OECD Reviews of Health Care Quality: Norway 2014
Raising Standards

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 services.
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Primary care physicians in Norway
Norway benefits from a strategic vision of how primary care and health care more broadly should develop over the short to medium term, as set out in the Coordination Reform. It also benefits from having several engaged and competent institutions that are ambitious to improve primary care quality. The few broad quality measures that exist suggest that Norway has a high performing primary care sector. In the absence of much central guidance, monitoring or accountability, this is in no small measure due to high levels of trust between those paying for and those delivering primary care and a reform process founded on consensus rather than confrontation.
The chapter opens with a description of how primary care is organised in Norway, followed by a discussion of key quality initiatives in the sector. It presents some indicators of the quality of Norwegian primary care alongside international benchmarks, describes the challenges facing the sector and closes by discussing recommendations for how primary care can be strengthened and its contribution to continuous quality improvement secured.
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