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The recommodification of healthcare? A case study of user charges and inequalities in access to healthcare in Sweden 1980-2005

Lookup NU author(s): Professor Clare BambraORCiD, Emeritus Prof David Hunter



This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).


Background: User charges in Swedish healthcare have increased during recent decades. This can be seen in terms of the recommodification of healthcare: making healthcare access more dependent on market position. This study investigates whether the increase in user charges had an impact on educational inequalities in access to healthcare in Sweden between 1980 and 2005.Methods: Data from the Swedish Living Conditions Survey were used to calculate the odds ratios of access to healthcare for the low and higher educated in Sweden, and the results were stratified by health status (Good and Not good health) for each year 1980-2005. These odds ratios were correlated with the average user charge for healthcare.Results: There were no educational differences in healthcare access in the group with Good health. In the group with Not good health, the higher educated had higher rates of healthcare access than the lower educated. Inequalities in access to healthcare were relatively stable over time, with a slight increase among those with Not good health. Discussion: Recommodification has had only a small association with access to healthcare in Sweden. The Swedish system has integral protections that protect the vulnerable against rising healthcare costs. This is an important caveat for other countries that are considering introducing or raising user charges.

Publication metadata

Author(s): Farrants K, Bambra C, Nylén L, Kasim A, Burström B, Hunter DJ

Publication type: Article

Publication status: Published

Journal: Health Policy

Year: 2017

Volume: 121

Issue: 1

Pages: 42-49

Print publication date: 01/01/2017

Online publication date: 14/11/2016

Acceptance date: 07/11/2016

Date deposited: 22/11/2016

ISSN (print): 0168-8510

ISSN (electronic): 1872-6054

Publisher: Elsevier


DOI: 10.1016/j.healthpol.2016.11.005


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