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Promoting competition in Swedish primary care

Journal article
Authors Lars Norén
Agneta Ranerup
Published in Journal of Health Organization and Management
Volume 29
Issue 1
Pages 25-38
ISSN 1477-7266
Publication year 2015
Published at Department of Applied Information Technology (GU)
Department of Business Administration, Management & Organisation
Pages 25-38
Language en
Keywords managed competition; primary care; quasi-market; Sweden; choice of care
Subject categories Information Systems, Social aspects, Economics and Business


Purpose - This paper examines the role of accreditation documents in the competition based on provider quality in a quasi-market for primary healthcare. Design/methodology/approach - The paper uses a mixed-method research methodology to analyse two primary healthcare accreditation documents in two Swedish regions. Nineteen interviews were conducted with actors involved in the creation and use of such documents. Findings - This paper points to the crucial role of accreditation documents in the identification of quality differences that influence the competition in primary healthcare. This finding contrasts with the commonly held laissez-faire idea that competition causes providers to develop their own service concepts and where the invisible hand creates quality differences. The paper adds to the discussion with its detailed description of how accreditation documents create competition among primary healthcare providers through selection processes, quality differentiation, and ranking. Research limitations/implications - The paper does not explore quality differences in the medical treatment of patients in primary healthcare centres. Practical implications - The paper provides insights for politicians on how to use accreditation documents to control competition and regulate choice. Originality/value ¬- The paper takes an innovative approach to the examination of how accreditation documents increase the competition in primary healthcare choice.

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