Patient experience surrounding service failure in Swedish public healthcare: a qualitative study of patient perceptions

Abstract: Background: Swedish healthcare is frequently claimed to be top class. A view not only communicated by politicians and the media, but also shared by an average citizen - for decades. Certain statistical indicators seem to support this: Sweden historically scores very high in life expectancy, stroke and cancer survival and infant mortality. At the same time, it is being reported that Swedish healthcare is suffering from a number of problems. While statistics looks reassuring, it focuses on results rather than processes, and does not take patient perceptions into account. Patient perspective seems to be somewhat overlooked in general in favour of more operations-focused research.   Purpose: The purpose of this study is to address the shortage of relevant literature and describe patient experience surrounding service failure in the fairly unique institutional context of Swedish public healthcare. Patient experience will include patient perceptions on service failure and recovery, as well as patient expectations and post-failure responses.   Method: The study employed a qualitative approach with 13 semi-structured interviews.   Conclusion: The study located reasons for service failure, which are fairly consistent with both previous research on this matter and the reported struggles of Swedish healthcare. It was also found that service recovery is not a common occurrence. Determinants for patient expectations and variability in patient post-failure responses were also uncovered.