Ludvigsson Jonas F, Bergman David, Lundgren Catharina Ihre, Sundquist Kristina, Geijerstam Jean-Luc Af, Glenngård Anna H, Lindh Marie, Sundström Johan, Kaarme Johan, Yao Jialu
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, SE-171 76, Sweden.
Department of Paediatrics, Örebro University Hospital, Örebro, Sweden.
Eur J Epidemiol. 2025 May 19. doi: 10.1007/s10654-025-01226-9.
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.
瑞典人口的特点是预期寿命高和可避免死亡率低。本综述概述了瑞典的医疗保健系统,该系统为所有居民提供普遍服务,并且在社会公平改革方面有着悠久的传统。医疗保健责任由国家、地区和市政当局分担。卫生和社会事务部提供总体医疗保健框架;此外,几个政府机构直接参与医疗保健和公共卫生倡议。21个地区组织、资助并提供大多数初级、中级和三级护理,以及健康信息渠道。初级保健资源比许多其他国家少。290个市政当局为老年人和有功能障碍的人提供护理。瑞典的医疗保健系统主要由税收资助,医疗保健总支出的86%来自公共费用,不到1%来自自愿医疗保险。2022年医疗保健支出占国内生产总值(GDP)的比例为10.5%,高于欧盟平均水平。由于全民覆盖和除牙科护理外的用户收费上限,民众未满足需求的水平较低。瑞典的医疗保健系统在护理质量和患者满意度方面表现良好,但存在劳动力短缺和护理碎片化的问题。护理协调方面的限制可归因于孤立的数字基础设施和护理治理、人均病床数量少以及往往无法激励协调的薪酬体系。尽管存在这些挑战,但瑞典的预期寿命较高,可避免死亡率较低。