Primary Care after the Health Care Choice Reform. Choice, Quality and Productivity

Since 2010, all county councils have introduced choice of care in primary care. The reform related to choice of care gives people the right to select the primary health centre of their choice and healthcare providers the right to establish health centres as long as they fulfil some basic requirements. How does choice in primary care work? What has been the result of the reform for the quality of care? Has health care become more available and efficient due to the choice of care?

Taking its starting point in studies of how choice works in primary care, this report describes and analyses how primary care has developed since the introduction of choice. The empirical findings are mainly from studies of primary care in Region Halland, Region Skåne and the region of Västra Götaland.

The overall picture is that there has been an increase in availability and that people have used the opportunity to choose provider, which is entirely in line with the objectives of the health care choice reform. However, the reform does not seem to have resolved the problem with continuity in the contact with patients or coordination with other parts in the health care system. It is not yet possible, from existing research, to draw any clear conclusions regarding the consequences of choice of care for equal access to care or the quality and efficiency of health care.

The author is ANNA HÄGER GLENNGÅRD, PhD in Business Administration, School of Economics and Management at Lund University.