This thesis researched whether or not Sweden’s Economic Equalisation for Local Government evens out differences in regions’ healthcare quality that are due to structural differences, such as differences in demographic and geography. To be able to analyse healthcare quality amongst Sweden’s regions six healthcare quality indicators were created. By performing regression analysis it was researched whether or not they correlate with the healthcare aspect of the cost equalisation system. If the correlation is high then it is assumed that there are systematic differences in healthcare quality, but if the correlation is low to non-existent it is assumed that there are few to no systematic differences amongst regions. But even if regions’s healthcare quality does not systematically differ this does not necessarily mean that it is due to the equalisation system. Some regions may simply be spending more per capita on healthcare than other regions to be able to provide a comparable healthcare quality. This thesis therefore also analysed whether regions’ healthcare expenditure rates systematically differed or not.  How regional decision makers decide to spend the money received from the equalisation system is also of importance. Even if the equalisation is sufficient (ie. if the money from the system is actually enough to be able to even out structural differences in healthcare quality) does not mean it will actually be spent on healthcare. Therefore it is of interest to determine how regional decision makers spend the money. Because there is a distinct lack of theories on this specific subject, I myself created two models which were based on the wider schools of thought sociological institutionalism and rational choice theory and these were used to help model the different possible outcomes of the study and to thereby help explain on what basis regional decision makers make their decisions when it comes to healthcare. From these models I created four hypotheses that were then tested.  The results of my study gave some modest support for the fact that the economic equalisation system fulfills its aim ie. it evens out structural differences in healthcare quality. It also supported the hypothesis that regional decision makers act in accordance with sociological institutionalism. But three outliers were found when it comes to healthcare expenditure, which if examined further may change the results of this study. More research is therefore needed on this topic.