From Promise to Practise : A Quantitative Investigation on the Implementation of the Act on System of Choice (LOV) and Care Quality, User Empowerment, and Costs in Swedish Homecare

Abstract: In the wake of the New Public Management (NPM) era, the Act on System of Choice (LOV) was introduced in 2009. While implementation was voluntary, over 152 of the 290 municipalities had implemented LOV by 2022. The new act promised improvements in which care quality, user empowerment, and cost-efficiency were almost ensured.  However, despite its large implementation, little research has focused on evaluating the policy's outcome and the extent to which LOV fulfilled its three main objectives. In addressing this knowledge gap, this study positions LOV into the theory of choice and public administration, presenting a revisited mechanism. The study then sets out to understand whether LOV has increased care quality, user empowerment, and cost through regression analysis and interaction effects. Results from the study point towards the inability of LOV to fully deliver on its promises when the elderly population in a municipality is high.