Specialist health service, accounts, 2002

Total expenditures include general hospitals, psychiatric institutions, ambulances, the care and treatment of substance abusers, administration and personnel and recruitment costs, but exclude depreciation.

Increased expenses to general hospitals

About 75 per cent of total expenses are related to general hospitals. Final figures show that gross operating expenditures, excluding depreciation, were NOK 44 billion in 2002, an increase of 13 per cent from 2001. Wages and salaries increased by 7 per cent from 2001 and 2002, and constituted about 70 per cent of total expenditures.

Expenses to psychiatric institutions

Final figures show an increase in gross current expenditures (exclusive depreciation) to psychiatric institutions of 8 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 gross expenditures, a slight increase from 2001.

Revenue in the specialist health service

Total revenue for specialist health services for 2002 amounts to NOK 60 billion. The major source was patient- and treatment- related grants and reimbursements, which constituted 50 per cent of total revenue. The diagnosis- related group revenue was the second largest source with 28 per cent. About 1 billion NOK came from out-of-pocket payments from patients.

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 relation 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 a resident. The majority of the health enterprises treat patients in their own region.

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.

The Norwegian Hospital Reform

The Norwegian Hospital Reform introduced 1 January 2002 resulted in the central government taking over the responsibility for all public hospitals. The reform also involved the hospitals to be operated as 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 Expenditure distributed on category of expenses and activity. 1998-2002. Million NOK
• Table 2 Gross current expenses (excl. depreciation) distributed on activity and region. 1998-2002. Million NOK
• Table 3 Gross current expenses (excl. depreciation) in general hospitals and psyciatric institutions distributed on regions. 1998-2002. NOK per inhabitant
• Table 4 Gross revenue distributed, by type of revenue and region. 2002. Million NOK
• Table 5 Revenue in outpatient care. 1990-2002. Million NOK
• Table 6 Investment distributed on type of investment and regions. 2002. Million NOK