(O)lika villkor i vården - jämlikhet, patientavgifter och regionala skillnader i svensk sjukvård

This thesis considers equity in the Swedish health care sector by examining the theoretical framework behind demand for health and health care, the purpose of co-payments in outpatient care as well as the implications for health care utilization, and in turn health outcomes. The Swedish Health Care Act frames the fundamental objectives of health care as good health and health care on equal terms for the entire population; thus over both socioeconomic and geographical groups. Regional differences in co-payments are therefore prima facie in conflict with these overarching goals, but there is no (current) system for collecting full data in order to understand the effects of co-payments on individuals’ full health care expenditure and health outcomes. Hence, the purpose of this thesis is to analyze the theoretical possibility that co-payments can guide health care utilization towards less inequity through its political functions; reducing over-consumption, steering consumption to the correct instance, increasing cost-awareness as well as contributing to cost-financing. By combining demand theory and previous research this thesis shows that there is a potential regional inequity as the levels of co-payments can neither be proven to affect health care demand such that health care utilization and health outcomes become equitable, nor shown to have effects that contribute to reducing inequity