Supporting tough decisions in Norway: A healthcare system approach

Mørland, Berit; Ringard, Ånen; Røttingen, John-Arne

doi:10.1017/s0266462310001030

Cited by 18 publications

(19 citation statements)

References 8 publications

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“…Norway—with its gradual but consistent attempts, beginning with the Lønning Commission in 1987, to set health care priorities—illustrates one way to address health care costs in a manner that physicians and the public have come to accept. 20 …”

Section: Discussionmentioning

confidence: 99%

Focus Groups Highlight That Many Patients Object To Clinicians’ Focusing On Costs

Sommers¹,

Goold

McGlynn

et al. 2013

Health Affairs

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Having patients weigh costs when making medical decisions has been proposed as a way to rein in health care spending. We convened twenty-two focus groups of people with insurance to examine their willingness to discuss health care costs with clinicians and consider costs when deciding among nearly comparable clinical options. We identified the following four barriers to patients’ taking cost into account: a preference for what they perceive as the best care, regardless of expense; inexperience with making trade-offs between health and money; a lack of interest in costs borne by insurers and society as a whole; and noncooperative behavior characteristic of a “commons dilemma,” in which people act in their own self-interest although they recognize that by doing so, they are depleting limited resources. Surmounting these barriers will require new research in patient education, comprehensive efforts to shift public attitudes about health care costs, and training to prepare clinicians to discuss costs with their patients.

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Section: Discussionmentioning

confidence: 99%

Focus Groups Highlight That Many Patients Object To Clinicians’ Focusing On Costs

Sommers¹,

Goold

McGlynn

et al. 2013

Health Affairs

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“…Due to rising health care costs, elaborate public control of health care and technological innovation, Denmark, Norway and Sweden were among the first countries in the world to list priority setting principles for rationing health care resources on a national level [18,19], including pharmaceuticals. These priority setting principles are reflected in the countries' current outpatient reimbursement criteria, and show similarities between the countries: Norway and Sweden put emphasis on need, stating that priority should be given to those in most need.…”

Section: Introductionmentioning

confidence: 99%

A comparative analysis of coverage decisions for outpatient pharmaceuticals: Evidence from Denmark, Norway and Sweden

Grepstad

Kanavos

2015

Health Policy

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“…Norway has adopted a well-developed comprehensive system in which complex problems and scientific support mechanisms such as health technology assessment and value-based priority-setting criteria were brought together to generate transparent solution [10]. As one of the richest countries it ranks second following the United States in health care spending and it enjoys one of the highest population health levels in the world.…”

Section: Introductionmentioning

confidence: 99%

Health care priority setting in Norway a multicriteria decision analysis

Deféchereux

Paolucci

Mirelman

et al. 2012

BMC Health Serv Res

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BackgroundPriority setting in population health is increasingly based on explicitly formulated values. The Patients Rights Act of the Norwegian tax-based health service guaranties all citizens health care in case of a severe illness, a proven health benefit, and proportionality between need and treatment. This study compares the values of the country's health policy makers with these three official principles.MethodsIn total 34 policy makers participated in a discrete choice experiment, weighting the relative value of six policy criteria. We used multi-variate logistic regression with selection as dependent valuable to derive odds ratios for each criterion. Next, we constructed a composite league table - based on the sum score for the probability of selection - to rank potential interventions in five major disease areas.ResultsThe group considered cost effectiveness, large individual benefits and severity of disease as the most important criteria in decision making. Priority interventions are those related to cardiovascular diseases and respiratory diseases. Less attractive interventions rank those related to mental health.ConclusionsNorwegian policy makers' values are in agreement with principles formulated in national health laws. Multi-criteria decision approaches may provide a tool to support explicit allocation decisions.

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Supporting tough decisions in Norway: A healthcare system approach

Cited by 18 publications

References 8 publications

Focus Groups Highlight That Many Patients Object To Clinicians’ Focusing On Costs

Focus Groups Highlight That Many Patients Object To Clinicians’ Focusing On Costs

A comparative analysis of coverage decisions for outpatient pharmaceuticals: Evidence from Denmark, Norway and Sweden

Health care priority setting in Norway a multicriteria decision analysis

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