Freedom of choice or cost efficiency? The implementation of a free-choice market system in community mental health services in Sweden

Forskningsoutput: TidskriftsbidragArtikel i vetenskaplig tidskrift


This case study investigates the implementation of a free-choice market system in community mental health services using the example of day centres for people with psychiatric disabilities. It was conducted in a major city that was about to implement a free-choice market system due to a new legislation that made it feasible. Eighteen semi-structured interviews were conducted. Agents situated in different parts of the organization were interviewed one year before and two years after the free-choice system was launched in 2010. Data showed a top–down political process. A majority of the intentions of the legislation advocated individual autonomy as the market system's main purpose; only one concerned organizational efficiency. Data reflected, however, that financial efficiency dominated the agents' experiences of the implemented system. The twofold market purpose was clearly reflected in the interviews. Front-line staff hoped for improvements mainly for the users, whereas managers mainly focused on the market as a resource allocator.


  • Maria Andersson
  • Mona Eklund
  • Mikael Sandlund
  • Urban Markström
Enheter & grupper
Externa organisationer
  • Umeå University

Ämnesklassifikation (UKÄ) – OBLIGATORISK

  • Annan hälsovetenskap
Sidor (från-till)129-141
TidskriftScandinavian Journal of Disability Research
Utgåva nummer2
StatusPublished - 2016 apr 2
Peer review utfördJa