JANUARY

NORWAY
The National System for the Introduction of New Health Technologies, established in 2014, bases its decisions
on whether to approve new, costly drugs or treatment mainly on Health Technology Assessments, which address
cost-effectiveness.
Norway has a low number of hospital beds (four per 1,000 inhabitants in 2012) compared with the OECD-Europe
mean of five (OECD, 2014). The low number is part of a policy to drive services toward outpatient and daycare
settings, and to make municipalities accountable for patients not needing specialized hospital care. There is an
ongoing debate about overdiagnosing and use of procedures that are not evidence-based. Clinical guidelines
and a published atlas of variation in frequency of some daytime surgical procedures (www.helseatlas.no) are the
only measures taken to date to reduce “low value” care. Although the Council on Priorities in Health Care has
debated, for instance, levels of end-of-life care and use of intensive care beds, no focused initiatives have
resulted from the debates.
What major innovations and reforms have been introduced?
Municipality cofinancing of hospital care was abolished in 2015, as it was concluded that it did not have the
intended effect of keeping patients out of the hospital.
Availability of single occupancy for patients in nursing homes for those preferring it has been a goal for many
years. The realization that the goal had not been met led the government to introduce reduced payments by
patients for occupancy in double rooms as a financial incentive (or penalty) for the municipalities effective from
January 2015. No plan is in place for evaluation of the effect.
A new Agency for Hospital Construction (Sykehusbygg HF) was established in November 2014. Owned by the
RHAs, the agency will serve as a national center of competence for hospital planning and construction for all
hospital trusts. There is no plan for evaluation.
The author would like to acknowledge David Squires and Ånen Ringard as contributing authors to earlier
versions of this profile.
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The Commonwealth Fund