Managing healthcare today and for the future

Healthcare governance requires organizations to manage immediate operational demands while simultaneously preparing for needs that may lie many years ahead.

This research examined how Region Stockholm manages these tensions, focusing on long-term healthcare planning and changing governance models for publicly operated hospitals.

Long-term governance: Målbild 2040

One part of the research followed the development of Målbild 2040 within Region Stockholm’s Health and Medical Care Administration.

Through observations, interviews, and internal documents, the study examined the challenges of long-term governance involving many stakeholders.

The analysis highlights a fundamental choice in how a long-term vision can function. It can serve as a boundary object, providing a shared framework for discussion and interpretation, or as a mediating instrument, designed to translate ambitions more directly into decisions and action.

The latter offers stronger steering capacity but also requires more organization and continued maintenance.

Changing governance of publicly operated hospitals

A second part examined changes in how Region Stockholm governs its publicly operated hospitals, including the move away from corporatized organizational forms.

The research studied historical and contemporary developments through observations, interviews, and document analysis.

It focused particularly on coordination between the Health and Medical Care Administration and hospitals including Karolinska University Hospital, Södersjukhuset, Danderyd Hospital, and Södertälje Hospital.

The project examined how different governance arrangements shape accountability, coordination, and the boundaries between the healthcare system as a whole and its individual organizations.

Why this matters

The research illustrates a central challenge in public healthcare: governance must create accountability while also enabling organizations to coordinate across institutional boundaries.

Understanding how different models shape these relationships can help inform the design of governance systems capable of addressing both current healthcare needs and long-term change.

Researcher

• Ebba Sjögren, Associate Professor.

The project was conducted in collaboration with Region Stockholm’s Health and Medical Care Administration.