CHOICE AND PARTICIPATION IN THE HEALTH-SERVICES - A SURVEY OF PREFERENCES AMONG SWEDISH RESIDENTS

Extending the possibilities for health-service consumers to choose amo ng providers has been an important objective on the political agenda i n Sweden and elsewhere. Little is known, however, about individual and group preferences concerning the demand for choices. It is often impl icitly assumed that individuals can be treated as a group with similar values and demands, but is this true? To what extent do individuals w ant more options in health care? Do preferences vary depending on age, education and place of living? This article explores these questions, starting from a survey of 2000 residents in four Swedish counties. Th e results of the survey point to many similarities, but also indicate important differences among residents. In particular, preferences seem to vary significantly depending on age and level of education. On the one hand, older people are more favourably inclined towards the free choice of physician. On the other hand, members of the younger generat ion, as well as well-educated residents, demand a more active part in the process of medical decision making. These differences, as well as expectations from younger generations, pose a great challenge to the f uture management of health services. (C) 1997 Elsevier Science Ireland Ltd.