Overview

The Swedish health care system is decentralized

Health care is part of social protection in Sweden, with predominantly tax-based financing and public provision. The goal is to provide good health and care on equal terms. The main responsibility for financing, organizing and providing health care is delegated to the 21 regions. The responsibilities of 290 municipalities include financing, organizing and providing health care in ordinary and special housing for elderly people and people with functional impairments, and health care in schools. The Ministry of Health and Social Affairs, with support from national government agencies, is responsible for overall health care policy and high-level oversight.

Health expenditure in Sweden is comparatively high and universal coverage applies

The Swedish health care system has high public funding, universal coverage, an ambitious uptake of modern technologies and efforts to prevent unhealthy lifestyles. These attributes contribute to low levels of unmet needs, favourable health outcomes and good health status in the population compared with other countries.

Important reforms have focused on improving the availability of services by improving patient choice, strengthening primary care and concentrating specialist care

Improving availability has been an explicit policy goal with efforts including the introduction of privatization and choice in primary care and selected areas of specialist care. Since 2012, reforms have mainly focused on improving waiting times, continuity and coordination of care, and overall health system efficiency. Several reform efforts have been directed at strengthening the primary care sector. Reform themes in specialist care concentrate on the implementation of evidence-based and standardized care processes and further concentration of services both at national and regional levels.

Increasing health system efficiency remains explicit policy goals

Regions have changed the financial incentives to providers by moving away from activity and P4P based payment models, towards fixed and/or capitated payment. Other innovative changes include support of substitution between staff categories and implementing digitalization. Future developments are likely to include continued discussion on a more decisive role for the national government.