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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. 140 The Commonwealth Fund
References Ahlberg, N., and S. Vangen (2005). “Pregnancy and Birth in Multicultural Norway.” Tidskr Nor Legefor 125(5):586–88. NORWAY Den norske legeforening (2015). Legestatistikk, http://legeforeningen.no/Emner/Andre-emner/Legestatistikk/. Accessed Nov. 19, 2015. Directorate for Health (2005). National Strategy for Quality Improvement for the Health and Care Services, 2005–2015. IS 1162. https://helsedirektoratet.no/publikasjoner/og-bedre-skal-det-bli-nasjonal-strategi-for-kvalitetsforbedring-i-sosial-oghelsetjenesten-20052015. Accessed Nov. 19, 2015. Finans Norge (2014). https://www.fno.no/statistikk/skadeforsikring/Arlige-publikasjoner/Behandlingsforsikring---kritisksykdomog-barneforsikring/. Acessed Nov. 19, 2015. Helsedirektoratet (2014). Fastlegestatistikk. https://helsedirektoratet.no/statistikk-og-analyse/fastlegestatistikk. Accessed Nov. 19, 2015. Ministry of Health and Care Services (2007). National Strategy to Reduce Social Inequalities in Health, Report No. 20 (Oslo: Ministry of Health and Care Services). Ministry of Health and Care Services (2009). The Coordination Reform: Proper Treatment at the Right Place and Time, Report No. 47 (Oslo: Ministry of Health and Care Services). Ministry of Health and Care Services (2011). Helse-og omsorgstjenesteloven (The New Law for Health and Care Services). Organisation for Economic Co-operation and Development (OECD) (2014). Health at a Glance Europe 2014. http://www. oecd-ilibrary.org/social-issues-migration-health/health-at-a-glance-europe-2014_health_glance_eur-2014-en. Accessed Nov. 19, 2015. Organisation for Economic Co-operation and Development (OECD) (2015). OECDStat. DOI: 10.1787/data-00285-en. Accessed July 2, 2015. Samdata (2013). Spesialisthelsetjenesten Helsedirektoratet 2014. https://helsedirektoratet.no/publikasjoner/samdataspesialisthelsetjenesten. Accessed Nov. 19, 2015. Statistics Norway (2015). Health Accounts. http://www.ssb.no/en/nasjonalregnskap-og-konjunkturer/statistikker/helsesat. Accessed Nov. 19, 2015. Ringard, Å., A. Sagan, I. S. Saunes, A. K. Lindahl. Norway: “Health System Review.” Health Systems in Transition 2013 15(8):1–162. International Profiles of Health Care Systems, 2015 141
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References<br />
Ahlberg, N., and S. Vangen (2005). “Pregnancy and Birth in Multicultural Norway.” Tidskr Nor Legefor 125(5):586–88.<br />
NORWAY<br />
Den norske legeforening (2015). Legestatistikk, http://legeforeningen.no/Emner/Andre-emner/Legestatistikk/. Accessed<br />
Nov. 19, 2015.<br />
Directorate for Health (2005). National Strategy for Quality Improvement for the Health and Care Services, 2005–2015.<br />
IS 1162. https://helsedirektoratet.no/publikasjoner/og-bedre-skal-det-bli-nasjonal-strategi-for-kvalitetsforbedring-i-sosial-oghelsetjenesten-20052015.<br />
Accessed Nov. 19, 2015.<br />
Finans Norge (2014). https://www.fno.no/statistikk/skadeforsikring/Arlige-publikasjoner/Behandlingsforsikring---kritisksykdomog-barneforsikring/.<br />
Acessed Nov. 19, 2015.<br />
Helsedirektoratet (2014). Fastlegestatistikk. https://helsedirektoratet.no/statistikk-og-analyse/fastlegestatistikk. Accessed<br />
Nov. 19, 2015.<br />
Ministry of Health and Care Services (2007). National Strategy to Reduce Social Inequalities in Health, Report No. 20<br />
(Oslo: Ministry of Health and Care Services).<br />
Ministry of Health and Care Services (2009). The Coordination Reform: Proper Treatment at the Right Place and Time,<br />
Report No. 47 (Oslo: Ministry of Health and Care Services).<br />
Ministry of Health and Care Services (2011). Helse-og omsorgstjenesteloven (The New Law for Health and Care Services).<br />
Organisation for Economic Co-operation and Development (OECD) (2014). Health at a Glance Europe 2014. http://www.<br />
oecd-ilibrary.org/social-issues-migration-health/health-at-a-glance-europe-2014_health_glance_eur-2014-en. Accessed<br />
Nov. 19, 2015.<br />
Organisation for Economic Co-operation and Development (OECD) (2015). OECDStat. DOI: 10.1787/data-00285-en.<br />
Accessed July 2, 2015.<br />
Samdata (2013). Spesialisthelsetjenesten Helsedirektoratet 2014. https://helsedirektoratet.no/publikasjoner/samdataspesialisthelsetjenesten.<br />
Accessed Nov. 19, 2015.<br />
Statistics Norway (2015). Health Accounts. http://www.ssb.no/en/nasjonalregnskap-og-konjunkturer/statistikker/helsesat.<br />
Accessed Nov. 19, 2015.<br />
Ringard, Å., A. Sagan, I. S. Saunes, A. K. Lindahl. Norway: “Health System Review.” Health Systems in Transition 2013<br />
15(8):1–162.<br />
International Profiles of Health Care Systems, 2015 141
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