The municipalities can have their own municipal emergency primary health care service/center, participate in intermunicipal cooperation on emergency primary health care, or source the operation of the emergency primary health care from private doctors or from specialist health services. The municipalities can also have a combination of arrangements.
A survey of emergency primary health care among the municipalities was carried out by Statistics Norway for the reporting year 2021, makes it possible to take a closer look at how municipalities in Norway organize this service, which personnel and how many work in emergency primary health care, how the service is staffed during day and night, staffing challenges, which duty/rota systems are used and the costs for the emergency primary health services. Furthermore, the survey has gathered information from the municipalities on whether they, in the future, will be able to report annually on man-years of doctors in emergency primary health care to Statistics Norway.
39 percent of the municipalities have their own municipal emergency primary health care service, without cooperation with other municipalities. 38 percent of these municipalities solely have daytime emergency service. 21 percent of all municipalities report that they are hosts for an intermunicipal emergency primary health care service/center. Host municipalities are often centrally located. 58 percent of municipalities are participants in an intermunicipal cooperation. The share of municipalities that are participants increases along with lower inhabitant-figures. 80 percent of municipalities are part of an intermunicipal emergency primary health care service all or part of the time (day or night).
24 percent of municipalities staffed the emergency primary health care with doctors who were employed directly at the emergency primary health care center. A far greater share, 92 percent, used regular general practitioners, 67 percent other doctors, 42 percent had nurses in their service and 25 percent had other health care personnel. The survey shows that there are differences between large and small municipalities, and between forms of arrangement, in how the service is staffed. 37 percent of the municipalities report staffing challenges in emergency primary health care during 2021.
Municipalities staff emergency primary health care with different types of personnel during day and/or night. Regardless of form of arrangement, it is most common to use regular general practitioners during both day and night. Regarding the use of different duty sessions, there are only small differences in the type of duties the municipalities use RGP and other doctors for. There are however some differences depending on the arrangement, time during the day or night and number of inhabitants. The most common duty is primary on-call-duty, on location. There is a tendency that large municipalities have a greater occurrence of both primary on-call-duty and second on-call, on location. In smaller municipalities it is more common with primary on-call, on stand-by duty.
All municipalities were asked to report net operating expenses for their emergency primary health care service. These figures were partially not complete and of uncertain quality. Data still imply a bit lower net operating expenses in municipalities participating in intermunicipal cooperation.
Statistics Norway finds that it is currently not possible to implement annual reporting on man-years of doctors in emergency primary health care. The share of municipalities informing that this will be too challenging is far too great.