Sweden has a regionally based, publicly operated and financed, national health care system. Implementation of policy and the provision of health care has been the responsibility of the county council. In 1992, the major responsibility and resources for care of the elderly was transferred to the municipalities. The start of this reform, unintentionally, coincided with an economic recession which caused additional difficulties for the financing of the present level of public services generally. This development, in combination with innovations in health care technology, resulted in a rapid decentralisation of certain elderly care services from acute care settings.