Norway: health system review 2013
Health Systems in Transition, Vol. 15 No. 8
Overview
Norway’s five million inhabitants are spread over nearly four hundred
thousand square kilometres, making it one of the most sparsely
populated countries in Europe. It has enjoyed several decades of high
growth, following the start of oil production in early 1970s, and is now one of
the richest countries per head in the world.
Overall, Norway’s population enjoys
good health status; life expectancy of 81.53 years is above the EU average of
80.14, and the gap between overall life expectancy and healthy life years is
around half the of EU average.
The health care system is semi-decentralized. The responsibility for specialist
care lies with the state (administered by four Regional Health Authorities) and
the municipalities are responsible for primary care.
Although health care expenditure is only 9.4% of Norway’s GDP (placing
it on the 16th place in the WHO European region), given Norway’s very high
value of GDP per capita, its health expenditure per head is higher than in most
countries. Public sources account for over 85% of total health expenditure;
the majority of private health financing comes from households’ out-of-pocket
payments.
The number of practitioners in most health personnel groups, including
physicians and nurses, has been increasing in the last few decades and the
number of health care personnel per 100 000 inhabitants is high compared to
other EU countries. However, long waiting times for elective care continue to
be a problem and are cause of dissatisfaction among the patients.
The focus of health care reforms has seen shifts over the past four decades.
During the 1970s the focus was on equality and increasing geographical
access to health care services; during the 1980s reforms aimed at achieving
cost containment and decentralizing health care services; during the 1990s the
focus was on efficiency. Since the beginning of the millennium the emphasis has been given to structural changes in the delivery and organization of health
care and to policies intended to empower patients and users. The past few years
have seen efforts to improve coordination between health care providers, as
well as an increased attention towards quality of care and patient safety issues.
Overall, comparing mortality rates amenable to medical intervention
suggests that Norway is among the better performing European countries.
Despite having one of the highest densities of physicians in Europe, though,
Norway still struggles to ensure geographical and social equity in access to
health care.