![]() All in all, user charges cover about 15% of total health expenditures and 7% of expenditures in municipal nursing and care services. Most health and long-term care expenditures are publicly financed, but some co-payment for outpatient primary and specialist health services, as well as home care (practical aid etc.) and long-term residential care, do exist. Municipal nursing and care services (long-term care) are mostly provided by public (municipal) providers. Primary care physicians are commonly organized in private group practices, working under contract with their local municipality, with a gatekeeping function for referral to specialist healthcare. Primary healthcare and long-term care is the responsibility of Norway’s 422 municipalities (2019). Most secondary healthcare services are run by public health enterprises owned by the RHAs and some by private providers under contract with the RHAs. Specialist (secondary) healthcare is the responsibility of four state owned regional health authorities (RHAs). Responsibility for health and long-term care services are split between the state and the local government in Norway. ![]() Second, to describe the change in service composition as age increases and, third, to describe user rates (users per capita) and average cost per user, addressing the question whether age differences in average cost relate to variation in user rates, cost per user or both.Īnalyses are done separately for males and females since there are systematic gender differences in health and care services consumption. First, to identify the age-groups with the highest health and care cost. This makes this study uniquely positioned to make reliable estimates of the age profiles and age distribution of health and care cost. Furthermore, Norway, like other Nordic countries, has an universal, extensive and mainly publicly funded health and care service system, which means that there are extensive service offerings for all in need of health related care, regardless of age. Including long-term care services is particularly important since age effects are likely to be most pronounced for these services. The ability to include population data on long-term care services for most publicly funded services is a major strength of this study. This study is the first to take advantage of population registries in Norway to provide estimates for a comprehensive set of these distributions. The health registries of the Nordic countries are known for their quality and high coverage. The aging populations of the western world have spurred interest in the age distribution and age profiles of healthcare cost. Our study also underscores the need for an attentive and pro-active stance towards the high service prevalence and high cost of mental health care in our upcoming generations.ĭemographic changes affect both the level and composition of health and care needs in the population. Hence, population aging and narrowing gender-gap in longivety calls for high policy awarness on changing health and care needs. The type of services used, and the related cost, show a clear life-span as well as gender pattern. Gender differences in the age pattern of health and care costs are also revealed and discussed. Healthcare cost per user follows roughly the same age pattern as user rates, whereas user cost for care services typically are either relatively stable or decrease with age among adults. Use of care services and in particular institutional care increases in old age. Use of other healthcare services are high in middle aged and elderly but decreases for the oldest old. ![]() Healthcare cost dominates in ages under 80 and mental health services dominates in adolescents and young adults. The age-group of 65 or older, on the other hand, represent only 15% of the population, but is responsible for almost half of the total cost. Half of the population is under 40 years of age, but only a quarter of the health and care cost is used on this age group. Per capita cost by age and gender was decomposed into user rates and cost per user for each of the eleven services. Data on cost and users were aggregated within four healthcare services and seven long-term care services subtypes. Cost for different services were calculated combining data on service utilisation from the registries and estimates of unit cost. Methodsĭata on service use in 2010 for the entire population in Norway were collected from four high-quality national registers. The aim of this study was to estimate utilisation and cost for a comprehensive range of health and care services by age and gender to provide an in-depth picture of the life-span pattern of service needs and related costs. Current demographic changes affect both the level and composition of health and care needs in the population. ![]()
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