Photo: Helena Wahlman/imagebank.sweden.se
Healthcare in Sweden
Healthcare in Sweden is largely tax-funded, a system that ensures everyone has equal access to healthcare services. Challenges include funding, quality and efficiency.
Sweden is divided into 290 municipalities and 20 county councils. Swedish healthcare is decentralised – responsibility lies with the county councils and, in some cases, local councils or municipal governments. This is regulated by the Health and Medical Service Act. The role of the central government is to establish principles and guidelines, and to set the political agenda for health and medical care.
County councils are political bodies whose representatives are elected by county residents every four years on the same day as national general elections. Halland, Skåne and Västra Götaland county councils – as well as Gotland municipality – are called regional councils and have assumed responsibility for regional development from the state.
Local and regional responsibilities
Swedish policy states that every county council must provide residents with good-quality health and medical care, and work to promote good health for the entire population. As of 2019, county councils also cover dental care costs for local residents up to the age of 23. Dental care from the age of 24 is subsidised by the state.
Sweden’s municipalities are responsible for care for the elderly in the home or in special accommodation. Their duties also include care for people with physical disabilities or psychological disorders and providing support and services for people released from hospital care as well as for school healthcare.
Just as in many other developed countries, people in Sweden are living longer and longer. The average life span is now 84 years for women and 81 years for men. This can be attributed in part to falling mortality rates from heart attacks and strokes. About one in five people is 65 or older. That means Sweden proportionally has one of Europe’s largest elderly populations. On the other hand, the number of children born in Sweden has been increasing each year since the late 1990s. The ageing population puts pressure on Sweden’s healthcare system.
Patient safety and the quality of care
Many of the challenges confronting Swedish healthcare can also be seen in other countries, and include issues of access, quality, efficiency and funding. One priority area is patient safety. In early 2011, Sweden enacted a new patient safety law, which gives patients, consumers and family members new opportunities to influence the quality of healthcare. The aim is to make it easier to report cases of wrong treatment.
The National Patient Survey provides an annual measurement of how patients perceive the quality of healthcare. Questions concern treatment, patient involvement, confidence in care and information. The results are compiled by every county council and region and are used to develop and improve care.
Specialist care within 90 days
Waiting times for pre-planned care, such as cataract or hip-replacement surgery, have long been a cause of dissatisfaction. As a result, Sweden introduced a healthcare guarantee in 2005.
This means all patients should be in contact with a local health centre the same day they seek help and have a doctor’s appointment within seven days. After an initial examination, no patient should have to wait more than 90 days to see a specialist, and no more than 90 days for an operation or treatment, once it has been determined what care is needed. If the waiting time is exceeded, patients are offered care elsewhere and the cost, including any travel costs, is paid by their county council.
Statistics from 2017 indicate that about 79.1 per cent of the patients see a specialist within 90 days and receive treatment or are operated on within a further 90 days.
Midwives bring down mortality
Sweden has long seen the importance of having professional midwives. Research shows this has resulted in a sharp reduction in mortality among women in childbirth.
In the 18th century, the rate was about 1 in 100. By the beginning of the 20th century, mortalities had dropped to 250 women per 100,000 live births. Today, maternal mortality in Sweden is among the lowest in the world: fewer than 3 out of 1,000 babies and fewer than 4 women out of 100,000 die in birth.
Photo: Simon Paulin/imagebank.sweden.se
Public spending on care
Costs for health and medical care as a percentage of Sweden’s gross domestic product (GDP) is fairly stable and on par with most other European countries. In 2016, health and medical care represented 11 per cent of GDP. The bulk of health and medical costs in Sweden are paid for by county council and municipal taxes. Contributions from the national government are another source of funding, while patient fees cover only a small percentage of costs.
Government spending on health and medical care, including dental, amounted to SEK 67.4 billion in 2017, one of the larger expenses for the government.
Private healthcare providers
It is now more common for county councils to buy services from private healthcare providers – in 2013, 12 per cent of healthcare was financed by county councils but carried out by private care providers. An agreement guarantees that patients are covered by the same regulations and fees that apply to municipal care facilities.
Last updated: 20 December 2018