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Choice policies in Northern European health systems

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  • Vrangbaek, Karsten
  • Robertson, Ruth
  • Winblad, Ulrika
  • Van de Bovenkamp, Hester
  • Dixon, Anna

Abstract

This paper compares the introduction of policies to promote or strengthen patient choice in four Northern European countries – Denmark, England, the Netherlands and Sweden. The paper examines whether there has been convergence in choice policies across Northern Europe. Following Christopher Pollitt's suggestion, the paper distinguishes between rhetorical (discursive) convergence, decision (design) convergence and implementation (operational) convergence (Pollitt, 2002). This leads to the following research question for the article: Is the introduction of policies to strengthen choice in the four countries characterised by discursive, decision and operational convergence? The paper concludes that there seems to be convergence among these four countries in the overall policy rhetoric about the objectives associated with patient choice, embracing both concepts of empowerment (the intrinsic value) and market competition (the instrumental value). It appears that the institutional context and policy concerns such as waiting times have been important in affecting the timing of the introduction of choice policies and implementation, but less so in the design of choice policies. An analysis of the impact of choice policies is beyond the scope of this paper, but it is concluded that further research should investigate how the institutional context and timing of implementation affect differences in how the choice policy works out in practice.

Suggested Citation

  • Vrangbaek, Karsten & Robertson, Ruth & Winblad, Ulrika & Van de Bovenkamp, Hester & Dixon, Anna, 2012. "Choice policies in Northern European health systems," Health Economics, Policy and Law, Cambridge University Press, vol. 7(1), pages 47-71, January.
  • Handle: RePEc:cup:hecopl:v:7:y:2012:i:01:p:47-71_00
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    Citations

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    Cited by:

    1. Moscelli, Giuseppe & Siciliani, Luigi & Gutacker, Nils & Gravelle, Hugh, 2016. "Location, quality and choice of hospital: Evidence from England 2002–2013," Regional Science and Urban Economics, Elsevier, vol. 60(C), pages 112-124.
    2. Martin Gaynor & Kate Ho & Robert J. Town, 2015. "The Industrial Organization of Health-Care Markets," Journal of Economic Literature, American Economic Association, vol. 53(2), pages 235-284, June.
    3. Sergey Shishkin & Alexandra Burdyak & Elena Potapchik, 2013. "Patient choice in the post-Semashko health care system," HSE Working papers WP BRP 09/PA/2013, National Research University Higher School of Economics.
    4. Tynkkynen, Liina-Kaisa & Alexandersen, Nina & Kaarbøe, Oddvar & Anell, Anders & Lehto, Juhani & Vrangbӕk, Karsten, 2018. "Development of voluntary private health insurance in Nordic countries – An exploratory study on country-specific contextual factors," Health Policy, Elsevier, vol. 122(5), pages 485-492.
    5. Gutacker, Nils & Siciliani, Luigi & Moscelli, Giuseppe & Gravelle, Hugh, 2016. "Choice of hospital: Which type of quality matters?," Journal of Health Economics, Elsevier, vol. 50(C), pages 230-246.
    6. Visa Pitkänen & Signe Jauhiainen & Ismo Linnosmaa, 2020. "Low risk, high reward? Repeated competitive biddings with multiple winners in health care," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(4), pages 483-500, June.
    7. Giuseppe Moscelli & Luigi Siciliani & Nils Gutacker & Hugh Gravelle, 2016. "Location, quality and choice of hospital: Evidence from England 2002/3 - 2012/13," Working Papers 123cherp, Centre for Health Economics, University of York.
    8. Moscelli, Giuseppe & Siciliani, Luigi & Gutacker, Nils & Cookson, Richard, 2018. "Socioeconomic inequality of access to healthcare: Does choice explain the gradient?," Journal of Health Economics, Elsevier, vol. 57(C), pages 290-314.
    9. Sveréus, Sofia & Kjellsson, Gustav & Rehnberg, Clas, 2018. "Socioeconomic distribution of GP visits following patient choice reform and differences in reimbursement models: Evidence from Sweden," Health Policy, Elsevier, vol. 122(9), pages 949-956.
    10. Elaine Kelly & George Stoye, 2015. "New joints: private providers and rising demand in the English National Health Service," IFS Working Papers W15/22, Institute for Fiscal Studies.
    11. Dahlgren, Cecilia & Dackehag, Margareta & Wändell, Per & Rehnberg, Clas, 2021. "Simply the best? The impact of quality on choice of primary healthcare provider in Sweden," Health Policy, Elsevier, vol. 125(11), pages 1448-1454.
    12. Emily J Steel, 2019. "The Duplicity of Choice and Empowerment: Disability Rights Diluted in Australia’s Policies on Assistive Technology," Societies, MDPI, vol. 9(2), pages 1-12, May.
    13. Fredriksson, Mio, 2013. "Is patient choice democratizing Swedish primary care?," Health Policy, Elsevier, vol. 111(1), pages 95-98.
    14. Jolanki, Outi & Tynkkynen, Liina-Kaisa, 2018. "Primary health care nurses’ views on patients’ abilities and resources to make choices and take decisions on health care," Health Policy, Elsevier, vol. 122(9), pages 957-962.

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