This book presents a comprehensive review of health care quality in Norway. It finds
that Norway has an impressive and comprehensive health system, which is the result
of sustained commitment to providing health care for the whole Norwegian population,
investment in the health system, and readiness to make changes to drive improvements.
On most indicators Norway’s health system appears to be performing well, although
there is some room for improvement. There have been a number of significant health
care reforms in Norway over the last decade, most recently the Coordination Reform,
which took effect in January 2012.
Broadly this is a positive story, but challenges do lie ahead for Norway. Norway is
putting in place measures to respond to these challenges, notably with the 2012 Coordination
Reform, but still has some way to go before the fruits of such labour are truly felt
across the health system. Norway’s ambitious reform agenda must now be balanced by
structured efforts ‘on the ground’. Attention should now turn to putting in place
appropriate data infrastructures, promoting meaningful engagement between key stakeholders,
and by balancing a generous health budget that allows for important investments in
developing new structures and services with attention to getting the most out of existing
Through the 2012 ‘Coordination Reform’ Norway set out a strategic vision for its health system, seeking to increase the role of primary and community services, including through a number of financial penalties and incentives.
The Coordination Reform’s financial incentives should be a strong driver for municipalities to strengthen care in the community and support early discharge from hospital, but may be working less well to promote good management of chronic conditions and prevent avoidable hospital admissions.
The core incentives of the Coordination Reform were directed at service delivered by municipalities, meaning that key players in reducing hospital admissions and promoting coordination of care, e.g. GPs and the mental health sector, have much weaker incentives for change.
Under-developed data infrastructures in primary care have limited progress towards securing better quality, and a lack of electronic patient records that are portable across care settings may impede smooth patient pathways across service settings.