TY - JOUR
T1 - A comparison of primary care systems in the USA, Denmark, finland and sweden
T2 - Lessons for scandinavia?
AU - Weiner, Jonathan
N1 - Funding Information:
ACKNOWLEDGMENTS This research was supported, in part, by a fellowship grant from the World Health Organization. However, the views in this paper are those of the author and should not be considered as representing that organization. The kind assistance of over 50 individuals in Scandinavia is gratefully acknowledged. Several persons with whom the au- thor visited reviewed earlier versions of this paper, their perceptive comments were most appreciated, as were the comments of the author’s colleague, Professor Barbara Starfield.
PY - 1988
Y1 - 1988
N2 - In the United States large corporately owned health care delivery institutions, some of which are known as health maintenance organizations (HMOs), are assuming an increased prominence in the provision of primary care (PC). These private organizations are similar in many ways to the public-sector providers that have functioned for decades within the Scandinavian systems. This article explores the similarities and differences between these two PC approaches. This is accomplished by contrasting the governance, organization, financing and staffing of the PC systems of three Nordic countries (Denmark, Finland, and Sweden) to that of the US. Also provided is a critical analysis of the extent to which each model attains the ideal attributes of PC including; 1) accessibility, 2) comprehensiveness, 3) coordination and continuity, and 4) sensitivity to the patient's social milieu. For each facet of PC assessed, the American models offer approaches that are worthy of consideration by Scandinavian clinicians and planners. These include innovations in the areas of coordination between primary and secondary care, preventive care for adults and incentives for financial efficiency. Also, although successful in attaining many attributes of PC, this article discusses some perceived weaknesses of the Scandinavian systems.
AB - In the United States large corporately owned health care delivery institutions, some of which are known as health maintenance organizations (HMOs), are assuming an increased prominence in the provision of primary care (PC). These private organizations are similar in many ways to the public-sector providers that have functioned for decades within the Scandinavian systems. This article explores the similarities and differences between these two PC approaches. This is accomplished by contrasting the governance, organization, financing and staffing of the PC systems of three Nordic countries (Denmark, Finland, and Sweden) to that of the US. Also provided is a critical analysis of the extent to which each model attains the ideal attributes of PC including; 1) accessibility, 2) comprehensiveness, 3) coordination and continuity, and 4) sensitivity to the patient's social milieu. For each facet of PC assessed, the American models offer approaches that are worthy of consideration by Scandinavian clinicians and planners. These include innovations in the areas of coordination between primary and secondary care, preventive care for adults and incentives for financial efficiency. Also, although successful in attaining many attributes of PC, this article discusses some perceived weaknesses of the Scandinavian systems.
KW - Denmark
KW - Finland
KW - HMOs
KW - International comparisons
KW - Primary health care
KW - Sweden
KW - USA
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U2 - 10.3109/02813438809009285
DO - 10.3109/02813438809009285
M3 - Article
C2 - 3353591
AN - SCOPUS:0023829674
SN - 0281-3432
VL - 6
SP - 13
EP - 27
JO - Scandinavian Journal of Primary Health Care
JF - Scandinavian Journal of Primary Health Care
IS - 1
ER -