Ransonering genom väntetid:En studie av psykologisk vård i Sverige– löner, kapacitetsbegränsningar ochregional psykologtäthet.

Sammanfattning

Title: Rationing by Waiting-time: A study of Psychological Care in Sweden – Wages, Capacity Constraints and the Regional Allocation of Psychologists The focus of this thesis is to investigate whether the tax-financed and budget-controlled organization of Sweden’s psychological care contributes to a structural undersupply of psychologists. Using a quantitative approach, the study combines descriptive time-series analysis (2000-2024) with a two-way fixed-effects panel data analysis of Sweden’s 21 regions (2005-2024). The analysis integrates economic theories on subsidized demand, budget constraints and human capital to evaluate the current state of the market for psychologists. The empirical results reveal that psychologists’ wages have experienced weaker growth compared to other academic professions and healthcare groups, despite a significant increase in demand for mental health services. Furthermore, accessibility has deteriorated sharply. The proportion of patients in adult psychiatric care who do not receive care within the 90-day healthcare guarantee has increased fivefold from 3.5 % in 2012 to 17.4 % in 2024. The panel analysis indicates that regional psychologist density is primarily driven by the educational level of the population rather than financial resources or health needs. Notably, the study finds a negative association between increased funding and psychologist density, suggesting potential inefficiencies in resource allocation within the public sector but with further robustness checks these results reveal themselves sensitive to model specification and reverse causality. However, when socio-economic controls are excluded, the model’s explanatory power collapses substantially, and several coefficients lose significance. The study concludes that the current institutional framework leads to a structural undersupply where waiting times have replaced price as the primary rationing mechanism. This imbalance indicates potential socio-economic costs due to delayed treatments and increased sick leave. The findings suggest that reforms aimed at allowing supply to adapt more dynamically to demand, potentially through increased direct patient financing, could improve the overall efficiency of the psychological healthcare system. The sensitivity of the results underscores the need for further research before resource allocation inefficiencies can be drawn.