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Increase in expenses and activity
statistikk
2004-09-02T10:00:00.000Z
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, 2003

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Increase in expenses and activity

In 2003, the health enterprises' costs related to the specialist health service amounted to NOK 61 billion. This is an increase of NOK 4.7 billion, or 8 per cent, from 2002. This corresponds to NOK 13 400 per inhabitant compared with NOK 12 500 per inhabitant in 2002.

For the first time in several years the growth in costs of psychiatric health care was larger than the growth in costs of general hospitals and institutions. More than NOK 11 billion was spent on psychiatric health care, and an increasing share of the total costs of psychiatric health went to children and adolescents. From 1990 to 2001, this share rose from 10 to 13 per cent, and the rise continues. In 2003, 17 per cent of the costs of psychiatric health care went to children and adolescents.

Specialist health service. Key figures, accounts. 2000-2003
  2000 2001 20021 2003
Gross current expenses, specialist health care, exclusive depreciation. NOK million 42 160 47 992 56 503 61 252
Gross current expenses, somatic hospitals and institutions, exclusive depreciation. NOK million 33 954 38 813 43 796 47 246
Gross current expenses, specialist psychiatric care, exclusive depreciation. NOK million 7 075 7 895 8 310 9 281
Gross current expenses, specialist psychiatric care for children and adolescents, exclusive depreciation. NOK million 1 059 1 240 1 579 1 856
         
Gross current expenses per inhabitant, specialist health care, exclusive depreciation. NOK - - 12 500 13 400
Gross current expenses per inhabitant, somatic hospitals and institutions, exclusive depreciation. NOK 7 600 8 600 9 700 10 300
Gross current expenses per inhabitant 18- years, specialist psychiatric care, exclusive depreciation. NOK 2 100 2 300 2 400 2 700
Gross current expenses per inhabitant 0-17 years, specialist psychiatric care for children and adolescents, exclusive depreciation. NOK 1 000 1 200 1 500 1 700
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.

More day treatments in hospitals

The growth in expenses is accompanied by a growth in activity in hospitals and institutions. Somatic hospitals registered approximately 42 000 more overnight stays in 2003 than in 2002, an increase of almost 5.4 per cent. The number of day treatments rose by almost 17 per cent to 419 000. The average length of overnight stays in somatic hospitals is becoming shorter. The average length of stay was 5.4 days in 2003, compared with 5.7 days in 2002. More than 3.3 million out-patient consultations were carried out in 2003, an increase of 4.6 per cent compared to the previous year.

Specialist health service. Key figures, activity. 1990-2003
  1990 1995 2000 2001 2002 2003
Beds 25 187 21 967 22 533 22 544 22 662 22 774
Discharges  646 910  676 541  764 546  801 939  820 660  869 320
Bed-days in 1 000 7 477 6 636 6 825 6 929 6 918 6 920
Out-patient consultations in 1 0001 2 943 3 793 4 347 4 386 3 993 4 378
Day-cases in 1 0002 0 0  470  613  584  623
1  From 2002, data from Norwegian Patient Register (NPR) is used in somatics.
2  Day-cases in general hospitals were incuded in out-patient consultations until 2002.

... and out-patient consultations in psychiatric health care

While the growth in personnel was relatively low last year, the strong growth in out-patient consultations that has been evident in recent years continued. Psychiatric institutions for adults registered 91 000 more consultations than in 2002. The number of out-patient consultations carried out in psychiatric health care for children and adolescents also increased. Almost 53 000 more consultations were recorded in 2003 than in 2002, a marked increase of 24 per cent.

Out-patient treatments in institutions and outpatient clinics are supplemented by private doctors (specialists) and clinic psychologists who have entered into contracts with regional health enterprises and health enterprises. We do not have statistics on the number of treatments carried out by this group. In total, 1130 man-years were recorded for private practitioners with such contracts, and this included somatic specialists and psychiatrists, as well as clinical psychologists.

Specialist health service. Key figures, personnel. 1990-2003
  19902 19952 2000 2001 2002 2003
Man-years1, total 63 062    67 098    80 297    82 929    85 442    87 897
Man-years1, physicians 5 680 6 700 9 001 9 279 9 300 9 690
Man-years1, psychologists  766 1 074 1 758 1 811 2 002 2 134
Man-years1, nurses and midwives 19 237 23 996 27 472 27 932 29 019 30 115
Man-years1, auxiliary nursing personnel 10 327 9 107 8 396 8 291 8 225 8 142
Man-years1, other occupational therapists 8 049 8 645 12 615 14 164 14 896 15 842
Man-years1, administration and service 19 002 18 890 20 887 21 452 21 999 21 974
1  Man-years is the number of full-time employees and part-time employees (converted to full-time
employees) at the end of the year. Overtime is not included.
2  Do not include the ambulance service.

More treatment personnel

From 2002 to 2003 the total number of personnel in the specialist health service increased by approximately 2 500 man-years. This represents personnel in all areas of the specialist health service and includes all hospitals and institutions defined as specialist health services, in addition to the ambulance service, private medical specialists and clinical psychologists who have entered into contracts with health enterprises or regional health enterprises. Private hospitals and specialist institutions without such contracts are also included.

The growth from 2002 to 2003 was particularly strong for treatment personnel, both in psychiatric health care for adults and for children and adolescents. In psychiatric health care for children and adolescents, the highest increase was among psychologists and clinical psychologists.

In 2003, the growth in man-years in psychiatric health care for adults seemed to level off. The growth was around 1.5 per cent, compared with just over 3 per cent in the two previous years. However, this growth represents growth in qualified personnel, such as doctors, psychologists, nurses and other personnel with university education related to the treatment of patients.

In somatic hospitals, the growth in man-years was 3 per cent at the end of 2003. This corresponds to 1 900 more man-years than at the end of 2002. For treatment and care personnel the growth has been stronger than for personnel in administrative, service and operating service positions.

When reviewing changes concerning the number of man-years some factors must be kept in mind. The restructuring of the sector and new registration routines in the health enterprises can give a false picture of the changes. As a consequence, what seem to be changes might be the effect of a changed registration routine. The strong growth in personnel in somatic hospitals is mainly related to hospitals in the regional health enterprise of northern Norway, especially the University Hospital of North Norway (Universitetssykehuset i Nord-Norge).

Development of day-and-night offer to adolescents

At the end of 2003, the number of beds in institutions in psychiatric health care for children and adolescents was 336, a marked increase of 24 beds from the end of 2002. A similar increase from one year to another has not been recorded earlier. The number of beds has increased in all regions except the northern health region.

Fewer beds for adults

Throughout 2003 the number of beds in institutions in psychiatric health care for adults continued to fall. At the end of the year there were 5 300 such beds. At the same time, the number of discharges after overnight stays increased and the average duration of stay went down. In 2003, the average was 42 overnight stays per discharge, compared with 56 overnight stays in 2000 and 123 in 1990.

Restructures

In January 2002, the Norwegian Hospital Reform was introduced, in which the responsibility for hospitals and institutions in the specialist health service was transferred from the counties to the state, and divided into five regional health enterprises (RHE). This has caused new challenges in the production of comparable statistical time series. Hospitals and institutions are organised as health enterprises that are included in regional health enterprises. Due to the restructures of 2003, the number of health enterprises was reduced from 43 at the end of 2002 to 31 at the end of 2003. Consequently there are fewer and larger health enterprises. The restructuring has been particularly extensive in the regional health enterprise of eastern Norway (Helse Øst RHF) and southern Norway (Helse Sør RHF). The regional health enterprise of eastern Norway was reduced from 15 health enterprises in 2002 to seven health enterprises in 2003. In southern Norway the reduction was from 13 to 10, while the regional health enterprise of middle Norway (Helse Midt-Norge RHF) included five health enterprises at the end of 2003, one less than one year earlier (for more information about the restructures, see "About the statistics").

See also :
Psychiatry
Ambulance service
Account
Somatic care
Specialists with operating agreements