Municipal health care service

Updated: 15 June 2023

Next update: Not yet determined

Spent per inhabitant 0-20 years at health centres and school health services
Spent per inhabitant 0-20 years at health centres and school health services
2022
4 447
NOK
Municipal health services, key figures
Municipal health services, key figures
2022Percentage change1
2018 - 20222021 - 2022
Man-years for physicians in the municipal health service (absolute figures)6 655.811.63.9
Man-years for physiotherapists in the municipal health service (absolute figures)5 230.23.80.9
Man-years in health centers and school health (absolute figures)2 6 834.521.92.6
Man-years for physicians in the municipal health service per 10 000 inhabitants12.18.02.5
Man-years for physiotherapists in the municipal health service per 10 000 inhabitants9.50.0-1.0
Man-years in health centers and school health per 10 000 inhabitants 0-20 years52.423.62.1
Gross operating expenditure3
Municipal health in total (1 000 NOK)30 744 96558.3-5.6
Health centres and school health services (1 000 NOK)5 803 44035.47.9
Preventive health (includes enviormental health care) (1 000 NOK)4 370 796156.9-41.4
Diagnosis, treatment and rehabilitation (1 000 NOK)20 570 72953.14.3
Municipal health in total per inhabitant5 60153.7-6.7
Health centres and school health services per inhabitant 0-20 years4 44737.17.4
Preventive health (includes enviormental health care) per inhabitant796149.5-42.2
Diagnosis, treatment and rehabilitation per inhabitant3 74848.73.1
1Percentage change is based on absolute figures.
2From march 2021 Statistics Norway has adopted a new method that provides better information on settled percentage of full-time equivalent (FTE) in the period 2015-2020. The new method affects the calculation of man-years.
3The gross operating expenditures are measured in current prices and apply to the municipality as a separate legal entity, supplemented with expenses from inter-municipal companies (IKS) and inter-municipal collaborations.
Explanation of symbols

Selected tables and charts from this statistics

  • Man-years for physicians by activity area
    Man-years for physicians by activity area
    2022Percentage change
    Absolute figuresPer 10 000 inhabitants2018 - 20222021 - 2022
    Physicians, total6 655.812.111.63.9
    Diagnosis, treatment and rehabilitation5 353.39.86.94.8
    School/health centre225.00.40.41.7
    Other preventive health care164.10.323.3-19.7
    Institutions for the aged and disabled629.81.18.61.0
    Offers for immediate assistance daytime stays in municipalities117.00.2-1.58.1
    Administration166.50.326.415.9
    Explanation of symbols
  • Man-years for physiotherapists by activity area
    Man-years for physiotherapists by activity area
    2022Percentage change
    Absolute figuresPer 10 000 inhabitants2018 - 20222021 - 2022
    Physiotherapists, total5 230.29.53.80.9
    Diagnosis, treatment and rehabilitation4 170.67.63.31.3
    School/health centre273.80.55.60.2
    Other preventive health care224.90.417.43.1
    Institutions for the aged and disabled469.90.93.2-0.4
    Immediate assistance daytime stays in the municipalities13.70.06.2-14.9
    Administration77.30.1-7.2-11.5
    Explanation of symbols
  • Activity in health centre service and school health service
    Activity in health centre service and school health service
    2022Percentage change
    2018 - 20222021 - 2022
    Pregnancy and postnatal care service
    Newly registered pregnant women who have been to pregnancy check-up at health centre service (absolute figures)52 9594.6-1.9
    Born during the year (absolute figures)1 51 480-6.6-8.2
    Percentage of newborn with home visits by midwives within three days of homecoming64.790.321.6
    Services for children
    Percentage of newborns with first-time home visits by nurse within two weeks after returning home85.7-3.19.7
    Percentage of infants with completed health examination within 8 weeks of birth99.10.31.4
    Percentage of children with completed health examination at 2 years of age99.02.86.1
    Percentage of children with completed health examination at 4 years of age98.33.85.7
    Percentage of children with completed health examination in the 1st grade of primary school96.018.89.2
    Percentage of municipalities offering health service centers for youth884.83.5
    1The number of births during the year pertains to live births.
    Explanation of symbols
  • Man-years in the health centre service and school health service
    Man-years in the health centre service and school health service1
    Absolute figuresPercentage change
    20222018 - 20222021 - 2022
    Personnel, total. function 2326 834.521.92.6
    Man-years midwives. function 232607.031.15.1
    Man-years public health nurses3 252.414.54.1
    Man-years other nurses. function 2321 237.246.3-0.3
    Man-years without professional education . function 232387.58.2-11.2
    Man-years other education. function 232851.637.58.2
    Man-years for Physicians. function 232225.02.11.7
    Man-years for Physiotherapists. function 232273.85.60.2
    1From march 2021 Statistics Norway has adopted a new method that provides better information on settled percentage of full-time equivalent (FTE) in the period 2015-2020. The new method affects the calculation of man-years.
    Explanation of symbols
  • Gross operating expenditure municipal health and care
    Gross operating expenditure municipal health and care
    Absolute figuresPercentage change
    20222018 - 20222021 - 2022
    Gross operating expenditure, total all functions185 575 80731.25.3
    Preventive health care, school/health centre5 803 44035.47.9
    Preventive health care4 370 796156.9-41.4
    Activation of elderly og disabled7 845 86116.68.8
    Diagnosis, treatment and rehabilitation20 570 72953.14.3
    Nursing and care services in institutions56 627 48021.26.2
    Nursing and care services, home-based82 057 98231.78.5
    Emergency health and care services1 007 19613.4-1.3
    Institution facilities7 292 32335.911.1
    Explanation of symbols

About the statistics

The statistics provide an overview of the municipal health care services. The statistics include information about general practitioners, physiotherapists, health centers and school health services, healthy life centers, and other preventive health work, as well as expenditures.

Municipal Health Care Services: Include services such as general practitioners, physiotherapists, psychologists, maternity and postnatal care, health centers and school health services, and other preventive health work. The term 'municipal health care’ is often used interchangeably with primary health care and is the part of the healthcare system responsible for providing services where people live and work. It also facilitates and coordinates the services that patients need, from other parts of the healthcare system.

Municipal health care and care services: The services municipalities are responsible for according to the Act relating to the municipal health services (Lov om kommunale helse- og omsorgstjenester m.m). It includes health promotion and preventive health care, diagnosis and treatment, habilitation/rehabilitation, as well as health and care services in institutions or at home. In Statistics Norway (SSB), the statistics 'Municipal Health Care Services' and ‘Care Services' together constitute the municipal health care and care services. You can find statistics for the care services here.

Municipal health care services and care services are closely related, and some variables presented under municipal health care services apply to the entire municipal health care and care services. For example, this applies to statistics on man-years of ergo therapists and psychologists.

KOSTRA – functions: The functions in KOSTRA aim to capture specific activities or services in the municipality, regardless of how the municipality has organized this work. The following functions make up the chart of accounts for KOSTRA for expenses related to the municipal health and care services:

  • 241 Diagnosis, treatment and rehabilitation
  • 232 Prevention health care, school/health centers
  • 233 Preventive health care
  • 234 Activation of elderly and disabled
  • 253 Nursing and care services in institutions
  • 254 Nursing and care services home-based
  • 256 Emergency health and care services

Functions 234, 253, 254, and 256 are included in the accounts of the care services. For statistics on man-years, overarching administration of health and care services, function 120 Administration, is also included.

Man-years: Man-years= Position percentage/100. For example, a 50 percent position is counted as half a man-year. Only agreed-upon working hours should be recorded, and overtime should not be included. This means that it's the contractual hours, not the actual hours worked, that are recorded. The registration covers contractual hours for personnel during a representative week at the end of the year. The number of hours per week is then converted into man-years by dividing by a standard number of hours per week. In practice, this means dividing by 36 hours for physiotherapists and 37.5 hours for physicians. Man-years for physicians and physiotherapists in municipal health and care services are reported in KOSTRA form 1. For other professional groups within municipal health and care services, man-years are obtained from a registry. Employees are registered based on their education as of December 31 of the year before the reference year.

Register-Based Employment Statistics: The data source for the register-based employment statistics is the "a-ordning". The a-ordning is a coordinated reporting of wage and employment information to the Norwegian Tax Administration (Skatteetaten), the Norwegian Labour and Welfare Administration (NAV), and Statistics Norway (Statistisk sentralbyrå), regulated by the A-information Act (A-opplysningsloven). You can read more about this under "Data Sources" and "Collection of Data." Statistics on psychologists, ergo therapists, and personnel in health centers and school health services are derived from Statistics Norway's register-based employment statistics.

Man-year figures at the municipal level do not account for potential purchases and sales across municipal borders. They also do not consider intermunicipal cooperation. If municipalities have intermunicipal cooperation for various personnel, the man-years will only be registered in the host municipality.

Agreement Type/wage agreements: By agreement type, we mean the form of affiliation that each individual physician and physiotherapist has with the municipality. A physician or physiotherapist can have an agreement/a contract with the municipality as a private practitioner, can be employed by the municipality with a regular pay, or be employed as a mandatory practitioner (LIS1 for physicians). For physicians, there is also an additional category in the statistics; physicians without an agreement. Starting from the 2021 dataset, only municipally financed hours for physicians without agreements are counted in the statistics. For previous datasets, man-years for private physicians without agreement, and not municipally financed, were also included. For the 2020 dataset, data for physicians without agreements was not reported.

Private physicians with agreements: Private practitioners who have an agreement with a municipality to be part of the general practitioner scheme. These practitioners are essentially self-employed but enter into agreements with the municipality or district to practice as a general practitioner, with responsibility for a specified number of residents. In addition, the agreements may require physicians to participate in on-call services and other municipal tasks such as care services and health centers. The extent to which each physician is required to perform these tasks, as well as the opening hours for their practices, is defined in the specific agreements between the physician and the municipality/district. The income for physician and physiotherapists with municipal agreements is based on reimbursements from the National Insurance Scheme, patient co-payments, and a fixed amount (operating subsidy) from the municipality. This arrangement is based on an agreement between the The Norwegian Association of Local and Regional Authorities (KS), the Ministry of Health and Care Services, and the physicians' organizations.

Municipal employed physicians: physicians employed as either municipal chief medical officers, physicians with regular pay agreements in a general practitioner position, or physicians with responsibilities for medical work in the municipal health care services, such as in health centers and/or school health services, possibly a combination of these.

Mandatory practitioner (LIS1): A physician who has begun specialist training and is employed in an educational position in municipal health and care services during the first part of their training.

Physicians without Agreements: Private physicians without a general practitioner agreement or employment with the municipality. In this statistics, only municipally financed hours should be reported for physicians without agreements. Hours worked by private physicians that are not municipally financed should be excluded from reporting. Until the 2019 dataset, wholly private physicians without agreements, not financed by municipalities, were included in man-year figures.

Regular General Practitioner: A physician who enters into an agreement with a municipality to participate in the general practitioner scheme, regardless of whether the doctor is employed by the municipality or is a private practitioner. According to the regulation on the general practitioner scheme in municipalities, the GP should cover all general practitioner tasks for the individuals on its patient list.

In the statistical tables related to general practitioners, under the heading 'Regular general practitioners' on the statistics page, the unit is individuals with agreements with municipalities to practice as general practitioners, not the number of agreements or full-time equivalents. Each general practitioner is counted only once. In cases where the general practitioner has agreements with multiple municipalities, the municipality with the longest patient list is chosen as the main practice municipality. If the general practitioner has an equally long list in multiple municipalities, the municipality where the agreement extends furthest into the future is chosen. The source of this data is from Fastlegeregisteret (General practitioner register). Data from Fastlegeregisteret is also part of the KOSTRA municipal health care services statistics: General Practitioner Lists and General Practitioner Consultations. Here, the statistical unit is general practitioner agreements.

Patient List Status: The variable is calculated as the ratio between the general practitioner's list capacity (established in the agreement with the practice municipality) and the number of residents (patients) on the list. A list is considered open (available spots) if the list capacity is more than 20 greater than the actual number of residents on the list. A list is considered closed (no available spots) if there are fewer than 20 available spots on the list.

Physiotherapists with Municipal Contracts: These individuals are typically private practicing physiotherapists but enter into agreements with the municipality or district. The income basis for physiotherapists with a municipal agreement includes reimbursements from the National Insurance Scheme, patient co-payments, and a fixed amount (operating grant) from the municipality as compensation for the agreement. This arrangement is based on an agreement between the Association of Norwegian Municipalities (KS), the Ministry of Health, and the organizations of physiotherapists. The municipality defines the need for and establishes the dimensioning of the physiotherapy service in its municipality, and the operating agreements may be of various sizes. Since 2013, operating agreements with less than 50 percent of full funding are not permitted.

Under municipal health care services statistics, you can also find figures on physiotherapists with municipal operating agreements from the KUHR-register (Control and Payment of Health Reimbursements).

Physiotherapist with regular pay: A physiotherapist who is employed by and receives salary from the municipality., covers full-time and part-time positions. The tasks of physiotherapists are defined through municipal instructions.

Mandatory practitioners - Physiotherapist: An individual who has completed physiotherapy education and is in rotational service, where 6 months are to be completed in municipal health and care services and 6 months in specialized health services. This form of rotational service is a requirement for obtaining authorization as a physiotherapist.

Midwife: A publicly approved nurse with a two-year specialization in care during pregnancy, midwifery, and women's health. In this statistic, you will find figures for contractual man-years for midwives working within the health centers and school health service. The contractual man-years within industry/NACE 86.903, which covers health centers and school health services in the Register based employment statistics, are counted for all individuals registered with midwife education in the education register. Man-years are counted in the municipality where they are employed, even if parts of the man-years are allocated to serve residents in other municipalities.

Ergotherapist: Professionally educated healthcare personnel who practice ergotherapy. Central to the work of ergotherapists is the targeted use of activity to promote mastery, meaning, and health. In this statistic, you will find figures for contractual man-years for ergotherapists. These include contractual man-years for all individuals registered with ergotherapy education who are employed within the municipal health and care services (municipal health care services + municipal care services), including both municipal and private practicing man-years. in the statistics man-years appear in the municipality where they are employed, even if parts of the man-years are allocated to serve residents in other municipalities. Private practicing man-years appear in the municipality where the business is registered.

Psychologist in the Municipal Health Care and Care Services: An individual who has completed a professional psychology degree and has obtained public-approved authorization. In this statistic, you will find figures for contractual man-years for psychologists employed within the municipal health and care services (municipal health services + municipal care services). In the statistics man-years appear in the municipality where they are employed, even if parts of the man-years are allocated to serve residents in other municipalities.

Activity in the Health Centers and School Health Service: The services provided by the health centers and school health services include various consultations/examinations. In this statistic, you will find figures for newly registered pregnant women, home visits by midwives within three days after returning home from the maternity ward, home visits by public health nurses for newborns, examinations at 8 weeks, 2 years of age and 4 years of age, and at 1st grade of primary school.

Healthy Life Center: The Healthy Life Center is a health-promoting and preventive health service. The target group includes individuals with illnesses, or an increased risk of illness, who need support to change their lifestyles and manage health challenges.

Number of Municipalities and Counties

The number of municipalities and counties has changed over time. There were some bigger changes in the start of 2020 and 2024. As of 2020, there were 357 municipalities and 11 counties, and as of 2024 there are 358 municipalities and 15 counties. You can find the current and older municipal divisions in the Classification of municipalities here and the current and older county divisions in the Classification of county here.

Municipal Groups

To better compare data between municipalities, Statistics Norway (SSB) have categorized municipalities based on population and economic frameworks since the 1990s. As a result of the municipal reform that took effect from January 1, 2020, a revision of the municipal groups used in KOSTRA for the publication of 2020 data was done. You can read more about the new and older KOSTRA groups here (ssb.no). An overview of the categories is available in Excel format on this webpage. The code list for KOSTRA municipalities is available here (ssb.no)

Classification of Municipal Centrality

The classification of how central different municipalities are is based on the classification of centrality (ssb.no). In the latest version from 2020, there are 6 codes for centrality, ranging from 01 (high) to 06 (low). In the previous standard applicable from 2008 to 2019, the categories were: Central municipalities, somewhat central municipalities, less central municipalities, and least central municipalities.

Statistics on General Practitioners (GPs) by Immigration Category

For the statistics on General Practitioners (GPs), Classification of immigration categories (from 2008) (ssb.no) is used. This standard has 6 categories, but in the statistics, only the code for immigrants (B) is used, while the other categories (A, C, E, F, G) are combined as "Regular GPs, other." General practitioners who are not resident in Norway are included as "Regular GPs, immigrants."

The grouping of general practitioners who are immigrants by country of birth follows the Classification of country codes (ssb.no). In the statistics table, countries of birth are grouped as follows: 1) Nordic countries (except Norway) 2) EU/EFTA/UK (except the Nordic countries) 3) Europe except EU/EFTA/UK 4) Asia, Africa, Latin America, Oceania excluding Australia and New Zealand 5) USA, Canada, Australia, and New Zealand.

Name: Municipal health care service
Topic: Health

Not yet determined

Division for Health, care and social statistics

The lowest geographical level is urban districts (bydeler) in Oslo, but for the rest of the country, it is municipalities (kommuner). Data is also published for KOSTRA groups, counties (fylke), and the whole country (including and excluding Oslo).

Annual publication in KOSTRA occurs on March 15th (unedited data) and June 15th (edited data) of the year following the statistical year. Additionally, the statistics page for the Municipal Health Care Service is updated in connection with the June 15th publication.

Some data is annually submitted to the OECD (Organization for Economic Co-operation and Development).

Collected and revised data are stored securely by Statistics Norway in compliance with applicable legislation on data processing.

Statistics Norway can grant access to the source data (de-identified or anonymised microdata) on which the statistics are based, for researchers and public authorities for the purposes of preparing statistical results and analyses. Access can be granted upon application and subject to conditions. Refer to the details about this at Access to data from Statistics Norway.

On the statistics page for municipal health care services, you can find key figures for the entire municipal health care and care services. Additionally, there are tables and information about news articles and reports related to municipal health care services, along with links to other relevant statistical areas such as general practitioner services and specialized health services.

For more information about KOSTRA, please visit KOSTRA's official website (ssb.no) .

Custom tables can be created, and API extracts can be made from Statistikkbanken (ssb.no).There is a dedicated page for municipal health services, and you can also find links to tables for nursing homes, home care services, and other care services.

The purpose of this statistic is to provide a comprehensive overview of municipal health care services. The statistics cover general practitioner services, rehabilitation services, healthy life centers, maternity and postnatal care services, school health services, physiotherapists, psychologists, and more.

Municipal health care services are a part of the health care services provided by municipalities, which also include nursing homes, home care services, and other care services. For information on recipients of various care services, the number of places, and the number of residents in municipal institutions, please see the Care services statistics (ssb.no).

Mutual statistics for municipal health care services and care services are found on both of respective statistics pages, including key figures, service expenses, and personnel figures.

The statistics for municipal health care and care services intend to provide central, regional, and municipal authorities with data for planning and supervision purposes. Among other things, the statistics provides knowledge about the personnel situation and about developments in local health care services.

Since January 1, 2012, the Act relating to municipal Health and care services (helse- og omsorgstenesteloven, lov nr. 30 av 24.06.2011) has defined the municipal health and care services, laying the foundation for municipal health and care statistics. An amendment was made to this law on June 18, 2021, with new requirements for the cooperation agreement between municipalities and health trusts. However, it is the law relating to personal health data filing systems and the processing of personal health data (Lov om helseregistre og behandling av helseopplysningar of June 20, 2014 nr. 43) § 16, in addition to the Statistics Act (Statistikkloven of June 21, 2019, no. 32) § 10 that provides the legal basis for collecting and publishing the statistics, as described in the section "Legal authority”.

The Health and Care Services Act (Helse- og omsorgstenesteloven) was introduced in connection with the health sector Coordination Reform (Samhandlingsreformen), replacing the act relating to the municipal health services (Lov om helsetjenesten i kommunene, law no. 66 of November 19, 1982) and the Act relating to social services, etc. (Lov om sosiale tjenester m.v, 1 of December 13, 1991 nr. 8).

With the introduction of the Coordination Reform in the health sector from 2012, municipalities were given the responsibility to develop health services before, and/or during and after hospital stays. Among other things, municipalities were required to finance parts of specialized health services, have financial responsibility for patients who are ready for discharge from hospital on day one, and provide 24-hour care when needed. The requirement for immediate assistance accommodation, applied from January 1, 2016, for somatic patients. From 2017, the requirement also applies to patients with mental health and substance abuse challenges.

The coordination reform also emphasizes municipalities' responsibility for the prevention of health problems. This is especially stated in the The Norwegian Public Health Act (Folkehelseloven, 24.6. 2011 no. 29) Chapter 2, which was updated at the same time as the Health and Care Services Act in 2012. Furthermore, responsibility for preventive health work is enshrined in the Health and Care Services Act § 3-2, first paragraph, nos. 1 and 2: "To fulfill the responsibility under § 3-1, the municipality must, among other things, offer:

1. Health-promoting and preventive services, including:

a. health services in schools, and

b. child health clinics

2. Pregnancy and post-natal care services

3. Assistance in the event of accident and other acute situations, including:

a. Accident and emergency units,

b. 24-hour emergency medical response, and

c. emergency medical services

4. Assessment, diagnosis and treatment, including the regular GP scheme,

5. Social, psychosocial and medical habilitation and rehabilitation

6. Other health and care services, including:

a. health services at home,

b. personal assistance, including practical assistance and training and support contacts

c. place in institutions, including nursing homes, and

d. respite measures"

The statistics are important for the central government authorities, who need current information for both planning and monitoring and evaluating local operations. Municipalities are also stakeholders for these statistics. They want to be able to compare healthcare services at both the municipal and county levels, as well as at the national level, and over time. In a democratic society, various interest groups, politicians, and individual citizens are also important recipients of this information.

Key users include the Ministry of Health and Care Services, Ministry of Local Government and Regional Development, the Norwegian Directorate of Health, the Norwegian Board of Health Supervision, the Norwegian Institute of Public Health, regional and municipal authorities, the Norwegian Association of Local and Regional Authorities (KS), other interest organizations, researchers, the media, and the general public.

No external users have access to statistics before they are released at 8 a.m. on ssb.no after at least three months’ advance notice in the release calendar. This is one of the most important principles in Statistics Norway for ensuring the equal treatment of users.

The statistics can be viewed in conjunction with several other KOSTRA areas, especially statistics for care services (ssb.no) and specialist health services (ssb.no).

For statistics on the population's use of a regular general practitioner (GP), refer to the statistics for the GPs and emergency primary health care (ssb.no).

The statistics are developed, produced and disseminated pursuant to Act no. 32 of 21 June 2019 relating to official statistics and Statistics Norway (the Statistics Act).

For summary data (KOSTRA forms): The data are collected by Statistics Norway on behalf of the Ministry of Health and Care Services in accordance with the Personal Health Data Filing System Act (Act of June 20, 2014, No. 43) § 10.

The register-based personnel statistics are regulated by the Statistics Act § 10, in accordance with the act on employers' reporting of employment and income, etc. (the A-opplysningsloven, Act of June 22, 2012, no. 43) § 3.

Not relevant.

The statistics are primarily based on reporting from municipal health care services in all municipalities and in the districts of Oslo.

Statistics on municipal health care services are based on the following data sources:

  • Annual submission of an electronic questionnaire (KOSTRA- form 1 Personnel and operations in municipal health care and care services) from all municipalities via KOSTRA (Municipality-State Reporting).
  • Annual submission of accounting data from municipalities via KOSTRA.
  • SSB's register-based employment statistics.
  • The regular general practitioner registry “Fastlegeregisteret” from the Directorate of Health is the data source for statistics on general practitioners and variables related to patient lists, etc.
  • The KUHR database (Control and Payment of Health Refunds) is the data source for statistics on general practitioner consultations and on physiotherapists with municipal agreements. The database is owned by the Directorate of Health.

The statistics cover all municipalities, and districts in Oslo.

Collection of data

Statistics on man-years of psychologists, ergotherapists, and personnel in health centers and school health services are based on Statistics Norway's register-based employment statistics.

Starting from 2015, data is collected through a common reporting solution called "A-ordningen" (skatteetaten.no). The "A-ordningen" is a coordinated digital collection of information on employment conditions, income, and tax deductions for the Norwegian Tax Administration, the Norwegian Labor and Welfare Administration (NAV), and Statistics Norway. This system allows Statistics Norway to receive information on wages and employees directly from the "A-meldingen," which is the electronic message containing all the collected information, instead of using multiple sources as in the past. For more information about the statistics based on A-meldingen please see the statistics page for Employment, register-based (ssb.no). The reference time for the man-year statistics is the middle of November.

Information about municipal health care services is collected from municipalities that fill out an electronic questionnaire. One questionnaire is in use, called "KOSTRA- form 1 Personnel and operations in municipal health care and care services". It covers health services such as physicians, physiotherapists, health centers, school health services, and other preventive services.

Collection and publication of statistics from municipalities are continuously developing. Much of the data is collected through the KOSTRA system (Municipality-State Reporting). KOSTRA started as a project in 1995 with the aim of coordinating and streamlining all reporting from municipalities to the state, while at the same time providing relevant information about municipal operations. KOSTRA is based on electronic reporting from municipalities to Statistics Norway and data from various other sources within and outside Statistics Norway. Notably, this includes accounting data, Statistics Norway's register-based employment statistics, and population data. In 2001, all municipalities participated in KOSTRA reporting for the first time.

For more information on KOSTRA reporting and detailed figures for each individual municipality, visit KOSTRA (ssb.no) and the Statistics Norway database – StatBank Norway (ssb.no).

Since 2003 Statistics on personnel in health care and care services are mostly derived from Statistics Norway's register-based employment statistics. Starting from 2010, man-years in health centers and school health services are also obtained from register.

Contracted man-years for doctors and physiotherapists are collected in KOSTRA-form 1.

Editing

Editing is defined here as checking, examining and amending data.

Some key variables are automatically checked during the completion of electronic KOSTRA questionnaires. Preliminary/unedited data is published on March 15th. This allows municipalities to review their data and compare it with others. Subsequently, Statistics Norway conducts checks and edits the data by comparing it with figures from previous years and evaluate the relative figures for individual municipalities. For instance, this can include the number of hours worked by physicians and physiotherapists, or the number of examinations carried out at health centers for specific age groups, in relation to the number of children in the respective age groups within the municipality. If the checks reveal significant deviations from one year to another, or relative sizes differ significantly from comparable municipalities, the municipality is contacted for further clarification and potential amendments. In addition to the mentioned checks, there are validations to ensure logical consistency between the data in different sections of the questionnaire.

An overview of general practitioners with unique personal identification numbers is coupled with the National Population Register, and variables related to immigration category and country of birth are added. General practitioners who are not residents in Norway do not have a unique personal identification number and therefore lack certain information. These general practitioners are included in the statistics along with general practitioners who are immigrants, but without information about their country of birth.

Despite extensive editing efforts, there may still be errors in the presented figures.

For information on the examining of employment statistics from the "A-ordning," see About the Statistics for Register-Based Employment Statistics (ssb.no)

Calculations

Data is published at various levels, including basic data and indicators. Basic data represents the number of units aggregated for a certain period, or on a specific reference date, and are reported as absolute figures. Indicators, on the other hand, are ratios (basic data related to each other, user groups, or population figures).

Additionally, for indicators, average values are shown for municipal groups, counties or the country total. Weighted averages are used, meaning that each user/recipient is counted equally, hence larger municipalities have a greater impact on the average than smaller municipalities for most indicators.

Estimation

Starting from the statistical year 2008, sums for basic data are estimated, including data for municipalities that have not submitted data. Averages are then calculated based on the estimated sum values. Before 2008, municipalities with missing data were excluded from the calculations for the numerator or denominator. For indicators in absolute numbers, an arithmetic average (each municipality counts equally, regardless of population) is used. The same applies to indicators based on yes/no questions.

National averages are shown both with and without Oslo. This is because the Oslo accounts cover both municipal and county municipal functions, figures are therefore not always directly comparable.

Not relevant

To ensure confidentiality, suppression is used in these statistics.

For data retrieved from KOSTRA forms that concern individuals, figures three and below are supressed to protect privacy and confidentiality. In tables with row and column sums, secondary suppression is also used. This primarily applies to published figures relating to health examinations in health centers and school health services.

The statistics have undergone several changes, but continuous time series can be provided for all key variables from 1987 for municipal health care services.

Statistics on general practitioners (GPs) cover the years from 2002, the first full year when the system covered the entire country.

The new KOSTRA tables contain data from the 2015 onwards. Statistics prior to 2015 are available under "closed time series" in the statistics database (ssb.no). Previous issues before 2015 for KOSTRA statistics can be found in the following tables under “Closed time series – KOSTRA” (ssb.no):

Municipal data:

07798: E1. Consolidated accounts. Municipal Health Services - basic data (M) (closed series) 1999 – 2016

07793: E1. Consolidated accounts. Municipal Health Services - key figures (M) (closed series) 2000 – 2016

Data for districts in Oslo:

04673: E. Municipality Health Services, city district - basic data (UD) (closed series) 2004 – 2017

04930: E. Municipality Health Services, city district key figures (UD) (closed series) 2004 – 2017

Register-based employment statistics are based on a new data source for employees called the a-ordning from 2015 onwards. Changing the data source results in changes in the time series from 2015. Figures for man-years based on the new data source cannot be directly compared with figures from the old data source. Please see About the statistic for the register-based employment statistics for more information about this (ssb.no).

Measurement and Processing Errors

The controls built into the electronic questionnaires, file extracts for accounting data, and data reception at Statistics Norway (SSB) provide an automatic and quick feedback loop to the respondent, allowing them to rectify any errors during reporting.

Errors due to missing units

KOSTRA data is based on a complete population count, meaning that all units in this statistic, including municipalities and districts, must report each year.

One challenge, primarily in March, is that several municipalities do not report data in time for inclusion in the preliminary publication of figures. If the number of missing units is substantial in March, it can be challenging to provide information at the national level for certain variables and indicators. To compensate for this, estimated values are calculated for municipalities lacking data, enabling the presentation of estimated values at national and regional levels.

Several methods are used to estimate national and regional values, depending on what suits the statistical variable. Some methods assume a positive correlation between the statistical variable and an explanatory variable, such as population or the previous year's value for the municipality. For municipal health services, population is used as the explanatory variable for all estimated variables. Based on this, an estimate can be given for the entire country and for various regional levels.

The estimated figures should only be used as an estimate of what the country total could have been if all data had been reported, and not as actual sums.

A-Ordningen, from 2015

There are omittances in reporting of share of positions, which are used to calculate contractual/normal working hours. This applies in particularly for hourly wages. Therefore, SSB has developed a new method that provides better information about working hours. More information in the article: New method provides better information about working hours (ssb.no).

Self-employed individuals are identified using information from the Sole-proprietorship registry. This register is available 11 months after the end of the year. Therefore, SSB uses information from the year before the reference year. Due to this time lag, individuals may be classified as employed if they terminated their business in the previous year.

Before 2015, total employment figures were determined by the Labor Force Survey (LFS) and divided into employees and self-employed. From 2015 onwards, only the number of self-employed individuals is determined by LFS. For employees, the uncertainty associated with survey data was eliminated. On the other hand, the level of employees was slightly underestimated. However, from April 26, 2018, the level of employees will no longer be the same. This is because new LFS figures were published after a new estimation method was introduced. More information about this can be read here: New method provides better LFS figures (ssb.no)

Limitations of man-year figures from Register-Based Employment Statistics

Man-year data from the register-based employment statistics at the municipal level does not account for potential cross-municipal border purchases and sales, or inter-municipal cooperation. If multiple municipalities have cooperation involving various personnel, man-years will only be registered in the host municipality. Man-year data also does not account for potential purchases from private providers or specialist health services.

Other Errors

The organization of municipal health care services can vary between municipalities; therefore, the questionnaire is not perfectly suited for all of them. This can result in discrepancies between the data registrations and the operational status that the questionnaire the intends to capture.

Hours worked by private practicing regular GPs with GP agreements: According to the questionnaire guidance, the figures should include hours per week agreed upon between the GPs and the municipality. The calculation of hours per week for a private practicing GPs assumes that a full position is equivalent to 37.5 hours per week. However, some municipalities may include actual hours worked, even if this exceeds the hours specified in the agreement.

Hours of municipal employed GPs: According to the guidance, overtime should not be included. However, some municipalities may include overtime. Figures for these municipalities are edited if SSB becomes aware that such work has been included.

Not relevant

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