A brief introduction to the Swedish health-care system UEMS-meeting 20/9/2014 Dr Elin Ericsson

• 9 500 000 inhabitants • 85 % live in the cities • 21 / km2 Funding of the

ó About 9 % of GDP

ó Taxpayer-funded ó Approx 97 % of medical costs

ó Patient fees

ó High-cost ceiling ó Patientfee max 110 €/year ó Prescribed medications 220 €/year Organization ó Shared responisibility ó Central government ó County councils ó Municipalities ó The Health and Medical Service Act regulates the responsibility for county councils and municipalities.

ó 21 counties ó 61 Hospitals with ER 24/7 ó 7 university hospitals ó Private care clinics ó 290 municipalities Central government ó The National Board of Health and Welfare ó Supervision ó Expert ó Licenses ó Establish principles and guidelines ó Set the political agenda for health and medical care ó Medical school ó Reaching agreement with the Swedish Association of Local Authorities and Regions Health care guarantee

ó Introduced 2005 as a part of the law.

ó Maximum: ó 0 days contact with (phone) ó 7 days doctors appointment in primary care ó 90 days to appointment with a specialist (if referd) ó 90 days to treatment / surgery Economical stimulation 2014

ó Aprox 1 million € divided between the counties each year

ó Min 70 % (80%)/ month ó to a specialist within 60 days ó To surgery / treatment within 60 days

ó Correct reports on waiting time 95% / month County councils ó Elected by the inhabitants in the county ó 90 % health care, 10 % culture, infrastructure etc ó Responsible for the health care ó Represented by the Swedish Association of Local Authorities and Regions in agreements with the central government ó Finance by ó Taxation ó Fees ó Government subsidies Municipalities

ó Care of the ó Elderly ó Physical och psychological disorders

ó Provide support and service after hospital care

ó School health care Problems

ó Lack of hospital beds, 2,7/1000 inhabitants (OECD- statistics)

ó Lack of nurses, at least in nursing

ó Heavy administration for doctors Do we have equal right to ?