health reform in norway coordination reform 2012
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Health reform in NorwayCoordination reform 2012
Starting point (OECD evaluation)
• Norway’s health system is high performing, and delivering high-quality care• System is performing well also when
benchmarked against countries that would be considered peers • Norwegians live long due to good health• Norway has shifted care away from the
hospital sector and towards primary care settings.
The Norwegian Health Care System
• Universal • Mainly
publicly/governmental funded• Two main authority levels
• 428 Municipalities• Primary care
• 4 Regional health authorities• Specialist care
Picture: David Liuzzo /Wikipedia
The Norwegian Health Care SystemMunicipalities • Public health • Prevention • General practitioner services • Basic emergency services • Physiotherapist services • Rehab. & post-hospital srv • Nursing homes • Home based care • Social services
Regional health authorities • Hospitals • Specialist outpatient services • Ambulance services • Laboratory and radiology
services • Transportation • Specialized rehabilitation
• Integrated patient care
• More effective prevention
• Increased user influence
• Services will be provided closer to where people live
• Municipalities should be given greater responsibility
• Specialist and primary care should enter into binding agreements
• Ensuring sustainable development
Objectives of the Coordination Reform 2012
Primary Health Care in Change
• The Government (2015) introduce measures to reduce fragmentation:
• Nurses and doctors working in teams• Stronger coordination within the system• Enhanced professional expertise• Enhanced professional leadership
New process after introduction of the coordination reform
• Common process
• Options when creating emergency care beds in the municipalities and intermediate care departments in the municipalities
Home Hospital Home
Home Hospital HomeEmergency care beds
Intermediatedepartment
Nursing home
Future Development of the Coordination Reform
• Increased use of services at home• Mobile teams to take care of the patients discharged from
hospital and the patients in need of immediate day services• Avoid fragmented patient care• More use of integrated, generics clinical pathways • Reducing patients' stress• Reduce complexity and bureaucracy
Mental Care
• The reform has had effect on mental health
• Strengthening care is delivered by municipalities
• At the same time; increasing specialist services, increasing resources going into the system and making mental health a policy priority.
How?
• Carrot and whip!
• The introduction of the economic incentives under the Coordination Reform
• The municipality is co-funding of hospital care, and financial penalties for municipalities if discharge is delayed
• Use of supplemented primary health care units
Prevention
• Involvement of the patient at all stages
• Focus on lifestyle and exercise/physical activities
• Help to stop smoking
• Eating habits
Challenges
• Aging population
• Refugees/migrants