The Norwegian hospital reform of 2002: Central government takes over ownership of public hospitals

Hagen, Terje P.; Kaarboe, Oddvar

doi:10.1016/j.healthpol.2005.06.014

Cited by 107 publications

(81 citation statements)

References 27 publications

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“…The reimbursement scheme for somatic hospitals changed in 1997 from a system of risk-adjusted global budgets to a combination of ABF and global budgets (Hagen and Kaarbøe 2006). Activity-based funding of somatic hospital services is based on the DRG system.…”

Section: Institutional Settingmentioning

confidence: 99%

Outsourcing day surgery to private for-profit hospitals: the price effects of competitive tendering

Hagen

Holom

Amayu

2017

HEPL

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Abstract:Setting prices for elective patient treatments in private for-profit (PFP) hospitals in traditional tax-funded health systems is challenging since both the organisation of these hospitals and the tasks they perform differ considerably from what we find in public hospitals. From the year 2000, Norway became one of a few countries to gradually implement a procurement system based on competitive tendering when outsourcing elective surgery. In this study we analyse the effect of introducing competitive tendering on the prices paid to PFP hospitals. Pricing data were collected from the formal contracts awarded to PFP hospitals and defined in terms of both absolute and relative prices. We found that PFP hospitals performed day surgeries at markedly lower prices than public hospitals and that competitive tendering triggered the price reduction. We speculate that the PFP hospitals' lack of acute services, less severe patient population, reduced teaching responsibilities and ability to streamline production, as well as other factors, explain the lower prices at PFP hospitals. Cambridge University Press AbstractSetting prices for elective patient treatments in private for-profit (PFP) hospitals in traditional tax-funded health systems is challenging since both the organisation of these hospitals and the tasks they perform differ considerably from what we find in public hospitals. From the year 2000, Norway became one of a few countries to gradually implement a procurement system based on competitive tendering when outsourcing elective surgery. In this study we analyse the effect of introducing competitive tendering on the prices paid to PFP hospitals. Pricing data were collected from the formal contracts awarded to PFP hospitals and defined in terms of both absolute and relative prices. We found that PFP hospitals performed day surgeries at markedly lower prices than public hospitals and that competitive tendering triggered the price reduction. We speculate that the PFP hospitals' lack of acute services, less severe patient population, reduced teaching responsibilities and ability to streamline production, as well as other factors, explain the lower prices at PFP hospitals.

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Section: Institutional Settingmentioning

confidence: 99%

Outsourcing day surgery to private for-profit hospitals: the price effects of competitive tendering

Hagen

Holom

Amayu

2017

HEPL

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“…All public hospitals were transferred from a system of county ownership to central government ownership. In so doing, the government expected to increase hospital efficiency by providing greater autonomy with respect to planning, budgeting and workforce policies of the health units (Hagen and Kaarboe, 2006). Johannessen et al (2017) used a non-parametric DEA model and panel analyses to study the overall physician productivity.…”

Section: Discussionmentioning

confidence: 99%

A model for multidimensional efficiency analysis of public hospital management

2017

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Introduction: Multidimensional efficiency analysis can provide important insights into the performance of hospitals.In this paper, we propose a multidimensional model based on Data Envelopment Analysis (DEA) to investigate and compare the efficiency of public hospitals in Brazil. Methods: Data from 21 public hospitals were collected from public databases (OECD -Organization for Economic Co-operation and Development; SIH-SUS -SUS Hospital Information System, Datasus, Brazil). Four inputs (Number of medical and non-medical staff, Annual revenue, Number of beds, Average length of patient hospitalization), four Variables of Influence (Type of hospital, Accredited hospital, Number of medical specialties, Resources from government) and four Outputs (Number of outpatient care services, Number of hospitalizations, Number of surgeries, Number of exams) were used to feed the DEA model. Results: Seven hospital units reach 100% efficiency and, according to DEA, can be considered efficient units. Two units were considered "almost efficient" and the remaining twelve units perform poorly, considering the data supplied to the DEA model. As a whole, the average efficiency of the hospitals investigated was 79% (0.79). Conclusion: A very heterogeneous performance has been found among the Brazilian public hospitals investigated. Besides, the reasonably low average efficiency seems to indicate that the system has a large potential for improvement in almost all areas associated with the input and output variables investigated in this paper.Keywords Hospital efficiency, Data Envelopment Analyses, Public hospital.This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.How to cite this article: Soares AB, Pereira AA, Milagre ST. A model for multidimensional efficiency analysis of public hospital management.

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“…Både handlingsregeln och planerna på en pensionsreform kan ses som integrerade moment i en mer allmän omstrukturering av den norska välfärdsstaten (Sejersted 2005, s. 445-446). 2002 genomdrevs en stor sjukvårdsreform som innebar att sjukhusen och specialistvården ombildades till halvprivata hälsoföretag som sorterar under fem administrativa sjukvårdsregioner under regeringens kontroll (Angell 2012;Hagen & Kaarbøe 2006). Här finns inte skäl att gå djupare in i denna reform, som i sin iver att på samma gång centralisera och decentralisera komplexa institutioner tycks skapa sin alldeles egen problemvärld (Laegreid, Opedal & Stigen 2005).…”

Section: Från Jämlikhet Till Frihetunclassified

Åldrande och olja. Norsk pensionspolitik i internationell belysning

Lundberg

2015

ATfS

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Arkiv. Tidskrift för samhällsanalys, nr 4 (2015) Åldrande och olja. Norsk pensionspolitik i internationell belysning Urban Lundberg sammandrag: På ytan faller den norska pensionsreformen från 2009 in i ett internationellt mönster där industrialiserade länder över hela västvärlden anpassar sina välfärds-system till en tvingande postindustriell problemvärld. Samtidigt är denna normalitet den norska reformens mest besynnerliga drag. Norge är alltjämt ett av världens rikaste länder. Under samma period som pensionsreformen förbereddes och beslutades växte oljeintäk-terna lavinartat. Urban Lundbergs artikel tar fasta på denna synbara paradox och visar hur norsk pensionspolitik måste förstås mot bakgrund av hur det dubbla trycket från globalisering och demografi, som i olika grad plågar alla andra jämförbara länder, i Norge genomgående filtreras genom en ännu större fråga om det mest ansvarsfulla sättet att för-valta en ändlig naturresurs. För att ytterligare framhäva den norska pensionsreformens unika särdrag placeras den in i en nordisk kontext där det mer välkända svenska exemplet ges avgörande betydelse.

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The Norwegian hospital reform of 2002: Central government takes over ownership of public hospitals

Cited by 107 publications

References 27 publications

Outsourcing day surgery to private for-profit hospitals: the price effects of competitive tendering

Outsourcing day surgery to private for-profit hospitals: the price effects of competitive tendering

A model for multidimensional efficiency analysis of public hospital management

Åldrande och olja. Norsk pensionspolitik i internationell belysning

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