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Choice of Primary Health Care: A Secondary Analysis of The Free Choice System in Stockholm and Three County Councils

Lunds universitet/Avdelningen för sociologi
Publication Date
  • Free Choice System
  • New Public Management
  • Primary Health Care
  • The Third Way
  • Public Sector
  • Private Sector
  • Civil Sector
  • Citizens’ Participation
  • Public Value Creation
  • Social Sciences
  • Economics
  • Law
  • Political Science


This Master’s thesis examines the outcomes of the new Free Choice policy with particular emphasis on whether giving residents the right to choose their providers of primary health care leads to a more equal distribution of primary health care accessibility. This study is based on the Secondary Analysis of assessment for vårdval (choice of health system) in Stockholm by Karolinska Institute (2010), socio-economic distribution in Stockholm and the Population Surveys in three county councils (Halland, Skåne and the Västra Götland Region) from 2009. By using the New Public Management (NPM) theory and the Public Value Creation this study tries to considerer effectiveness and efficiency of service and understand the meaning of citizen’s choice and participation in the free choice system. This study finds that the Swedish Primary health care system follows a line with the NPM theory, which more focuses on the outcomes and performance of service with high rates of patient satisfaction. In addition, individual choice of primary health care services will lead to stress citizens’ voice to improve the quality of services and create public value. However, this choice system brings about also new gaps between the people who are active and not and are still difference between the different residence areas related to socioeconomic status. It needs further studies to consider the balance between the individual choice and the government responsibility of the value of social equality.

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