Specialist health service, accounts, 2002

As a result of the hospital reform, the accounts now include expenditures, which were previously included in the accounts from the counties and it is therefore not possible to compare the total costs in 2002 with the total costs in previous years. However, comparable figures are presented for general hospitals, psychiatric institutions for adults and psychiatric institutions for children and adolescents.

Expenses to general hospitals

The preliminary figures show that the gross operating expenditures, excluding depreciation, were NOK 42 billion in 2002, an increase of 8 per cent from 2001. Wages and salaries increased by 5 per cent from 2001 and 2002, and constituted about 70 per cent of total expenditures.

Expenses to psychiatric institutions

Preliminary figures show an increase in the gross current expenditures (exclusive depreciation) to psychiatric institutions of 17 per cent from 2001 to 2002, to a total of NOK 10 billion. Expenditures to institutions for children and adolescents constitute 16 per cent of the expenditures, a small increase from 2001.

Expenditures distributed on health regions

Previously, the accounts for general hospital and psychiatric institutions have been published per county, but are now published per health region. The regions have a responsibility for its inhabitants to secure the access to health services. It is therefore relevant to show figures for the regions in relations to its inhabitants. It has been necessary to adjust the figures in order to calculate the expenditures on a regional level. In order not to include expenditures related to patients from other regions, the expenditures have been adjusted for income received for patients from other regions. Expenditures related to patients treated outside their own region are included in the expenditures of the region where the patient is resident. The majority of the health enterprises treat patients resident in their own region. The exception is Helse Sør. About 10 per cent of the inpatient stays in Helse Sør were related to other regions. The main explanation of this is that Radiumhospitalet and Rikshopitalet belong to Helse Sør, and these hospitals serve the entire country.

The regional figures include the administration costs related to the regional health enterprise, the health enterprises under the regional enterprise and expenditures of private institutions with operating agreements with either the regional enterprise or one of the health enterprises. The expenditures of these private institutions are adjusted for the value of the operating agreement in order to avoid double counting, since this is already a part of the accounts from the enterprises. It has not been possible to conduct a full consolidation of the accounts within the regions and it is therefore not adjusted for transactions between enterprises within the same health region.

The total for the country is calculated by adding the figures for the 5 regions together with operating expenditures for private institutions with no operating agreements.

Helseregion Øst constitutes 35 per cent of the expenditure and has the largest share of total expenditures. The smallest share is in Helseregion Nord with 11 per cent of the total expenditures. However, Helsregion Sør is the region, which use most in relation to its inhabitants with NOK 13 736 per inhabitant. In comparison, Helse Vest was the region with lowest expenditure per inhabitant with NOK 10 855 kroner. For the country as a whole, the expenditure was 12 400 NOK per inhabitant.

Responsibility

From January 1. 2002, the Central government took over the responsibility for the specialist health services, and organizes the activities under five regional health enterprises. Previously, the majority of hospitals were run by the counties health administrations. The government now also finances all or some of the services of private hospitals (foundations and commercial ones). Several aspects influence the comparability with previous years. For example, the principles behind the accounts have changed and the accounts now include some expenses, which were not previously included. One should therefore be cautious when interpreting the changes over time.

Tables:

• Table 1 Expenditures distributed on category of expenses and aggregated functions. 1998-2002. Million NOK (Corrected 2 June 2003)
• Table 2 Gross current expenses (excl. depreciation) distributed on functions and regions. 1998-2002. Million NOK (Corrected 2 June 2003)