Promoting competition in Swedish primary care.

Purpose - The purpose of this paper is to examine the role of accreditation documents (ADs) in the competition based on provider quality in a quasi-market for primary healthcare. Design/methodology/approach - The paper uses a mixed-method research methodology to analyse two primary healthcare ADs in two Swedish regions. In total, 19 interviews were conducted with actors involved in the creation and use of such documents. Findings - This paper points to the crucial role of ADs in the identification of quality differences that influence the competition in primary healthcare. This finding contrasts with the commonly held laissez-faire idea that competition causes providers to develop their own service concepts and where the invisible hand creates quality differences. The paper adds to the discussion with its detailed description of how ADs create competition among primary healthcare providers through selection processes, quality differentiation, and ranking. Research limitations/implications - The paper does not explore quality differences in the medical treatment of patients in primary healthcare centres. Practical implications - The paper provides insights for politicians on how to use ADs to control competition and regulate choice. Originality/value - The paper takes an innovative approach to the examination of how ADs increase the competition in primary healthcare choice.