Overview

I research the Swedish health system, with a particular focus on primary care. From a supply-side perspective, I've studied various aspects of payment models (pay-for-performance, activitity-based financing, risk adjustment) and how care providers respond to competition. From a demand-side perspective, I've studied patients' choices of care provider and use of digital primary care. For an overview of my research output, please consult my list of publications.

Ongoing

• Continuity in Swedish primary care. Continuity in the patient-physician relationship is viewed as a cornerstone of primary care. In Sweden, continuity is the exception rather than the rule, something that policymakers are eager to change. What determines the chance to get a high-continuity relationship in Sweden? What characterizes high-continuity providers? Is it helpful to have been assigned to a specific GP? What happens when one's doctor quits?

• Downstream effects of direct-to-consumer telemedicine. Since 2016, a market for direct-to-consumer telemedicine has arisen in Sweden, initially independent of but gradually more integrated into the ordinary primary care system. Telemedicine is a convenient way to get in touch with primary care, and may therefore substitute for face-to-face visits as well as induce new demand. To what extent is telemedicine a substitute for primary care visits? Does it prevent emergency department visits for parents with small children?

• Risk-adjusted payment to primary care providers. It is well known that prospective payments such as capitation may cause skimping or dumping of high cost patients. Such effects may aggravate existing socioeconomic health inequalities. To counter such effects, the capitation payment to primary care providers is risk-adjusted based on morbidity and/or socioeconomic factors in most Swedish regions. Does this kind of incentive lead providers to supply more care to low-SES patients?

• Use of performance measures in primary care. Earlier experiences of pay-for-performance has spurred a reaction towards more profession-driven quality improvement initiatives. A Swedish initiative, Primärvårdskvalitet, has developed a library of evidence-based quality indicators that enables most providers in the country to access update information about their practice and patients. To what extent do providers make use of this information? Do high-users improve their performance?