![Margareta Dackehag. Foto.](/sites/lusem.lu.se/files/styles/lu_personal_page_desktop/public/2024-03/MargaretaDackehag.jpg.webp?itok=_llJ8sAR)
Margareta Dackehag
Quality assurance coordinator
![Margareta Dackehag. Foto.](/sites/lusem.lu.se/files/styles/lu_personal_page_desktop/public/2024-03/MargaretaDackehag.jpg.webp?itok=_llJ8sAR)
Better off by risk adjustment? Socioeconomic disparities in care utilization in Sweden following a payment reform
Author
Summary, in English
Reducing socioeconomic health inequalities is a key goal of most health systems. A challenge in this regard is that healthcare providers may have incentives to avoid or undertreat patients who are relatively costly to treat. Due to the socioeconomic gradient in health, individuals with low socioeconomic status (SES) are especially likely to be negatively affected by such attempts. To counter these incentives, payments are often risk adjusted based on patient characteristics. However, empirical evidence is lacking on how, or if, risk adjustment affects care utilization. We examine if a novel risk adjustment model in primary care affected socioeconomic differences in care utilization among individuals with a chronic condition. The new risk adjustment model implied that the capitation—the monthly reimbursement paid by the health authority to care providers for each enrolled patient—increased substantially for chronically ill low-SES patients. Yet, we do not find any robust evidence that their access to primary care improved relative to patients with high SES, and we find no effects on adverse health events (hospitalizations). These results suggest that the new risk adjustment model did not reduce existing health inequalities, indicating the need for more targeted incentives and interventions to reach low-SES groups.
Department/s
- Department of Business Administration
- Dean's Office, LUSEM
- Department of Economics
Publishing year
2024-05-08
Language
English
Publication/Series
Journal of Policy Analysis and Management
Document type
Journal article
Publisher
Wiley-Blackwell
Topic
- Health Care Service and Management, Health Policy and Services and Health Economy
Status
Epub
ISBN/ISSN/Other
- ISSN: 0276-8739