Healthcare is an important issue in the run-up to the upcoming elections, with many ideologies, opinions and arguments being put forward. In these debates, it can be challenging to keep track of terminology and the meaning of certain concepts. We want as many people as possible to understand the ongoing debates and we want to help increase understanding in the run-up to the elections!
We will explain six concepts/areas that are commonly used: Close care, Regions' responsibility, Care providers (public/private), Accessibility, Equality and Place of care. We work with these concepts and areas daily in our assignments for various clients.
Please note that independent sources such as SKR, the National Board of Health and Welfare, Vinnova, IVO and Swedish laws have been used to explain the concepts.
Close care/primary care reform
Sweden has and has historically had strong hospital-based care. Good and close care can be described as an overarching goal for the transition taking place in health care. The aim of the transition is to ensure that healthcare is increasingly organized and provided on the basis of the patient's needs and circumstances. This means health care with primary care as the hub, with a shift from higher to lower levels of care. The starting point is that the patient's entry point into healthcare should be primary care, which through good interaction with other health services can help or refer the patient before the need for higher-level care arises. The shift means, for example, that patients who have previously been treated in inpatient care can be treated by day care or specialized outpatient care, and patients who have been treated in specialized outpatient care should be helped by primary care.
Responsibilities of regions and municipalities in health care
Regions have the basic responsibility to provide good healthcare and dental care. Regions are always responsible for the care provided by doctors. Municipalities are responsible for providing healthcare in certain areas, such as elderly care, home care and rehabilitation. Regions and municipalities decide on the size of the health care system and how it is organized, for example in the form of hospitals and health centres. They are responsible for staffing and reimbursement for their own activities and for local salaries. Parliament provides the framework for healthcare in the form of legislation governing what regions and municipalities should do. Parliament also decides on the budget, with general and targeted government grants.
Equality in health care
Equal care means that care is provided on equal terms to the whole population. The debate on health inequalities often highlights factors such as different treatment based on sex, gender, ethnicity, religion, place of residence and level of education. These factors are an important part of the debate, but not the only ones.
Other factors should also be highlighted when talking about equity of care that affect whether care is provided on equal terms or not, for example
- Geographical differences where the distance to health care differs if you live in a big city or a rural area
- Regional conditions where regions have different economic models
- Use of digital care
- Access to skills
- National structures for the implementation of new medicines and treatments
Public and private care providers
Anyone who provides healthcare or dental care is a healthcare provider. A healthcare provider can be, for example, a region, a municipality, a limited company or a self-employed person. Regions and municipalities have a great deal of freedom in choosing how to provide health and social care. They can decide to hand over regional and municipal care to private providers.
Private companies have become increasingly important as providers of welfare services. The fact that municipalities and regions have increasingly handed over assignments to private providers has been driven by the perception that competition can be a driving force for operational development. Receiving care from a private care provider is not the same as financing your own care. Self-financed care can involve specific care that is not part of the public sector's remit and which individuals therefore choose to pay for themselves for various reasons.
Accessibility
Accessible healthcare means that everyone - regardless of where they live in the country - should be able to access healthcare services when needed and on equal terms. Those who have the greatest need for health care should be given priority for care. To create accessibility in healthcare, Sweden's regions work on the basis of the care guarantee, which means that care must be offered within a certain time. It is a statutory right that specifies the time limits within which care must be offered, after a decision on care has been made.
Hospital beds
According to the National Board of Health and Welfare, a care place is defined as a bed or seat in a care unit that can be used for care or treatment. A care place is found in inpatient care. Inpatient care is defined as health care provided to a patient whose condition requires resources that cannot be met in outpatient care or home care.
It is important to highlight that there are different 'stages' of a care place with different meanings:
- Physical care space: lying or sitting space in a care unit that can be used for care and treatment
- Established place of care: Place of care in inpatient care decided by the principal
- Available bed: Inpatient bed with physical layout, equipment and staffing to ensure patient safety and working environment
These are available beds that are ready for immediate treatment. An overcrowding is, for example, an event when an enrolled patient is treated on a bed that does not meet the requirements of an available bed.
