The healthcare system in Sweden

Abstract

The Swedish population is characterized by high life expectancy and low avoidable mortality rates. This review outlines the Swedish healthcare system, which offers universal access to all residents and has a long tradition of reforms for social equity. Responsibility for healthcare is shared between the state, the regions, and the municipalities. The Ministry of Health and Social Affairs provides the overall healthcare framework; additionally, several governmental agencies are directly involved in healthcare and public health initiatives. The 21 regions organize, finance, and provide most primary, secondary, and tertiary care, as well as health information channels. Resources for primary care are less plentiful than in many other countries. The 290 municipalities deliver care to elderly people and those with functional impairment. The Swedish healthcare system is primarily tax-funded, with 86% of total healthcare expenditures from public expenses and < 1% from voluntary health insurance. The gross domestic product (GDP) share of healthcare expenditures, 10.5% in 2022, is above the EU average. The level of unmet needs in the population is low, due to universal coverage and caps on user charges except for dental care. Sweden's healthcare system performs well on care quality and patient satisfaction, but suffers from workforce shortage and care fragmentation. Limitations in care coordination can be attributed to a siloed digital infrastructure and care governance, a low number of hospital beds per capita, and a compensation system that often does not incentivize coordination. Despite these challenges, life expectancy is high and avoidable mortality rates are low in Sweden.

Keywords: Epidemiology; Health care; Public Health; Sweden; Swedish.

Fig. 1

Vital statistics and the prevalence of selected lifestyle risk factors and diseases. Values for Sweden are marked in bold. Values for Sweden are compared with seven countries including Denmark, Finland, France, Germany, Norway, the United Kingdom, and the United States, as well as the unweighted average across the Organization for Economic Co-operation and Development (OECD) and the European Union (EU), represented by the flag of each economic entity. Data source, if not stated otherwise: OECD Data Explorer (https://www.oecd.org/en/data/datasets/). ^a Missing values were filled with the data from the World Bank Open Data (https://data.worldbank.org/). ^b Missing values were filled with the data from the Eurostat (https://ec.europa.eu/eurostat). ^c Data from the Global Burden of Disease Study (https://ghdx.healthdata.org/)

Fig. 2

Healthcare regions and distribution of university hospitals

Fig. 3

Indicators related to health financing, physical and human resources, quality of care and health outcomes, and patient experience. Values for Sweden are marked in bold. Values for Sweden are compared with seven countries including Denmark, Finland, France, Germany, Norway, the United Kingdom, and the United States, as well as the unweighted average across the Organization for Economic Co-operation and Development (OECD) and the European Union (EU), represented by the flag of each economic entity. Data source, if not stated otherwise: OECD Data Explorer (https://www.oecd.org/en/data/datasets/oecd-DE.html). ^a Values published by SCB (Statistikmyndigheten SCB [Statistics Sweden]) could be found at https://www.scb.se/. ^b Values from Vården ur befolkningens perspektiv (PM 2024:3) [Care from the population’s perspective (PM 2024:3)] (https://www.vardanalys.se/digital-publikation/varden-ur-befolkningens-perspektiv/)