Web-economic-crisis-health-systems-and-health-web
Web-economic-crisis-health-systems-and-health-web Web-economic-crisis-health-systems-and-health-web
Country profiles of health system responses to the crisis | Sweden 493 % Sweden: Fig. 1 Economic and fiscal indicators 2000–2007 and 2008–2011 60 55 50 45 40 35 30 25 20 15 10 5 0 −5 −10 −15 −20 −25 −30 _ _ _ _ ● ● _ _ _ _ _ _ _ _ ● _ ● ● _ _ Real GDP per capita growth _ _ ● ● _ _ _ _ _ _ _ ● ● ● _ _ _ Deficit/surplus (% GDP) _ _ _ _ _ _ _ _ _ _ ● ● _ _ _ ● _ ● _ ● _ _ _ _ _ Government spending (% GDP) _ _ _ _ _ ● ● ● ● ● _ _ _ _ _ Government health spending (% total government spending) _ _ _ _ _ _ _ ● _ ● ● ● ● _ _ _ 10−year bond rates Notes: Deficit/surplus: Eurostat; 10-year bond rates: European Central Bank; Other indicators: WHO Health for All. Sweden: Fig. 2 Trends in per capita spending on health, 2000–2011 Year 2000−2007 2008 2009 2010 2011 _ _ _ _ _ _ _ _ _ ● ● ● ● ● _ _ _ _ _ Unemployment rate 3000 Public spending per capita OOP spending per capita Non−OOP private spending per capita Per capita spending $, PPP 2000 1000 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Growth % 75 50 25 0 Growth % 20 10 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Public spending per capita growth OOP spending per capita growth Note: Spending calculated from WHO Health for All. Non−OOP private spending per capita growth
494 Economic crisis, health systems and health in Europe: country experience User charges • Cap on OOP payments in a 12-month period increased from SEK 900 to SEK 1100 for health services and from SEK 1800 to SEK 2200 for prescription drugs; from 2013 increases in OOP payment cap are linked to the national index of prices and earnings (2012). Changes to health service planning, purchasing and delivery Prices of medical goods • No response reported. Salaries and motivation of health sector workers • Employment freeze in hospital sector (in some county councils) through not replacing retiring staff or covering for staff on sick leave (2012). Payment to providers • No response reported. Overhead costs: restructuring the Ministry of Health and purchasing agencies • There is an ongoing discussion on how to organize the national authorities. One report published in 2012 suggested a new structure with clearer responsibilities and fewer authorities. Provider infrastructure and capital investment • No response reported. Priority setting or protocols to change access to treatments, coordination of care and patterns of use • No response reported. Waiting times • The waiting time guarantee introduced in 2005 was enshrined in legislation (Health Care Act 2010), giving patients the right to seek care from an alternative provider at no extra cost if they are not treated within the guaranteed time and strengthening their rights to a second opinion and coordinated multidisciplinary care (2010). • Introduction of mandatory patient choice of primary care provider and freedom of establishment for accredited private providers across all counties to improve access to primary care and extend opening times (2010). Health promotion and prevention • Introduction of national guidelines in preventing smoking and alcohol consumption and for promoting good diet and exercise (2011). • Several county council initiatives with financial incentives to foster preventive actions within primary care.
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494 Economic <strong>crisis</strong>, <strong>health</strong> <strong>systems</strong> <strong>and</strong> <strong>health</strong> in Europe: country experience<br />
User charges<br />
• Cap on OOP payments in a 12-month period increased from SEK 900<br />
to SEK 1100 for <strong>health</strong> services <strong>and</strong> from SEK 1800 to SEK 2200 for<br />
prescription drugs; from 2013 increases in OOP payment cap are linked to<br />
the national index of prices <strong>and</strong> earnings (2012).<br />
Changes to <strong>health</strong> service planning, purchasing <strong>and</strong> delivery<br />
Prices of medical goods<br />
• No response reported.<br />
Salaries <strong>and</strong> motivation of <strong>health</strong> sector workers<br />
• Employment freeze in hospital sector (in some county councils) through not<br />
replacing retiring staff or covering for staff on sick leave (2012).<br />
Payment to providers<br />
• No response reported.<br />
Overhead costs: restructuring the Ministry of Health <strong>and</strong> purchasing agencies<br />
• There is an ongoing discussion on how to organize the national authorities.<br />
One report published in 2012 suggested a new structure with clearer<br />
responsibilities <strong>and</strong> fewer authorities.<br />
Provider infrastructure <strong>and</strong> capital investment<br />
• No response reported.<br />
Priority setting or protocols to change access to treatments, coordination<br />
of care <strong>and</strong> patterns of use<br />
• No response reported.<br />
Waiting times<br />
• The waiting time guarantee introduced in 2005 was enshrined in<br />
legislation (Health Care Act 2010), giving patients the right to seek care<br />
from an alternative provider at no extra cost if they are not treated within<br />
the guaranteed time <strong>and</strong> strengthening their rights to a second opinion <strong>and</strong><br />
coordinated multidisciplinary care (2010).<br />
• Introduction of m<strong>and</strong>atory patient choice of primary care provider <strong>and</strong><br />
freedom of establishment for accredited private providers across all counties to<br />
improve access to primary care <strong>and</strong> extend opening times (2010).<br />
Health promotion <strong>and</strong> prevention<br />
• Introduction of national guidelines in preventing smoking <strong>and</strong> alcohol<br />
consumption <strong>and</strong> for promoting good diet <strong>and</strong> exercise (2011).<br />
• Several county council initiatives with financial incentives to foster preventive<br />
actions within primary care.
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