Sweden: #8 in the 2022 World Index of Healthcare Innovation
Sweden, a world leader in digital health care, is experiencing a rapid rise in public health spending.
By Gregg Girvan, Grant Rigney, and Avik Roy
Introduction
Sweden ranked 8th overall in the 2022 World Index of Healthcare Innovation, a significant improvement from 18th in 2021 and 15th in 2020.
Sweden saw marked gains in Quality, jumping from 21st to 3rd. Fittingly, for the country best known for establishing and awarding the Nobel Prize, Sweden ranked highly in Science and Technology (7th).
Background
In 1982, the Health and Medical Services Act declared that Sweden’s healthcare system must cover all legal residents. Health insurance coverage became automatic and universal. Likewise, Sweden extended emergency coverage to all patients from the European Union, European Economic Area countries, and nine other nations with which Sweden held bilateral trade agreements.
The act, along with other legislation, partitioned the administration of healthcare among Sweden’s three levels of government. Nationally, the Ministry of Health and Social Affairs crafts Swedish health policy, sets budgets, and provides grants to independent regions. Subsequently, 21 regional bodies finance and deliver health services to all Swedish residents, and 290 local municipalities care for the elderly and disabled, including long-term care. The regional and local bodies prioritize local issues and are represented collectively by the Swedish Association of Local Authorities and Regions (SALAR).
While the Ministry of Health and Social Affairs provides national policy and regulation, SALAR plays a leading role in financing and providing healthcare. Most hospitals in Sweden are public. Sweden imposes caps on cost-sharing at SEK 1,150 ($125 USD) for health services and SEK 2,250 ($246 USD) for drugs per individual. Furthermore, private health insurance gained market share in Sweden over the last several years, mainly because it offers patients faster access to a broader range of health care services.
Sweden’s healthcare spending grew rapidly, despite its low debt-to-GDP ratio of under 40 percent. This increase consequently depressed Sweden’s score for Fiscal Sustainability. Moreover, Sweden has long been a home of innovative pharmaceutical companies, including Astra AB (now part of AstraZeneca) and Pharmacia (now part of Pfizer). Lastly, during the COVID-19 pandemic, Sweden minimized the restrictions it imposed on its economy, which led to a higher mortality rate than other countries but maintained its economy.
Quality
Sweden ranked 3rd in Quality. This represented a eighteen-place climb from the year before. Sweden earned a comparable ranking in 2022 for the measures of preventable disease (3rd), and its pandemic preparedness rank rose to 13th from 24th. Likewise, Sweden’s investments in hospital infrastructure boosted its infrastructure ranking to 9th from 26th. Lastly, Sweden rose to 2nd in patient-centered care.
Choice
Sweden ranked 20th for Choice. It ranked 16th in access to new treatments, 17th in affordability of health insurance, and 18th in freedom to choose healthcare services.
Science & Technology
Sweden performed exceptionally well in the Science and Technology, ranking 7th overall. Sweden’s medical advances ranked 6th, its scientific discoveries ranked 8th, and its health digitization ranked 6th.
Fiscal Sustainability
Sweden struggled in Fiscal Sustainability, ranking 22nd overall. The Swedish economy remained strong and maintained a low debt-to-GDP ratio, which ranked Sweden highly in national solvency (8th). However, Sweden struggled in public healthcare spending (27th), which measures aggregate spending. Sweden fared better in growth in public health spending (15th), which measures health spending relative to GDP over time.
