289865
/en/helse/statistikker/speshelse/aar
289865
statistikk
2017-06-22T08:00:00.000Z
Health
en
speshelse, Specialist health service, hospital, health enterprise, health region, mental health care, psychiatric institutions, substance abuse care, substance abuse treatment institutions, somatic health services, operating costs, investments, health personnel (for example doctors, nurses, psychologists), specialists, bed days, beds, day treatment, admissions, involuntary admissions, polyclinic consultations, follow-up care, discharges, ambulance assignments, ambulance cars, ambulances, ambulance boats, air ambulancesHealth services , Health
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Specialist health service

Updated

Next update

Not yet determined

Key figures

2 %

increase in man-years in the specialist health service in 2016

Specialist health service, main figures
Change in per cent
20162015-20162012-2016
1The figures are in current prices.
2Due to change of data source (healthy newborns in hospitals are no longer included) changes in Bed-days and discharges are not calculated for 2014 and earlier.
3"Man-years" refer to "Contracted man-years excl. long term leaves". Due to change of data source, changes in man-years are not calculated for 2014 and earlier.
Specialist health service
Expenses (NOK million)1140 934122
Expences per inhabitant (NOK)126 800017
Beds19 303-1-3
Discharges2858 5801:
Bed-days25 908 7963:
Out-patient consultations8 862 465119
Day cases414 8270-15
Man-years3112 8402:

See more tables on this subject

Table 1 
Specialist health service, general care. Main figures

Specialist health service, general care. Main figures
20162015 - 20162012 - 2016
Per centPer cent
1Due to change of data source (healthy newborns in hospitals are no longer included) changes in Bed-days and discharges are not calculated for 2014 and earlier.
2"Man-years" refer to "Contracted man-years excl. long term leaves". Due to change of data source, changes in man-years are not calculated for 2014 and earlier.
Expences (million NOK)100 915224
Beds13 484-1-3
Discharges1785 8950.4:
Bed-days14 104 0624.8:
Out-patient consultations5 882 099117
Day cases380 845-1-14
Man-years275 3251.1:

Table 2 
Mental health care. Key figures

Mental health care. Key figures
20162015 - 20162012 - 2016
Per centPer cent
1"Man-years" refer to "Contracted man-years excl. long term leaves". Due to change of data source, changes in man-years are not calculated for 2014 and earlier.
Expences (million NOK)23 262-211
Beds3 865-3-10
Discharges56 80011
Bed-days1 167 753-1-9
Out-patient consultations2 578 099321
Man-years119 5151:

Table 3 
Multidisciplinary specialist substance abuse treatment. Key figures

Multidisciplinary specialist substance abuse treatment. Key figures
20162015 - 20162012 - 2016
Per centPer cent
1"Man-years" refer to "Contracted man-years excl. long term leaves". Due to change of data source, changes in man-years are not calculated for 2014 and earlier.
Expences (million NOK)5 391327
Beds1 954110
Discharges15 885135
Bed-days636 981211
Out-patient consultations402 267-755
Man-years14 0533:

About the statistics

The specialist health service includes both public and private hospitals, mental health care, specialised drug treatment, ambulance services and private specialists. The statistics include data on accounts, personnel, activities and services.

Definitions

Definitions of the main concepts and variables

Specialist health service --includes somatic and psychiatric hospitals and institutions, institutions related to drug abuse, ambulance service and private specialists with operating agreements.

General (somatic) hospitals are "normal" hospitals, i.e. not psychiatric hospitals. Day-cases are planned admittances without the patient staying overnight. The treatment given is more comprehensive than outpatient treatment.

Outpatient consultations include consultations and treatment carried out in hospitals without the patient being admitted.

Mental health care
Psychiatric health care for adults covers treatment of patients aged 18 and up. Patients under 18 are treated in psychiatric health care for children and adolescents.

Ambulance
In accordance with "Definisjonskatalog for AMK-/LV-sentraler" the definition of an ambulance is as follows:

"Ground-, air- or sea vehicles constructed/built for and used for transporting ill or hurt persons, with personnel, facilitated and equipped for treatment ahead of and during the transport."

Government mandate

Private institutions with government mandate function as a part of the Public Health system. The government make plans for how these institutions may operate and these institutions are responsible for providing specialist health services to inhabitants in specific geografical areas. There are 12 private institutions with government mandate: Stiftelsen Betanien Hospital Skien, Voss DPS NKS Bjørkeli AS, Haugesund Sanitetsforenings Revmatismesykehus AS, Lovisenberg diakonale sykehus AS, NKS Jæren Distriktspsykiatriske senter AS, Diakonhjemmet sykehus AS, NKS Olaviken Alderspsykiatriske senter AS, Stiftelsen Betanien Bergen, Martina Hansens Hospital AS, Haraldsplass diakonale sykehus AS, Solli sykehus og Revmatismesykehuset AS.

Operating agreement
An operating agreement is an agreement entered into by physicians and HE, and concerns operations and private practice. The services delivered by institutions with operating agreements are de facto part of the ordinary provided health care in the respective health regions.

Additionally, HE (or RHE) might purchase health care services from privately owned enterprises. Those contracts are often more short-term based than an operating agreement. The services purchased contribute to the general health care provided by HE and RHE.

Expenditure eksl. revenues
Expenditure includes expenses on wages and social benefits, expenses on equipment and maintenance, other current expenses and transfer expenses. Public grants is not included. Interest, principal repayment, financing transactions such as funds, charging of accounting losses/profits as expenses and coverage of previous years' losses, are not included. Refunded wages from national insurance for paid sick leave are corrected.

Revenues
Revenues include sales and leasing revenues and transfers. This corresponds to items 300-399, 570, 571, 579 and 583 in the regulations for the health enterprises. Financial transactions such as funds, and recording of surplus in the balance sheet are not included.

Depreciation
Depreciation in total includes depreciation of commercial buildings and other real estate, means of transport, medical technical equipment, machines, other equipment and furniture, ICT-equipment (Information and Communication technology-equipment), immaterial properties and write-down of fixed assets and immaterial properties.

Man-years are the number of full time employees and part-time employees converted to full-time equivalents at 31 December of the statistical year. Man-years cover the agreed working hours. Overtime is not included.

Bed capacity at the institutions

This is the number of accessible beds in the institution as of 31 December each year. Beds that are temporarily closed (e.g., during public holidays, etc.) are included.

 

Bed-days

Number of days a patient remains in hospital

Outpatient treatment
In somatic hospitals an outpatient treatment is: Examination/treatment and/or medical advice administered in or by a hospital. Usually, a physician should be present at such consultations. Consultations related to admitted patients, telephone consultations, lab tests and x-ray examination, are not included.

Outpatient consultations include consultations carried out in outpatient clinics or in psychiatric institutions, giving reimbursement from the state.

Standard classifications

Ambulances operative parts of the day may denote vehicles operative between 8 a.m. and 4 p.m., or in another period of the day.

Ambulances in 24-hour readiness are vehicles that are operative 24 hours a day.

Other ambulances are vehicles that are not included in the daily operations. These are standby ambulances and supplementary ambulances.

Specialist physicians are placed in various classes of subsidy . This is done subsequent to local negotiations between Health Enterprises and the physicians, with basis in the specialist need for housing, technical equipment and personnel. Subsidy is provided according to the following scale:

Class Amount per year (per 01.07.2009)

1 NOK 700 000

2 NOK 813 200

3 NOK 1 042 500

Administrative information

Name and topic

Name: Specialist health service
Topic: Health

Responsible division

Division for Health Statistics

Regional level

Statistics are presented on national level and per region in tables related to Today's statistics. In the StatBank you will find statistics on Health Enterprise level and in some cases institutional level as well.

Frequency and timeliness

Annual

International reporting

The statistics are reported to OEDE, Eurostat, WHO and NOMESCO.

Microdata

Not relevant

Background

Background and purpose

The purpose of this statistics is to provide information on capacity, activity, personnel and economy within the Specialist health services.

2.1.1. Main trends
Up to and including the operating year 2001 the counties were responsible for the Specialist Health Service. The counties owned most of the hospitals and institutions included in this statistics, and entered in to operating agreements with private hospitals, institutions and specialists. In this period the sector went through administrative changes.

From January 1.st 2002 the central government took over responsibility for Specialist Health Service. The new organizational structure was a Health Enterprise model with 5 Regional Health Enterprises (RHE), being the owners of subsidiary Health Enterprises (HE). This includes a transition from an administrative organization to an enterprise organization. The responsibility for the population of a specific geographical area lies with the RHE the area belongs to. The specialist health service is produced by the HEs, private hospitals, institutions and specialists.

From January 1.st 2004 the regional health enterprises took over responsibility for multidisciplinary specialised substance abuse institutions from the counties. These institutions are now either owned by the regional health enterprises themselves or governed through operating agreements.

Organization - changes in the Health Enterprises from 2002 to 2005

Between 2002 and 2005 several changes has taken place in organisation of the Health Enterprises. The total number of Health Enterprises has decreased, and every Health Enterprise now includes several more institutions. For a more details, see table

 

Users and applications

The statistics are used by the Ministry of Health and Care services, the Directorate of health and social affaires, the National Board of Health, the Health Enterprises, organizations, researchers, students and more. According to the Specialist Health Service Act, the Health Enterprises are under an obligation to offer the population health services on specialist level. In connection with that, statistics are used to monitor the development in capacity, activity and personnel resources in the regions.

In addition, the Norwegian Directorate of Health uses the statistics as data source for their Samdata publications.

Equal treatment of users

No external users have access to the statistics and analyses before they are published and accessible simultaneously for all users on ssb.no at 8 am. Prior to this, a minimum of three months' advance notice is given inthe Statistics Release Calendar.

Coherence with other statistics

Statistics Norway’s overall statistics product for the specialist health service covers eight different statistics. An overarching overview is presented in the Specialist health service Focus on page

A statistical overview is currently published of health and social care personnel based on register data at company and individual level by Statistics Norway. Preliminary figures are published in mid March and final figures in mid June. These statistics are not broken down into individual enterprises or companies when published, but include more details of the employees’ level of education, gender, age etc. than the form-based statistics.

Account is taken of the fact that Statistics Norway uses registers as the main source for personnel data in the specialist health service from the statistics year 2008, with publishing in 2009. In order to ensure accuracy when replacing a data source, Statistics Norway will also collect personnel data from forms in 2009.

The accounts that are collected from enterprises and private activities within the specialist health service make up the central basic data for the National accounts

OECD has developed a system for the health accounts ("A system of Health Accounts", OECD 2000) based on a common framework that will ensure optimum comparability of data over time and between countries. The accounts cover all expenses for health purposes, both private and public, which are spent on consumption and investments in health services. The expenses are classified according to function (purpose), provider and financing source. Statistics from the specialist health service accounts are included as basic data in the compilation of the more extensive health accounts. See: http://www.ssb.no/english/subjects/09/01/helsesat_en//

In the StatRes Specialist health service statistics, the same basic data is used in statistics for the specialist health service as for public sector activity, see http://www.ssb.no/emner/03/02/helse_statres/

Data collected by Statistics Norway on the specialist health service is also published as control data in the Samdata reports published by the Norwegian Directorate of Health.

Legal authority

Special Health Service Act of 2 July 1999, Section 61 § 5-6.

EEA reference

Not relevant

Production

Population

The statistics cover Regional health enterprises, Health enterprises and private hospitals and institutions. All services within the specialist health services are included, that is all general hospitals and other institutions (convalescence and rehabilitation institutions, hospital and delivery wards), institutions in mental health care for adults and for children and adolescents, ambulance service, operating agreements with private specialists and clinical psychologists and multidisciplinary specialised substance abuse institutions.

Data sources and sampling

Questionnaires are completed by the institutions, and sent electronically to Statistics Norway through the Health Enterprises. Information on man-years within institutions related to treatment of drug abuse is collected through administrative registers. For more information on these registers: http://www.ssb.no/english/subjects/06/01/hesospers_en/

The statistics cover all somatic and psychiatric institutions within the specialist health service, as well as Regional Health Enterprises, ambulance service, operating agreements with private specialists and specialised substance abuse institutions.

Collection of data, editing and estimations

Data are collected via electronic schemes and electronic account files. Schemes are accessible on the Internet from January. Response deadline for activity is February 1.st for HE/RHE, and private institutions. Response deadline for accounts is April 1.st for HE/RHE and private institutions

Statistics Norway performs automatic sum controls of the data material. In addition, the data are compared with information from previous years, and with other sources (data on activity, personnel and patients). Institutions are contacted in the event of missing data or discrepancies in the data.

Contracted man-years adjusted for long term leaves

The number of full-time jobs and part-time jobs calculated as full-time equivalents adjusted for doctor-certified sickness absence and maternity leave.

Seasonal adjustment

Not relevant

Confidentiality

Not relevant

Comparability over time and space

In statistics, the length of time series that is relevant to produce can vary, with some variables dating far back in time. The greatest break was when the hospital reform was introduced in 2002 (ref. link to History specified under point 2.1). Prior to this, the specialist health service was a county municipal responsibility. The statistics are therefore broken down into the different regional levels before and after the reform. Up to 2001, the statistics were presented at county level, while from 2002, health regions and health enterprises are divided into the relevant regions. The changeover means that new service areas are gradually being added to the specialist health service. The most important expansion was in 2004, when multidisciplinary specialist treatment for substance abusers was transferred to the state via the regional health enterprises after the substance abuse reform. 2004 also saw the inclusion of the air ambulance service. When comparing total figures for the specialist health service, these expansions of the regional health enterprises' responsibility will explain various changes in overall sizes.

Private institutions

Statistics for the specialist health service have gradually been extended to cover greater parts of the activity in the private sector. Previously, only public-owned and private hospitals and institutions with an operating agreement with the public sector were included. Private hospitals and institutions without such agreements are now also included. Private hospitals were included in the statistics from 1995, while private rehabilitation institutions were included from 2000. Point 4.1 gives further details of the difference between private sector activities with and without an operating agreement.

From 2015 the statistics distinguish between private institutions with and without government mandate. Previously, private institutions were divided between those with and those without operating agreements.Temporarily, private institutions with government mandate are presented  as private institutions with operating agreements in the statistics. Those without government mandate are presented as "without operating agreements". Because of this change the 2015-numbers for regions and private institutions cannot be compared with previous years. During 2016 we will update all tables to present private institutions as "with government mandate" and "without government mandate" back to 2002.

During the hospital reform in 2002, a total of 43 health enterprises were established within the industrial classification Hospital services (SN 2002: 85.1), which were classified under five regional health enterprises. In addition, Hospital pharmacies were organised as health enterprises under regional health enterprises, but with other industry. During the subsequent period, the structure underwent major changes, and at the end of 2007 there were four regional health enterprises and 28 health enterprises. In order to make accurate comparisons at health enterprise level, we refer to information on reorganisations in the health enterprises, as per the link in point 2.1. The most recent change came into force on 1 June 2007, when the regional health enterprises Health East and Health South were merged to form Health South East. For statistical purposes, the change is regarded as applicable for the whole of 2007.

Comparisons can be made at institution level for the period for some service areas, but extensive reorganisations make this difficult in other service areas. With regard to somatic hospitals, time series are available at hospital level (capacity, activity and man-years) for the years from 2002, while for institutions within psychiatric health for adults, these are available for 2005 and 2006. In both cases, the merger of institutions will make it difficult to compare units from year to year without knowledge of the reorganisations that have taken place. Please contact those responsible for the respective statistics in Statistics Norway for further information on the possibilities for comparisons.

With regard to accounting data, the break as a result of the reorganisation during the hospital reform was so extensive that comparisons of total figures (total operating expenses) are not possible. However, it is possible to compare operating expenses for the service areas somatic services, psychiatric care for adults and psychiatric care for children and adolescents back to 1998. For comparisons at enterprise level from 2002, reference is made to the overview of reorganisations during the period (see the link in point 2.1). Changes have also taken place in the health enterprises’ duties during the period, which have resulted in changes in the function chart of accounts. The function chart of accounts has also undergone a number of minor changes in order to improve comparability. A link to an overview of functions that have been in use since 2002 is given in point 4.1.

A number of projects aimed at improving comparability between units and over time are in progress. Major changes are planned for the function chart of accounts for (regional) health enterprises from 2009. These changes are aimed at simplifying the accounts with a view to ensuring uniform use between the enterprises. Work is also underway under the direction of the Directorate of Health to carry out a corresponding review of the type chart of accounts.

The Directorate of Health, Norwegian Patient Register, is responsible for implementing the Register for units in the specialist health service, the purpose of which is to provide a complete overview of the specialist health service. In the long term, the said register will improve the possibility for comparing comparable units at different levels of detail. Statistics Norway is a key player in this work in order to ensure that the established statistical standards and the statistics needs are safeguarded in codes and registers.

Accuracy and reliability

Sources of error and uncertainty

The quality of the statistics depends on correct information from the questionnaire respondents. With control routines, we can only detect the most obvious errors. Moreover, errors may occur in processing the data, such as punching errors, code errors, etc. There is some uncertainty with regard to estimated data. Estimation of the respective parts' sizes is mainly done with regard to combined institutions, where the Health Enterprises administrate specialist health service in municipal institutions. Such combined institutions often lack an adequate system for separating Health Enterprise and county operations. The information we need must often be estimated for such institutions. A distribution formula is calculated for the ratio between municipal and county operations, based on the accounts for the entire institution and the subsidies the institution receives from the county.

Great effort is put into obtaining information from as many institutions as possible; hence there is very little missing data in these statistics.

Due to the implementing of new data-systems some of the institutions within the substance-abuse institutions has not been able to complete their questionnaires for 2005. Two institutions were not able to deliver their questionnaire at all. The published figures for 2005 are therefore minimum figures. Despite this the quality of data is of better quality the previous year.

The main source for establishing the sample is the register of enterprises and firms (REF) including among others information about name, address, sector and kind of business. To avoid errors originated in lack of reporting to the REF, Statistics Norway and HE/RHE cooperate on an annually check of quality within the REF. As a consequence of including the substance-abuseinstitutions in 2004, there will be conducted a necessary reconsideration of the REF in autumn 2005?. This process is supposed to establish more clearly general and detailed rules for distinctions of substance-abuse institutions on one side, and institutions within psychiatric health care on the other side.

Revision

Not relevant

Contact

Fact sheet

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