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Abstract

Background: Resource allocation in public health care principally involves politicians, administrators, and physicians. They all have their different roles, agendas and ambitions when it comes to how public health care resources should be spent. Previous studies on attitudes among health-care stakeholders have mainly focused on views and preferences among clinical decision-makers, while less attention has been paid to the views of health care politicians. Aim: The study aimed to investigate if the health care politicians’ views on priority setting and decision-making in health care differed from other stakeholder groups. Method: The study was based on a questionnaire conducted among health care politicians, administrators, and physicians in four county councils in Southern Sweden. Results: The findings show significant differences between the politicians and the other two groups in their views on health-care resources, financing, priority setting and decision-making. Conclusions: The findings could, at least partly, be explained by the special situation it means for the politicians to be forced to be re-elected every fourth year to stay in power.

Keywords

Accountability decision-making governance health-care politicians priority setting resource allocation

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References

Carpenter

. Is health politics different? Annu Rev Polit Sci 2012;15:287–311

Donaldson

Blate

Brambleby

. Moving forward on rationing: an economic view. BMJ 2008;337:a1872.

Waldau

Lindholm

Wiechel

. Priority setting in practice: participation opinions on vertical and horizontal priority setting for reallocation. Health Policy 2010;96:245–54.

Anell

Glenngård

Merkur

. Health systems in transition – Sweden. Copenhagen: WHO, 2012.

Smith

Anell

Busse

. Leadership and governance in seven developed health systems. Health Policy 2012;106:37–49

Chantler

. Health-care technology assessment: a clinical perspective. Int J Tech Assess Health Care 2004;20: 87–91.

Weaver

. The politics of blame avoidance. J Publ Pol 1986;6:371–98.

Pitkin

. The concept of representation. Berkeley, CA: University of California Press, 1967.

Lindbom

. Obfuscating retrenchment: The Swedish welfare policy in the1990s. J Publ Pol 2007;27:129–50.

10.

Fiorina

. Congress: Keystone of the Washington establishment. New Haven, CT: Yale University Press. 1977.

11.

Eagly

Chaiken

. The psychology of attitudes. Fort Worth, TX: Harcourt Brace Jovanovich College Publishers, 1993.

12.

Pierson

. Dismantling the welfare state? Cambridge, UK: Cambridge University Press, 1994.

13.

Czarniawska-Joerges

. Ideological control in non-ideological organizations. New York, NY: Praeger, 1988.

14.

Rosén

Karlberg

. Opinions of Swedish citizens, health-care politicians, administrators and doctors on rationing and health-care financing. Health Expectations 2002;5:148–55.

15.

Rosén

. Public dialogue on health care prioritization. Health Policy 2006;79:107–16.

16.

Werntoft

Edberg

. Decision makers’ experiences of prioritisation and views about how to finance healthcare costs. Health Policy 2009;92:259–67.

17.

Kouzes

Mico

. Domain theory: an introduction to organizational behavior in human service organizations. J Appl Behav Sci 1979;15:449–69.

18.

Årsredovisning 2012. Kristianstad: Region Skåne, 2012.

19.

Axberg

. Rättvisa och demokrati: om prioriteringar i sjukvården [Rationing health care resources]. Uppsala: Acta Universitatis Upsaliensis, 1997.

20.

Broqvist

Garpenby

. To accept, or not to accept, that is the question: citizen reactions to rationing. Health Expectations. 2014;17(1):89–92.

21.

Tenbensel

. Health prioritization as rationalist policy making: problems, prognoses and prospects. Policy & Politics 2000;28:425–40

22.

Klein

Williams

. Setting priorities: what is holding us back – inadequate information or inadequate institutions? In: Ham

Coulter

(eds) The global challenge of health care rationing. Buckingham: Open University Press. 2000, pp. 15–26.

23.

Daniels

. Accountability for reasonableness. Establishing a fair process for priority setting is easier than agreeing on principles. BMJ 2000;321:1300–1

24.

Mintzberg

., Structure in fives: designing effective organizations. Englewood Cliffs, NJ: Prentice-Hall International Editions 1983.

25.

Anell

. Varför är det så svårt att styra sjukvården? [Why is it so hard to steer the health care?] In: Blomqvist

(ed) Vem styr vården? – organisation och politisk styrning inom svensk sjukvård [Who governs the health care? – organization and political steering in Swedish health care]. Stockholm: SNS Förlag, 2007, pp. 78–103.

26.

Sabik

Lie

. Priority setting in health care: lessons from the experiences of eight countries. International Journal for Equity in Health 2008;7:1–13.

27.

Winblad

. Do physicians care about patient choice? Soc Sci Med 2008;67:1502–11.

28.

Blomqvist

. Vem styr vården? – organisation och politisk styrning inom svensk sjukvård [Who governs the health care? – organization and political steering in Swedish health care]. Stockholm: SNS Förlag, 2007.

29.

Holmberg

Weibull

Oscarsson

(eds). SOM-rapport nr 5 [SOM report no. 5.]. Lycksalighetens ö [Bliss Island]. Göteborg: SOM-institutet, 2011.

30.

Hofstede

. Culture’s consequences: comparing values, behaviours, institutions, and organizations across nations. Thousand Oaks: SAGE, 2001.

Priority setting in Swedish health care: Are the politicians ready?

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