Promoting coordination in Norwegian health care

Abstract

IntroductionThe Norwegian health care system is well organized within its two main sectors—primary health and long-term care on the one hand, and hospitals and specialist services on the other. However, the relation between them lacks mediating structures.Policy practiceEnhancing coordination between primary and secondary health care has been central in Norwegian health care policy in the last decade. In 2003 a committee was appointed to identify coordination problems and proposed a lot of practical and organisational recommendations. It relied on an approach challenging primary and secondary health care in shared geographical regions to take action. However, these proposals were not implemented. In 2008 a new Minister of Health and Care worked out plans under the key term “Coordination Reform”. These reform plans superseded and expanded the previous policy initiatives concerning cooperation, but represented also a shift in focus to a regulative and centralised strategy, including new health legislation, structural reforms and use of economic incentives that are now about to be implemented.DiscussionThe article analyses the perspectives and proposals of the previous and the recent reform initiatives in Norway and discusses them in relation to integrated care measures implemented in Denmark and Sweden.

Individual user involvement at Healthy Life Centres: a qualitative study exploring the perspective of health professionals

“…In Norway, user involvement constitutes an important part of a health reform (the Coordination Reform) implemented to strengthen health promotion and the prevention of NCDs (Ministry of Health and Care Services, 2009, 2011, 2013a, 2015b; Romøren, Torjesen, & Landmark, 2011). In this reform, Healthy Life Centres (HLCs) have been established in primary health care to promote health and prevent NCDs (Ministry of Health and Care Services, 2011, 2013b, 2015a; Norwegian Directorate of Health, 2016).…”

Clinical Practice and Evidence-based Knowledge: Reducing Urinary Tract Infection in Elderly Hip Fracture patients

“…The introduction of governmental coordination reform required decreasing LOS in the hospital unit [13]. An unexpected result in this study was a decrease in the median LOS from 11 days in A to 6 days in B and C, respectively, which was quite dramatic by Norwegian standards.…”

“…This period from 2012 to 2014 was a time of changing with new routines and workloads, due to the coordination reform [13]. Two other predictors remaining in the final stepwise model age >81 year, OR = 0.53 (CI = 0.33-0.84) and LOS > 11 days 2.61 (CI = 1.67-4.10).…”

Continuity of Care during Care Transition: Nurses’ Experiences and Challenges

“…Nursing-specific objectives such as providing medications for weekends and afternoons were often not fulfilled. Norwegian hospital regions and their associated municipalities are required by law to develop cooperation agreements, to provide a concrete division of duties and responsibilities between hospital and municipal health care [5] [26]. This agreement is similar to those in other Scandinavian countries [13].…”

“…Comparable to many other countries, Norwegian authorities have implemented the Coordination Reform [4]. By using incentives to skew treatment and care to municipal level, responsibilities and demands for nurses involved in care transitions of older patients are consequently altered [5]. Both hospital and municipal nurses play a key role during this important period of treatment and care, and they also have first hand contact with the older patients and their next of kin [6] [7].…”