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Substance abuse treatment raises costs and man-years
statistikk
2005-06-22T10:00:00.000Z
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, 2004

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Substance abuse treatment raises costs and man-years

In 2004, the health enterprises' costs related to the specialist health service amounted to NOK 66 billion. This corresponds to NOK 14.300 per inhabitant compared with NOK 13.400 per inhabitant in 2003.

73 per cent of the total costs are related to general hospitals. and a total of NOK 11 billion was spent in psychiatric health care, and NOK 3 per cent in substance abuse treatment.

Specialist health service, 2000-2004. Key figures, accounts
  2000 2001 20021 20032 20042
Gross current expenses, specialist health care, exclusive depreciation. Million NOK      42 160      47 992      56 503      61 110      65 894
Gross current expenses, somatic hospitals and institutions, exclusive depreciation. Million NOK 33 954 38 813 43 796 47 100 48 324
Gross current expenses, specialist psychiatric care, exclusive depreciation. Million NOK 7 075 7 895 8 310 9 437 9 631
Gross current expenses, specialist psychiatric care for children and adolescents, exclusive depreciation. Million NOK 1 059 1 240 1 579 1 705 1 851
Gross current expenses, specialized drug-treatment, exclusive depreciation. Million NOK .. ..  121  122 1 774
           
Gross current expenses per inhabitant, specialist health care, exclusive depreciation. NOK - - 12 500 13 400 14 300
Gross current expenses per inhabitant, somatic hospitals and institutions, exclusive depreciation. NOK 7 600 8 600 9 700 10 300 10 500
Gross current expenses per inhabitant 18- years, specialist psychiatric care, exclusive depreciation. NOK 2 100 2 300 2 400 2 700 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 1 600 1 700
Gross current expenses per inhabitant, specialized drug-treatment, exclusive depreciation. NOK 0 0 0 0  400
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 and 2004 were corrected June 27th 2005.

Restructuring of the health enterprises

The year after the major Norwegian Hospital Reform (2002) the country was divided into five regional health enterprises (RHE). Hospitals and institutions were organised as health enterprises (HE) and included in regional health enterprises. In 2002 there were 43 such health enterprises. Due to restructuring of the enterprises in 2003, the number was reduced to 31. Consequently there were fewer and larger health enterprises. For more information about the restructuring, see link

http://www.ssb.no/speshelse/foretaksorg_02-04.html

In January 2004 the regional health enterprises took over responsibility for 80 specialised institutions for substance abuse. The figures from these institutions are added to the total figures of the specialist health services.

Reduction in average length of overnight stay

The total number of beds in general hospitals and minor somatic institutions was close to 17 100, a slight reduction compared to 2003. More than 8 of 10 beds are in general hospitals. The average length of an overnight stay is now down to 5.2 days, a reduction of almost 4 per cent compared to 2003.

..but increase in day-treatment and out-patient consultations

More than 3.3 million out-patient consultations were carried out in public hospitals in 2004, an increase of 4.4 per cent compared to 2003. Out-patient consultations in private hospitals are not included in the 2004 figures. In 2003 these consultations amounted to 93 000. The number of day treatment in hospitals has increased by 9.5 per cent now amounting to almost 470 000.

Specialist health service. 1990-2004. Key figures, activity
  1990 1995 2000 2001 2002 2003 2004
Beds 25 187 21 967 22 533 22 544 22 662 22 774 24 086
Discharges  646 910  676 541  764 546  801 939  820 660  869 320 3 885 605
Bed-days in 1 000 7 477 6 636 6 825 6 929 6 918 6 920 7 220
Out-patient consultations in 1 0001 2 943 3 793 4 347 4 386 3 993 4 378 4 568
Day-cases in 1 0002 0 0  470  613  584  623 4 648
1  From 2002, data from Norwegian Patient Register (NPR) is used. 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 is not included in the figures for 2004.
2  Day-cases in general hospitals were incuded in out-patient consultations until 2002.
3  For substance abuse institutions the number of discharges are not available for 2004.
4  For substance abuse institutions the number of day-cases are not available for 2004.

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

The increase in number of out-patient consultations in psychiatric health care continued in 2004, both for children and adolescents under the age of 18 and for grown ups. The growth though seemed to level out, compared to last year.

Psychiatric institutions for adults registered almost 47 400 more consultations in 2004 than in 2003. This amounts 215 consultations per 1 000 inhabitants.

In psychiatric health care for children and adolescents the number of out-patient consultations were about 297 600 in 2004. This was an increase of 9 per cent from 2003.

Out-patient treatments in institutions and outpatient clinics are supplemented by private physicians (specialists) and clinic psychologists who have entered into contracts with regional health enterprises and health enterprises. The number of treatments carried out by this group is not reported. In total, 1 150 man-years were recorded for private practitioners with such contracts. This figure includes somatic specialists and psychiatrists, as well as clinical psychologists.

Specialist health service. Key figures, personnel.1990-2004
  1990 1995 2000 2001 2002 2003 2004
Man-years, total1 63 062 67 098 80 297 82 929 85 442 87 897 91 364
Man-years, physicians 5 680 6 700 9 001 9 279 9 300 9 690 10 189
Man-years,psychologists  766 1 074 1 758 1 811 2 002 2 134 2 388
Man-years, nurses and midwives 19 237 22 681 27 472 27 932 29 019 30 115 31 114
Man-years, auxiliary nursing personnel 10 327 9 107 8 396 8 291 8 225 8 142 7 821
Man-years, other occupational theraphists 8 049 8 645 12 615 14 164 14 896 15 842 18 073
Man-years, adminstration and service 19 002 18 890 20 887 21 452 21 999 21 974 21 780
1  The figures from 1990 and 1995 does not include the ambulance-services.

Increase in personnel due to drug treatment

From 2003 to 2004 the total number of personnel in the specialist health service increased by approximately 2 300 man-years or 3.8 per cent. The increase is mainly due to the new responsibility for substance abuse treatment gained by the health enterprises. Almost 7 out of 10 new man-years are found in these institutions. For other hospitals and institutions the growth in personnel was moderate.

In general there are problems connected to the registration and distribution of personnel outside patient-related work between general hospitals, psychiatry and drug treatment. A change in 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. Statistics Norway is hoping to change the data source for personnel, from scheme to register-data. This will give more reliable and comparative data for man-years.

In 2004 the number of man-years in psychiatric health care for children and adolescents under 18 was 3 030. This is an increase of 2 per cent since 2003. The highest increase is seen among the personnel with university-level education , the number of doctor and psychologist, have increased by 72 man-years since last year.

In psychiatric health care for adults the growth in man- years was 1.3 per cent and in general hospitals 0.5 per cent since 2003.

Development of day-and-night offer to adolescents

There was a marked increase in beds in institutions in psychiatric health care for children and adolescents from 2002 to 2003. Last years figures are showing a slight decrease. The total number of beds amounted to 331 by the end of 2004.

Fewer beds for adults

Throughout 2004 the number of beds in institutions in psychiatric health care for adults continued to decrease. By the end of the year there were 5 169 such beds, a decrease of 2.4 per cent compared to the figures from 2003. At the same time, the number of discharges related to overnight stays increased and the average duration of stays went down. In 2004, the average was 39 overnight stays per discharge, compared with 56 overnight stays in 2000 and 123 in 1990.

See also :

Psychiatry

Ambulance service

Account

Somatic care

Specialists with operating agreements