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Sweden: Health System Challenges

Sweden: Health System Future Challenges

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“The Swedish health system suffers from shortcomings in care coordination at different levels and in responding to patient expectations. Results from the 2016 Commonwealth Fund International Health Policy Survey showed that Swedish patients report negative experiences with care coordination more often than patients in the other ten countries participating in the survey (Commonwealth Fund, 2016). About one-third of respondents in Sweden declared they had experienced a problem with care coordination or communication problems, and half of patients reported experiencing a coordination gap in hospital discharge planning.

“Delayed discharges for patients who no longer need to stay in hospital is an example of coordination issues. The number of bed days related to delayed discharges in 2016 was much higher in Sweden than in Denmark and Norway (Table 1).

“Since 2018, new legislation has promoted more timely discharge from hospital by strengthening cooperation among the different actors in the system. This promotes better coordination between health care and social services following hospital discharge by creating safe and effective discharge processes. It outlines a formal discharge procedure, which begins at hospital admission. The law obliges regions and municipalities to enter into agreements on common guidelines for cooperation and planning discharges. Municipalities face financial penalties if they cannot reach an agreement to better manage and reduce delayed discharges.”

Source: OECD/European Observatory on Health Systems and Policies (2019), Sweden: Country Health Profile 2019, State of Health in the EU, OECD Publishing, Paris/European Observatory on Health Systems and Policies, Brussels.


“As in other EU countries, Sweden faces the challenge of responding to the growing health and long-term care needs of an ageing population in the coming decades. Budgetary pressures are projected to come not only from health care expenditure but also, and even more importantly, from long-term care expenditure. According to the latest projections from the European Commission’s Ageing Working Group, public spending on long-term care in Sweden may grow by 1.7 percentage points of GDP between 2016 and 2070, while public spending on health may grow by about 1 percentage point of GDP (European Commission-EPC, 2018). This highlights the challenge of responding efficiently to the growing needs of health and long-term care in the years ahead.”

Source: OECD/European Observatory on Health Systems and Policies (2019), Sweden: Country Health Profile 2019, State of Health in the EU, OECD Publishing, Paris/European Observatory on Health Systems and Policies, Brussels.


“Health indicators for the population are good—life expectancy and cancer and heart attack survival rates are among the highest in Europe according to Organisation for Economic Co-operation and Development (OECD) figures from 2017, and the country also came in the top five in the Lancet’s most recent Healthcare Access and Quality Index.

“But most Swedes will agree that, in recent years, concerns over whether provision of that care is faltering are being raised on a more regular basis.

“In the run-up to the elections, local media reported on concerns about waiting times, care continuity, under-capacity, and severe staff shortages. According to official data, there are nursing shortages in 80% of the health-care sector. The daily newspaper Svenska Dagbladet said that although the Swedish population has grown by 13% since the end of the 1990s, hospital bed numbers have fallen 30% over the same period. Data from the OECD show that Sweden’s hospital beds shortage is the worst in Europe, with 2·4 available beds per 1000 people in 2015.”

Source: Holt, Ed. Health in Sweden: a political issue. Lancet. 2018 Oct 6;392(10154):1184-1185. doi: 10.1016/S0140-6736(18)32459-0.


“The run-up to parliamentary elections [in 2018], which delivered a hung parliament, saw a strong rise in support for the Sweden Democrats, a nationalist party, and was dominated by debates over immigration and the welfare state.

“As in many previous elections in the country, health care was one of the top issues for voters. But this year, pre-election campaigning highlighted how many Swedes are beginning to raise serious concerns about one of the pillars of the country’s society.

“‘There is a perception among the public that the health-care system is worsening”, Niklas Bolin, a political analyst and associate professor at Mid Sweden University’s Department of Social Sciences, told The Lancet.

“Pre-election polling showed health care was the most important issue for almost 40% of voters.

“Campaigns for these elections happened in amid a scandal over the construction of what is expected to be the most costly hospital in the world, complaints about an increasingly severe lack of resources and capacity at health-care facilities, and failing treatment services for patients.”

Source: Holt, Ed. Health in Sweden: a political issue. Lancet. 2018 Oct 6;392(10154):1184-1185. doi: 10.1016/S0140-6736(18)32459-0.


Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems in the US and several other nations.


Page last updated May 18, 2021 by Doug McVay, Editor.

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