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Nordic Economic Policy Review

Challenges in health care financing and provision

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The Nordic Economic Policy Review is published by the Nordic Council of Ministers and addresses policy issues in a way that is useful for in-formed non-specialists as well as for professional economists. All articles are commissioned from leading professional economists and are subject to peer review prior to publication. The review appears twice a year. Content: Challenges in health care financing and provision - Tor Iversen and Sverre A.C. Kittelsen Ageing populations: More care or just later care? - Terkel Christiansen, Jørgen Lauridsen and Mickael Bech Comment by Anna Lilja Gunnarsdottir Lifestyle, health and costs – what does available evidence suggest? - Kristian Bolin Comment by Tinna Laufey Ásgeirsdóttir The economics of long-term care: A survey - Helmuth Cremer, Pierre Pestieau and Gregory Ponthiere Comment by Þórólfur Matthíasson The role of primary health care in controlling the cost of specialist health care - Stephen Beales and Peter C. Smith Comment by Helgi Tómasson Payments in support of effective primary care for chronic conditions - Randall P. Ellis and Arlene S. Ash Comment by Jørgen T. Lauridsen An economic assessment of price rationing versus non-price rationing of health care - Luigi Siciliani Comment by Mickael Bech Should pharmaceutical costs be curbed? - Kurt R. Brekke, Dag Morten Dalen and Steinar Strøm Comment by Helgi Tómasson Productivity differences in Nordic hospitals: Can we learn from Finland? - Clas Rehnberg and Unto Häkkinen Comment by Thorvaldur Gylfason

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The role of primary health care in controlling the cost of specialist health care

There is some concern that expenditure levels in developed health systems are reaching unsustainable levels. One cause appears to be the ‘avoidable’ use of expensive specialist services. The belief is that – with timely, high quality primary care – such utilization could be markedly reduced, with associated cost savings and improved quality of life for patients. This paper reviews the evidence for three broad forms of primary care intervention: reducing or delaying the onset of disease; reducing the use of specialist care once a clinical condition has been identified; and reducing the intensity of specialist care once a need for such care has arisen. We examine the role of incentives in promoting the cost containment role of primary care. The paper concludes with a discussion of the associated policy implications.

English

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