vårdvalssystemet

Vårdvalssystemet refers to a policy framework in Sweden that aims to give patients greater influence over their care by allowing them to choose among approved care providers within a region. The concept is most closely associated with vårdval i primärvården, where primary care centers and practices can compete for patients on a regional list.

How it works in practice is regionally defined. Regional authorities (landsting or, in modern structures, regioner) set criteria that providers must meet to be included on a public list. Patients register with a provider on the list and receive care from that provider; if unsatisfied, they can switch to another listed provider, subject to regional rules. Providers receive compensation largely on a capitation basis, i.e., a fixed payment per registered patient, sometimes complemented by fee-for-service for consultations. The aim is to improve accessibility, responsiveness, and quality through patient choice and competition among providers. The details—such as eligibility criteria, reimbursement levels, and rules for switching providers—vary between counties and regions.

Vårdvalssystemet is implemented and managed at regional level, and thus there is no single nationwide model. Some regions emphasize rapid access and expanded provider availability, while others focus on quality standards and patient rights. The system has undergone ongoing evaluations, with reported effects including improved patient satisfaction and increased provider diversity, but also criticisms related to administrative costs, potential selection biases, and unequal access in some areas. Overall, it remains a central element of Sweden’s efforts to reform primary healthcare through patient choice and regional adaptation.