Decreasing growth in central government specialist health service

The central government spent NOK 88 billion and employed almost 85,000 man-years in the specialist health service.

Central government specialist health service – national level

Specialist health services produced by central government cost NOK 88 billion in 2009. The costs increased by 5 per cent from 2008 to 2009; the lowest annual cost increase in the last three years. Central government specialist health service amounted to 85,000 contracted man-years adjusted for long-term leave.

StatRes – Specialist health service includes data and statistics on the central government’s own production of specialist health services, organised into Regional Health Enterprises and Health Enterprises.

Data and statistics on the specialist health service including private sector production are available on http://www.ssb.no/speshelse_en/.

Average waiting period for ordinary effected referrals increased by 6 days between 2006 and 2009.

Central government specialist health service – regional level

The South-East is by far the largest health region. In this region the operating costs of own production including depreciation amounted to NOK 48 billion in 2009. The Western region was the second largest with NOK 16 billion. Furthermore, The Mid region cost NOK 13 billion, while the North cost NOK 11 billion.

The specialist health service includes hospitals and institutions within general hospitals, mental health care and multidisciplinary specialist treatment of substance abuse, ambulance service and private specialists with an operating agreement. The legal basis for the specialist health service is the Specialist Health Service Act of 1999.

The specialist health service is organized into four health regions/regional health enterprises, South-East, West, Mid and North. The regional health enterprises have overall responsibility to ensure that health policy objectives and laws are fulfilled within their geographic area of responsibility. The objectives are stipulated in the legislation on health enterprises and specialist health services. The policy objectives are specified in national resolutions and plans relating to health policy, research policy and education policy.

A health enterprise is a Norwegian state activity owned by a regional health enterprise, and each health enterprise is a legal entity. Health enterprises carry out specialist health services, research, teaching and other services related to these. Each health enterprise in turn organizes a number of hospitals and institutions in general hospitals, mental health care and multidisciplinary specialist treatment of substance abuse.

The South-East accounted for 46,800 contracted man-years adjusted for long-term leave. In the West this number was 15,800, in Mid-Norway 12,200 and in the North 10 200. The North had the highest number of man-years per 1,000 capita; 22 man-years. The number of contracted man-years adjusted for long-term leave does not include hired labor.

The South-East region accounted for 54 per cent of all beds and 56 per cent of out-patient treatments in the central government specialist health service. The increase in the number of out-patient treatments was highest in South-East, but changes in registration routines caused a break in the time series. The number of beds decreased in all the regions, most of all in the North by 6 per cent.

The indicators on the relative level of costs are developed by the Norwegian Directorate of Health, and published as a productivity indicator in StatRes. The relative level of cost is calculated by operating costs per DRG (Diagnosis-related groups). The figures show that the relative level of costs was lowest in the South-East region, and highest in the North.

General hospitals owned by the central government

The production in general hospitals run by the central government cost approximately NOK 57 billion in 2009; a decrease of about 7 per cent from 2008. At the end of 2009, there were around 11,700 beds at general hospitals; a decrease of 300 beds compared to 2008. This is in accordance with the development in recent years. There was a decrease in in-patient discharges and bed-days. There were approximately 800,000 in-patient discharges in central hospitals in 2009. The inclusion of discharges of healthy new-borns gives an increase compared to earlier years, when these discharges were not included. The number of out-patient consultations was more than 4 million at the central government`s general hospitals. Due to a change in the registration practice (Norwegian Patient Register), these figures are not comparable with figures for out-patient consultations that were published in previous years.

In 2009, a trend showing more out-patient consultations and more day cases continued. The number of day-cases in the general hospitals increased by approximately 20 000 (4 per cent) from 2008 to 2009. The number of day treatments increased, especially in private commercial hospitals (30 per cent). Read more: Patient statistics, 2009.

In 2009, the total number of contracted man-years adjusted for long-term leave in central government general hospitals and other somatic institutions was almost 59 600.

The national quality indicators are developed by The Norwegian Directorate of Health, and published in StatRes for the first time in 2010. The national quality indicators show that corridor patients as a percentage of all beds decreased from 2.3 in 2005 to 2.0 in 2009. Furthermore, the percentage of epicrisis sent to patients within seven days of discharge increased from 57 to 68 in the same period. More details of national quality indicators are available on the Directorate`s website, www.helsedirektoratet.no/statistikk/indikatorer.

Mental health care in central government

The central government production of mental health care cost approximately NOK 16 billion in 2009. This was an increase of about 5 per cent from 2008. Mental health care for adults amounted to almost NOK 13 billion and mental health care for children and adolescents cost about NOK 3 billion. The increase was strongest in mental health care for children and adolescents, with 7.6 per cent, while the cost increase was 4.6 per cent in mental health care for adults.

The number of out-patient consultations in mental health care increased by 6 per cent from 2008 to 2009. The increase was 5 per cent in mental health care for children and adolescents, whereas the increase was 8 per cent for adults.

The national quality indicators on mental health care show a decrease of 30 per cent in the median number of waiting days for primary consultation for patients with a legal right to psychiatric help. Among children and adolescents, 84 per cent of all epicrisis were sent to the patients within 7 days of discharge.

Multidisciplinary specialist substance abuse treatment in central government

Multidisciplinary specialist substance abuse treatment cost about NOK 1.8 billion in 2009. This was an increase of about 11.5 per cent from 2008. From 2008 to 2009, the total man-years within multidisciplinary specialist substance abuse treatment increased by 15 per cent.

Source: Statistics Norway

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