Patient choice reforms and the socioeconomic distribution of Swedish primary health care

Swedish primary health care (PHC) has undergone significant changes in recent years. Following the introduction of patient choice reforms, the number of PHC clinics and visits has increased. In this project we study who has benefited from the increased access to Swedish PHC – has everyone benefited equally, regardless of age, sex, education and income?

Aim of the project

The aim of the project is to describe how Swedish PHC is distributed over individuals with different socioeconomic background. The aim is also to assess any possible effects of patient choice reforms on the socioeconomic distribution of access to, utilisation of and outcomes from PHC. The project is based on administrative health care data from three Swedish counties, which has been linked to registry data on individual education, income and other socioeconomic factors.

Results in brief

Results from the first sub-study reveal that the reforms led to increased access to GP visits, but implied small changes in their socioeconomic distribution. In the county where patient choice was combined with provider reimbursement models with incentives for higher visit volumes, changes were more pro-poor over time. It is however not clear whether this was at the expense of reduced visit length or content for poorer individuals. Other aspects of the reform will be further analysed in upcoming substudies.

Continued work

This is an ongoing project which is expected to finish in 2023.

Reports and publications

Socioeconomic distribution of GP visits following patient choice reform and differences in reimbursement models: Evidence from Sweden.
Sveréus S, Kjellsson G, Rehnberg C
Health Policy 2018 Sep;122(9):949-956

Contact person

Sofia Sveréus

Affiliated to research
Unit for Health Economics and Policy
C7 Department of Learning, Informatics, Management and Ethics