Resource dependency, doctors and the state: quality control in Sweden

This paper focuses on the interaction between the state and the medical profession on the national level in Sweden with respect to issues concerning quality in health care. Using the concepts of policy network and resource dependency as points of departure, two examples of interorganisational relationships are analysed which relate to medical/professional quality and organisational quality, respectively. These are (1) the control of the national quality registers and (2) the development of third-party accreditation in health care organisations. During the 1990s the state has become increasingly dependent on participation by the profession in order to obtain outcome data and other resources controlled by the profession. In Sweden, a fragmented state has established various types of linkages with the organised medical profession, all of which are characterised by mutual resource dependency.