Background: The topics in this paper are “If, and to what extent, privatization and competition within the health care service has effected the costs” and “If, and to what extent, privatization and competition has led to selection of patients”. Competition can be understood by principal-agent theory where a main point is that in this case the private hospitals may take advantage of information to lower efficiency or take out profit in different ways. By presenting the private hospitals for competition, going from a standard price all hospitals are getting, to a tender, the Regional Health Enterprises would under ideal conditions be able to see the private hospitals real costs, and make contracts with the hospital with the lowest costs and also prevent selection of patients.
Method: The analysis is based on patient data from day-surgical treatments performed by private commercial hospitals in the period 2002-2005 combined with data collected with a questionnaire from the Regional Health Enterprises. The prices the regional health enterprises are paying for the treatments (percentage of full DRG) are used as an indicator for the regional health enterprises’ costs, while the age mix of patients is used as an indicator for patient selection.
Results: The analysis of the costs gives evidence of a reduction in the DRG-costs over the period of time. The analysis of patient age gives some evidence of selection of patients in the year 2003 and 2004, but not in 2002 and 2005.