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Rise in costs continues
statistikk
2007-06-20T10:00:00.000Z
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, 2006

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Rise in costs continues

The total cost of specialised health care per capita increased by NOK 1 100 to NOK 16 200 in 2006. This is the highest increase in costs since the hospital reform in 2002.

The total cost of the specialised health care sector exceeded NOK 81 billion in 2006. This figure includes depreciation, but if depreciation is excluded the figure is NOK 75.8 billion, which is equivalent to a 7.9 per cent increase from 2005. The increase is partly explained by the introduction of new tasks for the health enterprises: rehabilitation, patient transport, patient damage compensation and financing TNF-restrainers (tumour necrosis factors restrainers) are some of the new tasks. However, the main reason for the increase in costs is the activity growth.

Specialist health service. 2000-2006. Key figures, accounts
  2000 2001 12002 20032 20042 2005 2006
Expenditure, specialist health care, inclusive depreciation. NOK million           75 342 81 246
Expenditure, specialist health care, exclusive depreciation. NOK million 42 160   47 992   56 503   61 110   65 894   70 231   75 717
Expenditure, general hospitals, inclusive depreciation. NOK million           54 692 58 648
Expenditure, general hospitals, exclusive depreciation. NOK million 33 954 38 813 43 796 47 100 48 324 50 627 54 342
Expenditure, psychiatric health care for adults, inclusive depreciation. NOK million           11 314 11 924
Expenditure, psychiatric health care for adults, exclusive depreciation. NOK million 7 075 7 895 8 310 9 437 9 631 10 602 11 117
Expenditure, psychiatric health care for children and adolescents, inclusive depreciation. NOK million           2 124 2 407
Expenditure, psychiatric health care for children and adolescents, exclusive depreciation. NOK million 1 059 1 240 1 579 1 705 1 851 2 007 2 268
Expenditure, health care and treatment of substance abuse, inclusive depreciation. NOK million           2 132 2 320
Expenditure, health care and treatment of substance abuse, exclusive depreciation. NOK million .. ..  121  122 1 774 2 049 2 223
               
Expenditure per inhabitant, specialist health care, inclusive depreciation. NOK           16 200 17 400
Expenditure per inhabitant, specialist health care, exclusive depreciation. NOK - - 12 500 13 400 14 300 15 100 16 200
Expenditure per inhabitant, general hospitals, inclusive depreciation. NOK           11 800 12 500
Expenditure per inhabitant, general hospitals, exclusive depreciation. NOK 7 600 8 600 9 700 10 300 10 500 10 900 11 600
Expenditure per inhabitant 18 years and over, psychiatric health care for adults, inclusive depreciation. NOK           3 200 3 300
Expenditure per inhabitant 18 years and over, psychiatric health care for adults, exclusive depreciation. NOK 2 100 2 300 2 400 2 700 2 700 3 000 3 100
Expenditure per inhabitant 0-17 years, psychiatrichealth care for children and adolescents, inclusive depreciation. NOK           1 900 2 200
Expenditure per inhabitant 0-17 years, psychiatrichealth care for children and adolescents, exclusive depreciation. NOK 1 000 1 200 1 500 1 600 1 700 1 800 2 100
Expenditure per inhabitant, health care and treatment of substance abuse, inclusive depreciation. NOK            500  500
Expenditure per inhabitant, health care and treatment of substance abuse, exclusive depreciation. NOK 0 0 0 0  400  400  500
1  From 2002, gross current expenses incl. ambulances, health care and treatment of substance abusers and administration in the regional enterprices. Previously, these expenses were incl. in the counties' health administrations.
2  The figures from 2003 were corrected June 27th 2005.

The largest growth in costs took place within psychiatric health care for children and adolescents, increasing by 13 per cent since 2005. Costs related to general hospitals increased by 7.3 per cent, while costs related to psychiatric health care for adults increased by 4.9 per cent. Costs for substance abuse treatment increased by 8.5 per cent.

72 per cent of the total costs were spent on general hospitals. This figure is almost unchanged from 2005. Psychiatric health care for adults and psychiatric health care for children and adolescents accounted for 14.7 per cent and 3 per cent of the total costs respectively. Substance abuse treatment accounted for 2.9 per cent.

For the first time, figures for the financial results of the health enterprises are published. Only one of the 29 health enterprises has reported a positive balance.

Specialist health service. 2000-2006. Key figures, activity
  2000 2001 2002 2003 2004 2005 2006
Beds 22 533 22 544 22 662 22 774 24 086 23 861 23 427
Discharges  764 546  801 939  820 660  869 320 1 885 605  912 694  924 255
Bed-days in 1 000 6 825 6 929 6 918 6 920 7 220 7 286 7 127
Out-patient consultations in 1 0002 4 347 4 386 3 993 4 378 4 568 4 848 5 101
Day-cases in 1 000  470  613  584  623 3 648  679  693
1  For institutions within substance abuse treatment the number of discharges is not available for 2004.
2  Data from Norwegian Patient Register (NPR) is the main source for this information. I addtion Statistics Norway gathered information on out-patient consultations in private hospitals for 2002 and 2003, 34 679 and 93 127 consultations respectively. This information was not included in the figures for 2004.
3  For institutions within substance abuse treatment the number of day-cases is not available for 2004.

Increasing activity in specialist health service

There has been an increase in the overall activity in the specialist health service. This applies to hospitalisations and day-cases as well as out-patient consultations. The biggest increase is seen in the number of out-patient consultations, where the figures show a total of 5.1 million, an increase of 5.2 per cent from 4.8 million in 2005. The number of day-treatments increased by 2.2 per cent in 2006. Discharges after hospitalisation increased by 1.3 per cent. The number of bed-days decreased by 2.2 per cent, however. So did the number of beds, as about 1.8 per cent fewer beds were available in total.

Continued increase in man-years - mostly for psychologists

The number of man-years in the specialised health care sector reached almost 95 000 in 2006. This is an increase of more than 2 200 man-years, or 2.4 per cent, from 2005. Psychologists accounted for the highest increase, with a growth of 7.5 per cent compared to 2005. With the exception of auxiliary nursing personnel, there has been a rise in all main personnel categories. Whilst auxiliary nursing personnel decreased by 3.1 per cent, the number of man-years for nurses rose by 2.7 per cent, and the corresponding figure for physicians was 3.2 per cent.

Specialist health service. 2000-2006. Key figures, personnel
  2000 2001 2002 2003 2004 2005 2006
Man-years, total 80 297   82 929   85 442   87 897   91 364   92 700   94 923
Man-years, physicians 9 001 9 279 9 300 9 690 10 189 10 515 10 854
Man-years, psychologists 1 758 1 811 2 002 2 134 2 388 2 548 2 738
Man-years, nurses and midwives 27 472 27 932 29 019 30 115 31 114 31 387 32 219
Man-years, auxiliary nursing personnel 8 396 8 291 8 225 8 142 7 821 7 513 7 281
Man-years, other occupational theraphists 12 615 14 164 14 896 15 842 18 073 18 361 19 196
Man-years, adminstration and service 20 887 21 452 21 999 21 974 21 780 22 347 22 636

Increased activity in general hospitals

The development for general hospitals mirrors the situation in the sector as whole. The number of day-cases increased by 7.4 per cent in 2006. The number of discharges increased by 1.0 per cent to about 861 000. In total, more than 3.5 million out-patient consultations were given. The total number of bed-days in general hospitals fell by 2.7 per cent from 5.0 million in 2005 to 4.9 million in 2006. The development towards shorter overnight stay continued in 2006. An average stay lasted 5.0 days in 2006, compared to 5.1 days in 2005.

The general hospitals had around 13 900 beds in total at the end of 2006; a decrease of about 100 beds compared to 2005.

Large increase in bed-days and out-patient consultations within substance abuse treatment

In recent years, the number of bed-days in substance abuse treatment has increased by about 4 000 to more than 561 000 in 2006. The number of beds was constant from 2005 to 2006. A large proportion of these are ad-hoc-places (sold freely without contracts with regional health enterprises). About half of the institutions are publicly owned. The number of out-patient consultations increased by almost 25 per cent to about 87 200 in 2006. This increase is partly due to better reporting routines. The number of man-year rose by about 10 per cent.

Psychiatric health care: large increase in out-patient consultations

The number of out-patient consultations within psychiatric health care rose by 10.7 per cent to more than 1.4 million in 2006. The bed capacity for adults decreased slightly (49 beds), while the number of beds for children and adolescents remained stable. The number of bed-days in the psychiatric health care was about 1.58 million for adults, while the figure for children and adolescents was about 84 000.

Increasing use of ambulance services

From 2005 to 2006 the number of ambulance service tasks rose from 497 000 to almost 530 000. The total mileage covered by ambulance cars and boats was more than 29 million kilometres in 2006.

Specialist health service structure

Following the hospital reform of 2002, Norway was divided into five regional health enterprises (RHE). Hospitals and institutions were organised as health enterprises (HE) under the regional health enterprises. In 2002, the number of health enterprises was 43. Due to continued restructuring of the enterprises, the number has been reduced since then. For more information about the restructuring, see this link (norwegian only).

Cooperation with SINTEF Helse

The quality assurance of health enterprise accounting figures has been carried out in cooperation with SINTEF Helse. The aim of the cooperation has been to reduce and eventually eliminate the discrepancy in accounting figures between the two institutions. SINTEF Helse has been responsible for the Samdata reporting since 1986. There have at times been large differences in the estimates for total costs. In 2005, specialist health service expenditure came to NOK 70.2 billion according to Statistics Norway and NOK 68.3 billion according to Samdata figures. The difference is partly due to a different basis for estimation. For 2006, the differences between Statistics Norway and SINTEF Helse have been reduced considerably.