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Health system review: Norway.

Ringard A., Sperre Saunes I., Lindahl A.K.
Observatoire Européen des Systèmes et des Politiques de Santé. Bruxelles. EUR, European Observatory on Health Systems and Policies. Brussels. EUR
Copenhague : OMS Bureau régional de l'Europe, 2013

The Health Systems in Transition (HiT) series provide detailed descriptions of health systems in the countries of the WHO European Region as well as some additional OECD countries. An individual health system review (HiT) examines the specific approach to the organization, financing and delivery of health services in a particular country and the role of the main actors in the health system. It describes the institutional framework, process, content, and implementation of health and health care policies. HiTs also look at reforms in progress or under development and make an assessment of the health system based on stated objectives and outcomes with respect to various dimensions (health status, equity, quality, efficiency, accountability). Norwegian citizens are fortunate to enjoy one of the highest per capita health expenditure in the world. The level of public health care coverage is high (85%) and the health status of the population is very good. However, the satisfaction of people using health care services seems to be ‘only' average compared to other OECD countries that spend less. What can be done to improve it? Poor coordination of hospital care with other health services and long waiting times for elective care are the key reasons for dissatisfaction with the health system. While both of these issues have been on the policy agenda for a long time, the “coordination reform” has recently made a renewed effort to improve these two aspects of the system. The Municipal Health and Care Act and the Public Health Act, enacted in 2011, are the cornerstones of the coordination reform. Their aim is to improve coordination between hospital care and other health services, especially in non-hospital settings. This should reduce pressure on overcrowded hospitals (the average bed occupancy rate in Norway is 93%) by reducing both the average length of stay (ALOS) and waiting times. At the same time, and separately from the coordination reform, increased attention is paid to quality of care and patient safety. The evaluation of the coordination reform is ongoing. Should it lead to improved coordination of care and a reduction in waiting times, it may well succeed in improving the satisfaction of Norwegian patients with the health care system.


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