Overview
In Sweden, citizens pay 30-50% in income tax and 27% of that goes to health care. Sweden is divided into 21 regions, each of which are governed by elected politicians. An individual region gets a pot of money from the state and can decide how to use the money, though the state gives guidelines, for example which medicine and medical aids a person with diabetes shall have.
What happens if you need to see a doctor?
Health centers are the firstline health care for all citizens. Every doctor has responsibility for about 2000 listed patients. Doctors treat and check for acute and chronic diseases. If a patient wants contact, the doctor has to call or see the patient in a week, if deemed necessary. For severe and acute situations, the patient goes directly to the hospital. People with type 1 diabetes (T1D) are connected to an Endocrinology Specialist at a hospital. People with T1D go one to two times a year for lab results and prescriptions, and to a nurse for discussions and prescriptions for medical devices. Patients can reach nurses by phone whenever they want.
Who decides what doctors can prescribe?
The Medical Products Agency (Läkemedelsverket, LV (opens in a new tab)) is responsible for regulation and surveillance of the development, manufacturing and sale of drugs and other medicinal products. Each region purchases special medicines and medical devices in order to get the lowest price. These medicines and devices then become what the doctor and nurse can prescribe. In Stockholm the region has purchased every kind of medicine and medical device available and as a person with T1D you can choose whatever you want. In smaller regions people may not have as much choice – for example patients will often have just one or only a couple of insulin pumps to choose from.
Practically, what is it like to live with type 1 diabetes in Sweden?
These days it’s easy to live with T1D in Sweden, especially in a major city. Insulin and all medical devices are currently available for free, but every year the question is raised and there is a threat that the policy will change. Though Sweden is a highly-educated society, knowledge about diabetes and insulin is lacking in the general population and within healthcare. Many people with diabetes feel shame about not being like others and don’t speak up about their condition at school or work. This leads to people letting their sugar levels run high without correcting and not get the help they need when low. People have died in prison because of hypoglycemia who were arrested by the police who thought they were drunk (intoxicated). Recently, a 6-year old with newly debuted diabetes nearly died, even after the parents had visited a health care center several times and nurses didn’t understand what was wrong.
What about getting admitted to hospital?
It is easy to be admitted to a hospital with the only barrier being often a very long wait time. People can even choose which hospital, as long as it is in their region.
How does diabetes care and technology vary throughout the country?
As mentioned above, technology and medication access varies from region to region, with smaller, less-populated regions typically having less technology and medications available. Care is universally available across Sweden, but wait times for health care can differ. For example, to get a procedure like a Magnetic Resonance Imaging (MRI) in the northern part (a less-populated rural area) can take several months, whereas in Stockholm it might take just a couple of weeks. On the other hand, to see a doctor at the emergency room at a hospital in Stockholm takes about 24 hours, compared to the countryside emergency room with hardly a queue, but where distance to the hospital can be very long. For diabetes care wait time does not differ as much between the rural and more densely-populated, urban areas.
Thanks to Christina Barklund, T1International Global Advocate, for providing this information.
Last updated 2021