Scandinavian Working Papers in Economics

Working Papers,
Lund University, Department of Economics

No 2016:36: Patient Choice, Entry, and the Quality of Primary Care: Evidence from Swedish Reforms

Jens Dietrichson (), Lina Maria Ellegård () and Gustav Kjellsson ()
Additional contact information
Jens Dietrichson: The Danish National Centre for Social Research (SFI)
Lina Maria Ellegård: Department of Economics, Lund University, Postal: Department of Economics, School of Economics and Management, Lund University, Box 7082, S-220 07 Lund, Sweden
Gustav Kjellsson: Department of Economics, University of Gothenburg

Abstract: Policies aimed to spur quality competition among health care providers are ubiquitous, but their impact on quality is ex ante ambiguous. This study contributes to the sparse empirical literature on primary care quality by examining the heterogeneous impact of recent competition enhancing reforms in Sweden. The reforms led to substantially more entry of new providers in more exposed markets, but the effects on primary care quality in these markets were modest: we find small improvements of patients’ overall satisfaction with care, but no consistently significant effects on avoidable hospitalization rates or satisfaction with access to care.

Keywords: Competition; Patient choice; Primary health care; Quality

JEL-codes: D04; H75; I11; I18

73 pages, First version: December 14, 2016. Revised: June 27, 2018.

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