms.
最近瑞典的基层医疗改革涉及到为民众提供选择服务提供商的机会，同时也允许服务提供商自由设立和私有化。本研究以瑞典三个县的人口调查为基础，重点研究了个人在多大程度上感到自己选择了服务提供商，他们选择的原因以及他们从何处寻找信息，这些都是基于对改革后一段时间内的差异以及与改革相关的新服务提供商的设立和替代服务提供商数量的差异进行的研究。在这三个县中，大约 60%的人表示，他们在引入以选择和私有化为重点的改革后或之后，对服务提供商做出了选择。新服务提供商的设立和有足够的信息增加了做出选择的可能性，而直接向专家寻求帮助的偏好则降低了做出选择的可能性。数据还表明，个人在寻找信息方面相当被动，倾向于选择他们之前有过接触的服务提供商。这与之前的研究结果一致，也给郡议会的改革治理带来了挑战。
