Central and local control in Nordic health care: the public organisation spectrum revised.

One of the distinguishing characteristics of national health care systems is the degree of public involvement in service provision, funding and policy making. In international comparisons the Nordic countries are usually seen as a uniform group. Yet, the countries do have important differences, and a descriptive model was sought to demonstrate these, and, at the same time, to differentiate the concept of public control. Using the central-local dichotomy, differences within the public framework were demonstrated between the countries, e.g. in methods of funding, financial regulation, formal planning instruments, and control of resource allocation. Financial control and planning were identified as two distinct components of public control. An analysis of the degree of centralisation along both dimensions separated the Nordic countries, which are otherwise homogenous as to public sector dominance.