Primärvårdspolitik, vinstintresset och jämlik tillgång till vård: Regional styrning och fördelningen av vårdcentraler i Region Skåne 2015-2021

Sammanfattning: This thesis examines how free establishment for private health care providers relates to the geographical distribution of primary care centers in the Skane region. Also, the region’s work with the primary cares’ reimbursement systems is examined. I theorize different ownership forms based on profit motive; publicly-run, private-in-own-operation, cooperative-private-limited-companies, and corporate-group. Each primary care center’s address is linked with socioeconomic, demographic, and political election variables at the neighborhood and municipal level during 2015-2021. The analysis was performed via comparison of mean and descriptive statistics. From the politician’s perspective, the results indicate that differentiation of ownership of primary care centers renders a relatively even distribution of primary care centers. From the citizens’ perspective there is more primary care centers in cities and densely populated areas, while inhabitants in rural areas renders less possibilities to choose provider. The literature argues that politicians rationally adjust the reimbursement systems to counteract geographical inequality. By studying the reimbursement system 2014-2021, and by conducting two interviews with civil servants, I argue that path dependence is of central value to understanding this process. However, the results indicate that there is a discussion to be had whether the region’s work should be seen as rational or based on imitation.