Sweden health system review.
Sweden health system review.
复制标题
瑞典卫生系统审查。
作者：
A. Anell;A. Glenngård;S. Merkur
瑞典的预期寿命很高，在与以疾病为导向的卫生服务成果和护理质量指标的比较中，该国表现良好。瑞典卫生系统致力于确保所有公民的健康，并遵守人的尊严、需求和团结以及成本效益的原则。国家负责总体卫生政策，而服务的供资和提供主要由省议会和地区负责。市政当局负责照顾老年人和残疾人。大多数初级保健中心和几乎所有医院都归省议会所有。卫生保健支出主要由税收提供资金（80%），相当于国内生产总值的9.9%（2009年）。只有大约4%的人口有自愿健康保险。用户收费约占卫生支出的17%，对专业人员就诊、住院和药品收费。急症护理医院病床的数量低于欧洲联盟（欧盟）的平均水平，瑞典分配给卫生部门的人力资源比大多数经合组织国家都多。过去，瑞典医疗保健的致命弱点包括诊断和治疗的等待时间长，以及最近地区和社会经济群体之间的医疗质量差异。解决等待时间长的问题仍然是一个关键的政策目标，沿着的还有改善获得服务者的机会。在过去十年中，最近的主要保健改革涉及：集中医院服务;保健服务区域化，包括合并;改善协调的保健;增加初级保健的选择、竞争和私有化;药房部门的私有化和竞争;改变共同付费;以及日益重视质量和效率指标的公开比较，卫生保健投资的价值和对病人需求的反应。改革往往是在地方一级进行的，因此各地方政府的改革模式各不相同，尽管模仿行为通常会发生。
Life expectancy in Sweden is high and the country performs well in comparisons related to disease-oriented indicators of health service outcomes and quality of care. The Swedish health system is committed to ensuring the health of all citizens and abides by the principles of human dignity, need and solidarity, and cost-effectiveness. The state is responsible for overall health policy, while the funding and provision of services lies largely with the county councils and regions. The municipalities are responsible for the care of older and disabled people. The majority of primary care centres and almost all hospitals are owned by the county councils. Health care expenditure is mainly tax funded (80%) and is equivalent to 9.9% of gross domestic product (GDP) (2009). Only about 4% of the population has voluntary health insurance (VHI). User charges fund about 17% of health expenditure and are levied on visits to professionals, hospitalization and medicines. The number of acute care hospital beds is below the European Union (EU) average and Sweden allocates more human resources to the health sector than most OECD countries. In the past, the Achilles heel of Swedish health care included long waiting times for diagnosis and treatment and, more recently, divergence in quality of care between regions and socioeconomic groups. Addressing long waiting times remains a key policy objective along with improving access to providers. Recent principal health reforms over the past decade relate to: concentrating hospital services; regionalizing health care services, including mergers; improving coordinated care; increasing choice, competition and privatization in primary care; privatization and competition in the pharmacy sector; changing co-payments; and increasing attention to public comparison of quality and efficiency indicators, the value of investments in health care and responsiveness to patients needs. Reforms are often introduced on the local level, thus the pattern of reform varies across local government, although mimicking behaviour usually occurs.