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This paper contributes to the current discussion on whether ‘soft’ regulation actually influences policy outcomes by examining the effects of national policy instruments on municipal climate and energy planning. Sweden has experienced shifts in the incentive context over the last decades complementing soft planning regulations with stringent conditions for getting national economic support to local energy and climate action. We hypothesize that when soft regulations are surrounded by detailed conditions for getting state support, there will be higher degrees of local institutionalization of climate and energy strategies. The importance of economic support as part of national policy is confirmed by evidence from local energy and climate strategies and from interviews with local decision-makers. We also find that specific municipal features such as earlier municipal engagement in national support programs and relevant inter-municipal networks function as drivers for the institutionalization of local action. [ABSTRACT FROM PUBLISHER]

Aims: Low back pain (LBP) is a major public health problem in both Norway and Sweden. The aim of the study was to estimate the prevalence of LBP and sickness absence due to LBP in two neighbouring regions in Norway and Sweden. The two areas have similar socioeconomic status, but differ in health benefit systems. Methods: A representative sample of 1,988 adults in Norway and 2,006 in Sweden completed questionnaires concerning LBP during 1999 and 2000. For this study only individuals in part or full time jobs, (n = 1,158 in Norway and n = 1,129 in Sweden) were included. Results: In Norway the lifetime prevalence was 60.7% and in Sweden 69.6%, the one‐year prevalence was 40.5% and 47.2%, and the point prevalence 13.4% and 18.2% respectively. There was a significantly higher risk of reporting LBP in Sweden, even after controlling for gender, age, education, and physical workload. There was no difference in risk of self‐certificated short‐term sickness absence (1–3 days), but it was a 40% lower risk of sickness absence with medical sickness certification in Sweden compared with Norway. Conclusion: The prevalence of LBP was higher in the Swedish area than in the Norwegian. The risk of self‐certificated sickness absence, however, showed no differences and the risk of medically certificated sickness absence was lower in the Swedish area. This contradiction might partly be explained by the economical “disincentives” in the Swedish health compensation system. [ABSTRACT FROM AUTHOR]

This article examines the consequences of implementing extended producer responsibility (EPR). The analysis identifies to what extent EPR creates economic incentives, and what the financial consequences are. The case of car scrapping in Sweden is used as an example. EPR gives rise to two responsibilities; the consumer has the responsibility to return the product, the end-of-life vehicle, and the producer has the responsibility to handle the end-of-life management. EPR implicitly assumes that consumers will fulfil their responsibility without any economic incentive. This has no empirical support in the literature. The consumers will bear the costs associated with dismantling although the producer is responsible for the payment. This responsibility gives rise to a major future financial liability. [Copyright &y& Elsevier]

Background: Competition-promoting reforms and economic incentives are increasingly being introduced worldwide to improve the performance of healthcare delivery. This study considers such a reform which was initiated in 2009 for elective hip replacement surgery in Stockholm, Sweden. The reform involved patient choice of provider, free establishment of new providers and a bundled payment model. The study aimed to examine its effects on hip replacement surgery quality as captured by patient reported outcome measures (PROMs) of health gain (as indicated by the EQ-5D index and a visual analogue scale (VAS)), pain reduction (VAS) and patient satisfaction (VAS) one and six years after the surgery., Methods: Using patient-level data collected from multiple national registers, we applied a quasi-experimental research design. Data were collected for elective primary total hip replacements that were carried out between 2008 and 2012, and contain information on patient demography, the surgery and PROMs at baseline and at one- and six-years follow-up. In total, 36,627 observations were included in the analysis. First, entropy balancing was applied in order to reduce differences in observable characteristics between treatment groups. Second, difference-in-difference analyses were conducted to eliminate unobserved time-invariant differences between treatment groups and to estimate the causal treatment effects., Results: The entropy balancing was successful in creating balance in all covariates between treatment groups. No significant effects of the reform were found on any of the included PROMs at one- and six-years follow-up. The sensitivity analyses showed that the results were robust., Conclusions: Competition and bundled payment had no effects on the quality of hip replacement surgery as captured by post-surgery PROMs of health gain, pain reduction and patient satisfaction. The study provides important insights to the limited knowledge on the effects of competition and economic incentives on PROMs.