User choice in Swedish eldercare – conditions for informed choice and enhanced service quality

Abstract

Proponents of user choice argue that this type of policy arrangement improves the quality of public social services since users are expected to select the most highly performing providers. In order for users to make informed choices, however, they need quality information about the services offered by different providers. In this article, we carry out a case study, investigating whether information about service quality was presented to users of home-based elderly care in Sweden. The analysis is based on unique data regarding the information of 223 providers in 10 municipalities. The results suggest that the information was poor and lacking in important quality dimensions. This indicates a lack of real user power since it is virtually impossible for users to make informed choices without relevant information. It also makes it less likely that the general quality level of home-based services will increase as a result of the user choice.