PMID- 11766477
OWN - NLM
STAT- MEDLINE
DCOM- 20020516
LR  - 20190513
IS  - 1101-1262 (Print)
IS  - 1101-1262 (Linking)
VI  - 11
IP  - 4
DP  - 2001 Dec
TI  - Internal market systems in Sweden: seven years after the Stockholm model.
PG  - 380-5
AB  - BACKGROUND: Sweden, like other European countries in the 1990s introduced 
      internal market reforms in the delivery of health care. Specifically, in 
      Stockholm county, the Stockholm model was introduced to strengthen the position 
      of patients in their choice of care. Other reform measures introduced included 
      the family doctor's legislation, care guarantee and the adel reform. This paper 
      reports interviews with Swedish physicians, politicians and health economists 
      seven years after the introduction of these reforms. The broader goals of this 
      paper are to explore the extent to which these changes have overtime affected the 
      views of physicians as they reflect on their working conditions and experiences 
      with the use of the diagnostic-related groups (DRG) system. METHODS: Data was 
      obtained from in-depth interviews of 15 primary care physicians, 4 heads of 
      hospital departments (surgery), 5 county council members and 4 health economists 
      (N = 28). A content analysis was performed on major themes on the interview 
      transcripts. RESULTS: The majority of our respondents reported that the financial 
      incentives introduced through performance-based reimbursements do exist in 
      Stockholm county and that productivity and efficiency have increased over the 
      period of investigation. Primary physicians voiced support for the privatization 
      process in health care delivery. Most physicians reported that they were 
      generally satisfied with their work. Over half of the general physicians 
      complained about their working conditions but felt they have a unique way to play 
      as 'gatekeepers' in the overall Swedish health care delivery system. CONCLUSION: 
      Our findings suggest that physicians are generally satisfied with their working 
      conditions. Over 90% of our respondents support the use of a diagnostic-related 
      group. What is clear though is that the primary care physician's role due to its 
      potential benefit as an agent of cost control is important, but it is not clear 
      that the primary care physicians have made a major contribution to the Swedish 
      health care delivery system as they should be.
FAU - Quaye, R K
AU  - Quaye RK
AD  - Department of Sociology and Anthropology, College of Wooster, Wooster, Ohio 
      44691, USA. rquaye@acs.wooster.edu
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Eur J Public Health
JT  - European journal of public health
JID - 9204966
SB  - IM
CIN - Eur J Public Health. 2003 Mar;13(1):90-1; author reply 91. PMID: 12678323
MH  - *Attitude of Health Personnel
MH  - Choice Behavior
MH  - Diagnosis-Related Groups
MH  - Family Practice/organization & administration
MH  - *Health Care Reform
MH  - Health Care Sector/*organization & administration
MH  - Hospital Administration
MH  - Humans
MH  - Interviews as Topic
MH  - Job Satisfaction
MH  - Models, Organizational
MH  - Physician's Role
MH  - Politics
MH  - *Privatization
MH  - Reimbursement, Incentive
MH  - State Medicine
MH  - Sweden
EDAT- 2002/01/05 10:00
MHDA- 2002/05/17 10:01
CRDT- 2002/01/05 10:00
PHST- 2002/01/05 10:00 [pubmed]
PHST- 2002/05/17 10:01 [medline]
PHST- 2002/01/05 10:00 [entrez]
AID - 10.1093/eurpub/11.4.380 [doi]
PST - ppublish
SO  - Eur J Public Health. 2001 Dec;11(4):380-5. doi: 10.1093/eurpub/11.4.380.