Primary physician service, municipal expenses

Municipal differences in expenditure to primary physicians

Published:

Norwegian municipalities expenditure to the primary physician service in 2002 was NOK 738 per inhabitant. The differences among municipalities are considerable. In comparison, municipalities with a population less than 2 000 reported an expenditure of NOK 2 300 in average per inhabitant.

In 2003 Statistics Norway executed a study on behalf of the Ministry of Health. Data from 2002 were collected by a questionnaire sent to a representative sample of Norwegian municipalities. The municipalities were asked to report expenditures and income concerning primary physician services. Expenditures that are included are operating expenditure for municipal casualty clinics and health centers, wages for physicians and mandatory practitioners, and grants to private physicians. A similar study was executed in 2000 collecting data from 1999.

Continued municipal differences

The 2002 figures show municipal gross expenditure to primary physician service to be NOK 738 per inhabitant, an increase of 9 per cent in fixed prices from 1999. The difference between municipalities is, however, considerable; municipal expenditure decreases with higher population. An example is municipalities with a population less than 2 000 with expenditures of NOK 2 300 per inhabitant. This expenditure level is three times the average. Corresponding municipal differences were found in the 1999 figures. The main cause is that small municipalities need relatively more physicians than larger municipalities in order to produce the same level of services.

 

Gross expenditure to primary physician service
 
  Average
per inhabitant
in current prices 		Average per inhabitant in fixed prices Number of municipalities
  2002 2002 1999 2002 1999
 
Total1  738  616  567  116  145
           
0-1 999 2 337 1 950 1 797 15 25
2 000-4 999 1 422 1 186  950 39 50
5 000-9 999  867  723  673 32 36
10 000-19 999  638  532  474 13 17
20 000-29 999  549  458  432 9 9
30 000-49 999  478  399  415 3 4
50 000+  531  443  418 5 4
 
1  Total expenditure is a weighed average.

 

Background

Until the 1June 2001 primary physicians in Norway were organized in two main categories. Physicians with a fixed salary, and private physicians who are remunerated by a fixed grant plus fee-for-service payments. In 2001 a reform giving all inhabitants a right to a regular physician was introduced. With the so-called "regular doctor arrangement" (Fastlegeordningen) the physician has a main responsibility for the patients on his list. The new organizational setup also replaced the fixed grant with a per-capita grant.

Municipalities finance 60 per cent of total national expenditure

Municipalities and physicians receive grants and payments from the National Insurance Administration. Total national expenditures to primary physician service are calculated by summing municipalities' net expenditure and NIA expenditures, and calculated per inhabitant expenditures amount to NOK 1 050. In average, municipalities finance approximately 60 per cent of total national expenditure to primary physician service.

More here: Notat 2004/6

Tables

Contact