Abstract
BackgroundThe Swedish government has increasingly begun to rely on so called informative governance when regulating healthcare. The question this article sets out to answer is: considered to be “the backbone” of the Swedish state’s strategy for informative governance in healthcare, what kind of regulatory arrangement is the evidence-based National Guidelines? Together with national medical registries and an extensive system of quality and efficiency indicators, the National Guidelines constitutes Sweden’s quality management system.MethodsA framework for evaluating and comparing regulatory arrangements was used. It asks for instance: what is the purpose of the regulation and are regulation methods oriented towards deterrence or compliance?ResultsThe Swedish National Guidelines is a regulatory arrangement intended to govern the prioritizations of all decision makers – politicians and administrators in the self-governing county councils as well as healthcare professionals – through a compliance model backed up by top-down benchmarking and built-in mechanisms for monitoring. It is thus an instrument for the central state to steer local political authorities. The purpose is to achieve equitable and cost-effective healthcare.ConclusionsThis article suggests that the use of evidence-based guidelines in Swedish healthcare should be seen in the light of Sweden’s constitutional setting, with several autonomous levels of political authority negotiating the scope for their decision-making power. As decision-making capacity is relocated to the central government – from the democratically elected county councils responsible for financing and provision of healthcare – the Swedish National Guidelines is part of an ongoing process of healthcare recentralization in Sweden, reducing the scope for local decision-making. This represents a new aspect of evidence-based medicine (EBM) and clinical practice guidelines (CPGs).Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-014-0509-1) contains supplementary material, which is available to authorized users.
Highlights
The Swedish government has increasingly begun to rely on so called informative governance when regulating healthcare
The question this article sets out to answer is: considered to be “the backbone” of the state’s strategy for informative governance, what kind of regulatory arrangement is the Swedish National Guidelines? For instance, what is the purpose of the regulation, what organizations and activities are subject to regulation, are regulation methods oriented towards deterrence or compliance, and what methods are used for monitoring compliance? These questions are asked within the context of a decentralized healthcare system where the responsibilities for healthcare are divided between three different governing levels: the central state, county councils/regions and municipalities
The results presented here imply that Sweden, through its use of Clinical practice guidelines (CPGs), is departing from a governance model which gives professional groups and local and regional authorities substantial autonomy in monitoring and improving their own standards of practice [21]
Summary
The Swedish government has increasingly begun to rely on so called informative governance when regulating healthcare. The National guidelines are considered “the backbone” of the state’s strategy for informative governance in healthcare, which comprises e.g. the National Quality Registries, the Regional Comparisons of Quality and Efficiency in Swedish Health Care, the webbased health library for health professionals, and systematic knowledge reviews produced by government agencies. Informative governance is a system that seeks to increase the extent of evidence-based practice [9] through the developing, dissemination and implementation of best available knowledge to achieve the best possible benefit to users and patients [10] It differs from EBM as it includes activities to create and maintain structures and processes that lead to the use of best available knowledge when making clinical and administrative decisions [11].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
