Sweden: regional and local autonomy

The chapter analyses the challenges, obstacles and solutions for better coordination of healthcare and long-term care in Sweden, based on interviews with major stakeholder organizations. The Swedish systems of healthcare and long-term care are universal in principle, but separated from each other in institutional and financial terms. Health is regionally, and long-term care locally organized. Coordination mainly develops at the organizational and professional levels. The long-established practice of primary healthcare centers, a well-developed hospital infrastructure, and the core of local long-term care services enable relatively effective coordination. In addition, Sweden has a highly developed digital infrastructure by international standards in both health and long-term care. Still, however, stakeholders complain that these digital tools are often incompatible with each other. Even if institutional conditions in Sweden are supporting coordination, in the eyes of stakeholders there are still shortcomings that need further policy actions.