20856
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20856
Specialist health service approaching NOK 100 billion
statistikk
2010-06-18T10:00:00.000Z
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 service2009

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Specialist health service approaching NOK 100 billion

The specialist health service reaches NOK 100 billion in operating costs and 100 000 man-years. The costs are still increasing, but not as fast.

Figures regarding man-years in the article and the table for key figures were corrected 27 October 2010

Previously, the specialist health service was published in several different articles on www.ssb.no : accounts, general hospital, mental health care, ambulance, multidisciplinary substance abuse treatment, medical specialists. These statistics are now published collectively on www.ssb.no/speshelse . Previous articles are available on www.ssb.no/speshelse_en/arkiv/artikler.html

Specialist health service - national level

In 2009 the Norwegian specialist health service cost NOK 99 billion including depreciation. Health enterprises owned by the central government account for 91 per cent of the costs, and the private sector for the remaining 9 per cent of the costs. The costs increased by 5 per cent from 2008 to 2009, the lowest annual cost increase in 2005-2009. The increase was approximately the same in the central government sector and in the private sector.

The number of contracted man-years adjusted for long-term leave amounted to 97 000. Man-years increased by 2.4 per cent from 2008 to 2009. The number of beds amounted to 22 000, with no increase from 2008. The number of outpatient treatments reached 6.3 million; an increase of 9 per cent.

Specialist health service, 2005-2009. Key figures
  2009 2008-2009 2005-2009
  Absolute figures Per cent Per cent
Specialist health service. Key figures, accounts      
Expenditure, specialist health services, inclusive depreciation. Million NOK 99 413 5 32
Expenditure, general hospitals, inclusive depreciation. NOK million1 63 030 -7 15
Expenditure, psychiatric health care for adults, inclusive depreciation. NOK million 14 818 5 31
Expenditure, psychiatric health care for children and adolescents, inclusive depreciation. NOK million 3 135 9 48
Expenditure, health care and treatment of substance abuse, inclusive depreciation. NOK million 3 282 9 54
Specialist health service. Key figures, activities2      
Beds 21 840 -1 -8
Discharges in 1 000  957 4 5
Bed-days in 1 000 6 673 -1 -8
Out-patient consultations in 1 000 6 290 9 29
Day-cases in 1 000  660 4 -3
Specialist health service. Key figures, Contracted man-years adjusted for long term leaves3      
Contracted man-years adjusted for long term leaves, specialist health services 97 037 1 :
Contracted man-years adjusted for long term leaves, general hospitals 65 356 -1 :
Contracted man-years adjusted for long term leaves, psychiatric health care for adults 15 095 3 :
Contracted man-years adjusted for long term leaves, psychiatric health care for children and adolescents 3 179 4 :
Contracted man-years adjusted for long term leaves, health care and treatment of substance abuse 3 115 8 :
1  From 2009, operating costs in lab- and x-ray-services are excluded from costs in general hospitals. This causes a break in time series.
2  Break in time series due to change i routines of registration for outpatient treatments at The Norwegian Directorate of Health. 2009 figures also
include healthy new borns.
3  Changes in figures on contracted man-years adjusted for long term leaves may be due to improved data compilation in new data source.

 

Specialist health service - regional level

South-East is by far the largest health region. In this region the operating costs including depreciation amounted to NOK 54 billion in 2009. The Western region was the second largest with NOK 18 billion. Furthermore, Mid-Norway cost NOK 14 billion and North was NOK 12 billion.

South-East accounts for 51 300 contracted man-years adjusted for long term leave. In West this number was 17 900, in Mid-Norway 12 600 and in North 10 400. North had the highest number of man-years per 1 000 capita; 22 man-years. The number of contracted man-years adjusted for long-term leave does not include hired labour.

The South-East region accounts for 46 per cent of all beds and 57 per cent of out-patient treatments. The increase in the number of out-patient treatments was highest in South-East, but changes in registration routines caused a break in the time series. The number of beds has decreased in all the regions, most of all in North by 5 per cent.

Some issues need to be accounted for in the regional analysis of the specialist health service: first, the accounting figures are adjusted for inter-regional activities. Furthermore, the patient’s right to choose any hospital in any region causes inter-regional activities. South-East had the largest income related to treatment of guest patients (patients that are residents of another region). South-East had NOK 2.5 billion in guest patient income, 74 per cent of the total guest patient income. Inter-regional activities cannot be accounted for in the figures on beds, treatments or man-years.

Some private sector producers, without an operating agreement with regional health enterprises, cannot be connected to the regional level.

Fewer bed-days, more day treatments at general hospitals

Total operating costs in 2009 were approximately NOK 71 billion; an increase by about 4.4 per cent from 2008. Lab/roentgen (635) in 2009 also includes costs related to mental health care and multidisciplinary specialist substance abuse treatment. In 2008 these costs were related to general hospitals only.

By the end of 2009, there were around 12 600 beds at general hospitals; a decrease by 300 beds compared to 2008. This is in accordance with the development during the last years. There was a decrease in in-patient discharges and bed-days. There were approximately 850 000 in-patient discharges in general hospitals in 2009. The inclusion of discharges of healthy new-borns gives an increase of approximately 47 500. For earlier years these discharges were not included. In 2009, the average length of an in-patient stay was 4.6 days compared to 4.8 days in 2008. The number of out-patient consultations was more than 4 200 000 at the general hospitals. Due to a change in the registration practice (Norwegian Patient Register), these figures are not comparable with figures for out-patient consultations that were published in previous years.

In 2009, a trend showing more out-patient consultations and more day cases continued. The number of day-cases in general hospitals increased by approximately 25 000 (4.6 per cent) from 2008 to 2009. The number of day treatments in private commercial hospitals increased by almost 30 per cent. Read more: Patient statistics, 2009 .

In 2009, the total number of contracted man-years adjusted for long-term leave in general hospitals and other somatic institutions was close to 65 400. In general hospitals, physician man-years represent 15 per cent of the total number, and professional nurses 40 per cent.

More polyclinic consultations in mental health care

Total operating costs in 2009 in mental health care were approximately NOK 18 billion. This was an increase by about 5.2 per cent from 2008. Mental health care for adults amounted to almost NOK 15 billion and mental health care for children and adolescents was about NOK 3.1 billion. The increase was strongest in mental health care for children and adolescents with 9 per cent, while in mental health care for adults the cost increase was 5 per cent.

The number of involuntary committed patients in mental health care for adults decreased by 14 per cent from 2005 to 2009. The number of out-patient consultations increased by 7 per cent from 2008. The number of beds in mental care institutions for children and adolescents is stable, and for adults the decrease continues.

More man-years within substance abuse

Total operating costs in multidisciplinary specialist substance abuse treatment was about NOK 3.3 billion. This was an increase of about 9 per cent from 2008. From 2008 to 2009, the man-years of physicians and psychologists increased by 17 per cent and total man-years within multidisciplinary specialist substance abuse treatment increased by 9 per cent. The number of beds increased by 3 per cent between 2008 and 2009, while out-patient consultations increased by 20 per cent.

Ambulance and transport of patients

Operating costs including depreciation for ambulance and air ambulance amounted to approximately NOK 3.7 billion in 2009. The number of contracted man-years adjusted for long-term leave was 3 300. The total number of ambulance operations was 571 000 and the number of operations by air ambulance was 17 000.

Operating costs including depreciation in ambulance and air ambulance services increased by 10 per cent from 2008 to 2009. The number of operations increased by 6.5 per cent for ambulances and decreased by 2.3 per cent for air ambulances.

Specialist physicians and psychologists with independent operating agreements

The number of specialist physicians and psychologists with independent operating agreements in 2009 was approximately 1 200. This number has been stable in recent years.

The specialist health service includes hospitals and institutions within general hospitals, mental health care and multidisciplinary specialist treatment of substance abuse, ambulance service and private specialists with an operating agreement. The legal basis for the specialist health service is the Specialist Health Service Act of 1999.

The specialist health service is organised into four health regions/regional health enterprises, South-East, West, Mid and North. The regional health enterprises have overall responsibility to ensure that health policy objectives and laws are fulfilled within their geographic area of responsibility. The objectives are stipulated in the legislation on health enterprises and specialist health services. The policy objectives are specified in national resolutions and plans relating to health policy, research policy and education policy.

A health enterprise is a Norwegian state activity owned by a regional health enterprise, and each health enterprise is a legal entity. Health enterprises carry out specialist health services, research, teaching and other services related to these. Each health enterprise in turn organises a number of hospitals and institutions in general hospitals, mental health care and multidisciplinary specialist treatment of substance abuse.

Contracted man-years adjusted for long-term leave

From the statistical year of 2008 the source of official statistics on man-years in the specialist health service is administrative registers. This caused a break in time series from 2007 to 2008.

From 2008 to 2009 the registry on contracted man-years adjusted for long-term leave has improved. This causes some adjustments between general hospitals, mental health care and multidisciplinary substance abuse treatment. Statistics Norway publishes man-years by education and occupation. Occupational data, published for the first time in 2010 (for the statistical years of 2008 and 2009), gives a more complete picture of the input of man-years to support services, i.e. administration and management.

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