385418
/en/helse/statistikker/pleie/aar
385418
statistikk
2019-06-24T08:00:00.000Z
Health;Public sector
en
pleie, Care services, elderly care, nursing homes, disabled, home nursing care, home help, home help services, IPLOS, retirement homes, institutions, care homes, nursing staff, discharge, support person, care benefit, UCPA (user controlled personal assistance)KOSTRA , Health services , Public sector, Health
true

Care services

Updated

Next update

Not yet determined

Key figures

31.2 %

of inhabitants 80 years and over used home-based services in 2018

Nursing and care services
Percentage changePercentage change
20182017 - 20182015 - 2018
1Home-based services: Home-nursing and home-help. Activity and facility services not included
2Includes nursing homes, retirement homes, relief institutions and dwellings for children. Dwellings for the elderly not included.
3Statistics Norway has adopted a new method that provides better information on settled percentage of full-time equivalent (FTE) in 2018. The new method affects the calculation of man-years, and changes in the number of man-years, for example from 2017 to 2018 is thus not real. The new method is under development. Statistics Norway intends to publish final figures for man-years for the years 2015-2019 by new method through KOSTRA in March 2020. Read more about the new method here: https://www.ssb.no/arbeid-og-lonn/artikler-og-publikasjoner/ny-metode-gir-bedre-informasjon-om-arbeidstid
4KOSTRA functions included: 234 Activity programmes, 253 Health and care institutions, 254 Home-based services, 256 Acute help, 261 Institutions buildings. Government grants for municipal co-financing of general hospitals function 255 is included until 2015.
Home-based services (selected services)Users 12.31.
Assistance in daily living79 164-2.6-5.8
Home health services, includes both somatic and psychiatric care.157 5932.38.8
User-controlled personal assistance3 462-1.310.0
Care benefits (benefits to individuals whom provides care on a voluntary basis to parents, spouses or others)10 1510.54.4
Percentage of inhabitants age 80 years and over that are home service users131.2-2.5-5.5
Nursing homesBeds 12.31.
Beds in total39 572-0.3-0.3
Percentage of private beds9.8-5.1-11.5
Institution services2Residents 12.31.
Long-term stay32 234-1.5-3.9
Short-term stay9 056-3.2-2.7
Care and nursing services staff3Man-years
Man-years - total142 754....
of these...
Man-years in user directed services with health education103 338....
Percentage in user directed services with health education74.5....
Nursing and care expenditure4NOK billions
Nursing and care expenditure, total122.07.519.2

See selected tables from this statistics

Table 1 
Health and care institutions, beds and rooms by type and ownership

Health and care institutions, beds and rooms by type and ownership1
2015201620172018
1Per 31.12.
Number of institutions974968955942
 
Total number of beds40 70840 49440 40140 126
Nursing home39 67439 60539 67439 572
Old people's home1 034889727554
 
Private beds (per cent of total)11.711.310.810.2
Private non-profit5.25.14.85.0
Private commercial6.66.26.05.2
 
Single rooms (per cent)97.597.698.198.1
User adapted single room with own WC and bathroom (per cent)83.784.286.687.8

Table 2 
Residents in institutions for the elderly and disabled, by age

Residents in institutions for the elderly and disabled, by age1
2015201620172018
1Per 31.12.
Total42 85042 64442 09241 290
Under 67 years::::
67-79 years8 1318 4458 5708 579
80-89 years17 09716 85516 49416 081
90 years and over12 72012 53612 26411 956

Table 3 
Residents in dwellings for the aged and disabled.

Residents in dwellings for the aged and disabled.1
201520162017
1Per 31.12.
Total44 01444 45444 529
Under 67 years19 51619 83420 058
67-79 years7 5337 7597 859
80-89 years10 52710 31910 082
90 years and over6 4386 5426 530

Table 4 
Users of home-based services, by age.

Users of home-based services, by age.1
2015201620172018
1Per 31.12.
Total182 500185 505189 520191 882
Under 67 years76 22778 95981 95384 349
67-79 years34 95236 00637 44438 057
80-89 years50 07548 85448 40647 592
90 years and over21 24621 68621 71721 884

Table 5 
Users of home-based services and residents in institutions for the elderly and disabled. Need for assistance and kind of service

Users of home-based services and residents in institutions for the elderly and disabled. Need for assistance and kind of service1
Number of usersPer cent
20152016201720182018
Total, need for assistanceSmall need for assistanceAverage to much need for assistanceExtensive need for assistanceUnspecified need for assistance
1Per 31.12.
Total, services275 200278 017282 302285 582100.036.333.823.26.7
Users of home help only37 66335 95435 48934 289100.054.827.813.04.4
Users of home nursing only82 40087 19990 92494 868100.048.136.27.08.7
Users of both home help and home nursing62 43762 35263 10762 725100.019.949.530.00.6
Other home-based services49 85049 86850 69052 410100.048.825.79.316.2
Residents in institutions, short term stay9 3039 5509 3599 056100.010.840.244.94.2
Residents in institutions, long term stay33 54733 09432 73332 234100.00.913.785.20.3

Table 6 
Average numbers of assigned hours per week for users of home help and home nursing. Age and need for assistance

Average numbers of assigned hours per week for users of home help and home nursing. Age and need for assistance
Average number of hours per week
Total, need for assistanceSmall need for assistanceAverage to much need for assistanceExtensive need for assistanceUnspecified need for assistance
Years, total9.41.76.537.52.9
0-17 years21.34.514.842.412.6
18-49 years16.41.710.368.73.5
50-66 years12.21.76.848.92.4
67-79 years5.91.64.921.12.1
80-89 years4.41.64.513.61.8
90 years or older5.71.95.414.81.7

Table 7 
Recievers of respite care, personal support contact, recievers with next of kins receiving pay for caring work and user-controlled assistance. Age.

Recievers of respite care, personal support contact, recievers with next of kins receiving pay for caring work and user-controlled assistance. Age.1
2015201620172018
1Per 31.12.
Respite care
Total8 0037 8957 8297 639
0-66 years7 7867 6787 6157 409
67 years and over217217214230
Personal support contact
Total31 11831 60532 32632 747
0-66 years25 09225 24425 68125 871
67 years and over6 0266 3616 6456 876
Care recievers with next of kins receiving pay for caring workt
Total9 7259 97910 09910 151
0-66 years8 1558 3368 5458 595
67 years and over1 5701 6431 5541 556
User-controlled assistance
Total3 1463 3303 5093 462
0-66 years2 7792 8663 0303 066
67 years or older367464479396

Table 8 
Gross expenditure in municipal health and care services. NOK 1 000

Gross expenditure in municipal health and care services. NOK 1 000
NOK 1 000 (current prices)
2015201620172018
1Government grants for municipal co-financing of general hospitals function 255 was closed from 2015.
Gross expenditure - total117 829 589124 889 659131 331 755141 403 232
232 Preventive health care, school/health centre3 168 2803 525 4163 858 5244 286 297
233 Preventive health care1 263 6821 338 0311 452 4861 701 307
241 Diagnosis, treatment and rehabilitation11 070 35911 896 69012 519 05713 433 515
255 Co-financing of somatic services133 749...
256 Emergency health and care services526 830697 418804 720887 851
234 Activation of elderly og disabled5 582 2095 930 9156 335 2296 727 792
253 Nursing and care services in institutions41 313 57343 113 55944 188 29146 707 706
254 Nursing and care services, home-based50 466 72853 685 81957 143 51962 293 036
261 Institution facilities4 404 1794 701 8115 029 9295 365 728

About the statistics

The statistics provide a summary of care services, and include information about users of various care services, capacity and resource input, such as number of beds and staff. Accounting figures are also given.

Definitions

Definitions of the main concepts and variables

Man-year

These data are intended to embrace all kinds of activities within the home based services and the institutions, and are not only restricted to health care functions. The data also contain administration and management personnel and as far as the institutions are concerned, kitchen and cleaning functions etc. The personnel are registered on the basis of their formal education by December 31st. The figures are reported in man-years, which means that the total numbers of part-time employees are converted into number of full time employees. Thus the total number of man-years is based on the assumption of stability among the personnel during the year. Employees without the specified education are recorded in collective groups.

Man-years - positions

For personnel, the recording unit is hours per week, and applies to hours set for those with permanent full-time or part-time positions. The number of hours per week is recalculated into man-years (full-time positions) by dividing the number of contract working hours per week. In practice this means that we have divided by 36 hours for physiotherapists and 37.5 hours for doctors, and 35.5 for the other occupational groups.

Organisation

Organisation means the forms of association the individual physicians and physiotherapists have with the municipality. Municipalities offer practitioners four possible forms of association. The two most common forms are fixed salary and contract.

Physicians and physiotherapists with fixed salaries

Physicians and physiotherapists with fixed salaries are municipal employees, in municipal medical officer or physiotherapist positions advertised by the municipality. These positions may be full or part-time. The municipalities cover all expenses of the positions, but the National Insurance scheme provides fixed grants to the municipalities per position. The duties of these fixed-salary physicians and physiotherapists are set by municipal instructions.

Physicians and physiotherapists with municipal contracts

Physicians and physiotherapists with municipal contracts are basically private practising physicians and physiotherapists who sign an agreement with the municipality or borough. The provisions of this agreement are based on an agreement between the Norwegian Association of Local Authorities, Ministry of Health and Care Services and the physicians' and physiotherapists' organizations. The agreement implies that all physicians are obliged to participate in the medical duty service and municipal responsibilities such as care of the elderly and preventive medicine. How much the individual doctor is to perform these duties and the opening hours of the curative practice are defined in the specific agreements between the individual practitioner and the municipality/borough. The basis of the income of physicians and physiotherapists with municipal agreements is National Insurance reimbursements, patient co-payments and a fixed amount (operating grant) from the municipality as compensation for the agreement. Physicians and physiotherapists with combinations of fixed salary part-time positions and part-time contract practice are regarded as practitioners with a municipal contract.

Physicians and physiotherapists without municipal contracts

There are also practitioners with private practices who do not have a contract with the municipality. For the individual patient, it is of no financial significance if you go to a mandatory practitioner, doctor with fixed salary or doctor with a municipal contract. Physicians without a municipal contract may, with certain limitations, take as high a co-payment as the patient is willing to pay.

Following changes in sections 5-4, 5-7 and 5-8 of the National Insurance Act of 1 July 1998, national insurance reimbursements are no longer to be paid to private practising health professionals who do not have an operating agreement with the municipality or county. Exceptions have been made for general practitioners pending the introduction of the regular GP scheme.

Vacant authorised posts/ positions

Authorised posts or fixed-salary positions that are vacant at December 31st due to leave, illness or other reasons, are regarded as filled if the absence is less than four months, otherwise it is regarded as vacant.

Overtime

From the statistical year 1994, data on man-years worked by physicians also include hours worked under extended working time agreements pursuant to the central union federation special agreement between the Norwegian Association of Local Authorities and the Norwegian Medical Association. This agreement permits, for up to one year at a time, the signing of an agreement on extended working hours beyond 37.5 hours per week. Overtime work beyond this is not included.

Users of home based services

The figures cover all users of home help and home nursing or both services that were registered as active users at the end of the year. In general every person receiving services is regarded as one user, with one exception; households consisting of two or more persons receiving help are regarded as one user.

Institutions

These are defined as a group of buildings where parts of the floorage are shared between residents, the household is common and care personnel are present 24 hours a day. This definition embraces all kinds of institutions falling under the law mentioned above and are as follows: nursing homes, old peoples homes, combined nursing and old peoples homes and in addition various municipal dwellings with full-time services.

Dwellings for the aged and disabled

This category includes other kinds of municipal dwellings reserved for persons in need of help because of old age or handicap. They are also offered to mentally retarded persons who have left the traditional institutions according to a major reform concerning this group of disabled in 1991. These dwellings are not included in the institution-category, as they do not have a full-time service offer, and the residents own or pay rent for the dwelling. Some of them have care and nursing services during parts of the day. The other dwellings do not have this offer, and the residents are instead users of the home based services in the same way as other ordinary users. Many of these flats are adjusted for functionally disabled residents and some of them do also have to some extent common floorage and household.

Standard classifications

The 429 municipalities are grouped into 16 groups by population and economic conditions. The classification is based on Audun Langørgen and Rolf Aaberge (2011): Classification of municipalities by population and economic conditions of 2008. Report 2011/8, Statistics Norway. In the calculation of average figures for the county, municipalities are divided into 19 counties by the current standard for municipality classification (two first digit).

Regional statistics

The counties are divided into five groups. The classification is identical to subdivisions of counties in health regions apart from that there is established a separate group for Oslo.

Administrative information

Name and topic

Name: Care services
Topic: Health

Responsible division

Division for Health, care and social statistics

Regional level

Municipality, and for Oslo: parts of town.

Frequency and timeliness

Annual.

International reporting

Figures are annualy delivered to OECD.

Microdata

The web addresses are http://www.ssb.no/helsetjko   and http://www.ssb.no/pleie .

The statistics are published twice a year, preliminary figures are published in June and yearly figures in March the succeeding year.

Official statistics of Norway, Nursing and Care statistics and Municipal Health Services, was published yearly/each second year. From 2003, these publications are replaced by a common Municipal Health and Care services. Some figures are also published yearly in "Health Statistics in the Nordic Countries by NOMESCO and in "Social protection in the Nordic Countries" by NOSOSCO.

Background

Background and purpose

These statistics are supposed to meet the increasing need for information among the central authorities for planning purposes, supervision and evaluations of the municipalities' health and care services. In addition, the municipalities themselves are in need of comparable figures on county and national level to evaluate their own services. The statistics embrace an overview of the total input of the recourses in the general practitioners services, physiotherapist services, midwife services, school health services, and maternal and child health centre services. It also embrace all kinds of activities within the home based services and the institutions, and are not only restricted to nursing and care functions. The data also contain administration and management personnel and as far as the institutions are concerned, kitchen and cleaning functions etc.

he Municipal Health Services Act was enacted in 1982 and took effect in 1984. The purpose of the law was to strengthen the primary health services. From 1 January 1998 the law was expanded to include prison health services and county nursing homes. Under the act, the municipalities were given responsibility for board of health activities and user groups such as the mentally retarded and psychiatric patients. Municipal health service statistics provides the health authorities' with data for planning and supervisory purposes. They shall provide knowledge about the staff situation and about delivery of health care in the local health service.

From the 1st of January 2012 the Municipal Health Services Act is replaced by “Lov om kommunale helse- og omsorgstjenester m.m”

The statistics for the different parts of the municipal health and care service are based on annual data from the municipalities. For the first year, 1984, the data were basically limited to information about staff resources. From 1985 the statistics were expanded to include the maternal and child health centres and school health service. Staff without background as a health professional was included in the statistics for the school health service and maternal and child health centres in 1988 (maternal and child health centres) and 1994 (the school health service).

Since 1995, data on vaccinations in the school health service and maternal and child health centres were removed entirely from the questionnaires. Since then, they have been collected by the Norwegian Board of Health through a individual-based system (SYSVAK).

The official statistics of the public care and nursing services were for the first time collected in one data gathering and publishing routine in 1989. The background for this was the transfer of the responsibility for the nursing homes from the counties to the municipalities. Thus the total responsibility for all these services was transferred to the municipalities, and the administrative distinction between social (municipality services) and health services (county services) was abolished.

The statistical basis has undergone major changes since the statistical routine was established. This makes it difficult to follow the developments over time.

Users and applications

The Ministry of Health and Care Services, the Directorate of Health,

the Ministry of Local Government and Regional Development, the municipalities, research institutes and media.

Equal treatment of users

No external users have access to the statistics and analyses before they are published and accessible simultaneously for all users on ssb.no at 10 am. Prior to this, a minimum of three months' advance notice is given in the Statistics Release Calendar. This is one of Statistics Norway’s key principles for ensuring that all users are treated equally.

Coherence with other statistics

The statistics can be viewed in the context of several other KOSTRA areas and specialist health services.

Legal authority

For aggregated data (KOSTRA forms): The data are collected by Statistics Norway on behalf of the Ministry of Health and Care Services pursuant System Act (Act of 18 May 2001 No. 24) § 10

Statistics Norway also uses the information to the production of official statistics under the Statistics Act (Act of June 16, 1989 No. 54) § 2-2.

For individual data (pseudonym register for Individual-based Nursing and Care Statistics, IPLOS): System Act § 9, of IPLOS Regulations (17 February 2006 No. 204) § 2-1.The register-based statistics personnel is authorized by the Statistics Act § 3-2.

EEA reference

Not relevant.

Production

Population

The statistics are based on the registration of health care services in all municipalities, including all municipal health care institutions, both private and public.

 

Data sources and sampling

The statistics are based on the registration of health care services in all municipalities, including all municipal health care institutions, both private and public.

Health and care statistics are based on the following data sources:

  • Annual submission of three electronic questionnaires to all municipalities and institutions for the elderly and persons with disabilities through KOSTRA (Municipality-State-Reporting)
  • Annual submission of data about users and seekers of health care services at the individual level to IPLOS Register
  • Statistics Norway's register-based employment statistics.
  • General practitioner register from the directorate for health is data source for statistics on general practitioners and list length. The statistics cover all municipalities and districts in Oslo.
  • The statistics also includes all users and seekers of health and care services and all institutions within the municipal health care services, see Law on health and care services § 3-2 and regulations on the health care institution.

Collection of data, editing and estimations

Collection of data

The statistics of the municipal health services is partly based upon annual dispatch of three questionnaires to all municipalities in Norway. These municipalities deliver electronic questionnaires that are included in the national statistics for the municipal health and care services. From 2002, all municipalities report by the KOSTRA system (Municipality - National authorities - Report).

Data are also collected trough different data filing systems. For instance are the man-year data mainly based upon data filing systems for health personnel. (From 2015: A-ordningen)

Register-based employment statistics: From 2015 onwards

From 2015 onwards a new joint reporting solution called a-ordningen gathers the reporting from the employers to the Ee-register, produced by the Norwegian Labour and Welfare Administration, as well as some reports to the Tax Administration and Statistics Norway. A-ordningen is a coordinated digital collection of data on employment, income and tax deductions to the Tax Administration, the Norwegian Labour and Welfare Organization and Statistics Norway. This new joint collection provides Statistics Norway with information on wages and employed persons directly from a-meldingen, which is the electronic message containing all the information collected, rather than the multiple sources used until 2014. You can find more information about the new reporting at www.altinn.no/en/a-ordningen.

A-ordningen has replaced the Register of Employers and Employees and the Register of End of the Year Certificates (Register of Wage Sums). In addition to a-ordningen other registers provide additional information, the most important is the Register for Personal Tax Payers administered by the Directorate of Taxes, the Register of Conscripts from the Armed Forces Personnel and National Service Centre and The Central Coordinating Register for Legal Entities.

The registers mentioned above are still being used to assure the quality of the data, to consolidate the consistency between different data sources as well as choosing the right main job and to classify people as employed. A few additional registers are also being used for these purposes, where the ARENA-register produced by the Norwegian Labour and Welfare Organization is one example. It provides data on unemployed and people engaged in labour market projects.

Individual data on recipients of care services are collected in IPLOS.

Quality control

The new data are compared with data from the preceding year and various relative figures. In any case of conspicuous deviation from preceding years, the data basis is further checked and the figures are corrected as far as possible. Besides these controls, there are ordinary logical and validity controls intending to secure the logical relation between the items in the complemented questionnaires. In spite of an extensive correction of data some reservations must be taken concerning the figures presented on municipal level.

Upon the release of final figures, municipalities failing to give data will be included with figures from the preceding year.

A-ordningen: Controls are carried out at several stages. For information: http://www.ssb.no/en/arbeid-og-lonn/statistikker/regsys/aar/2016-05-27?fane=om#content

Estimations

In the case of non-response from either municipalities or institutions the questionnaires are completed with information from the previous year or by other methods of estimation.

Seasonal adjustment

Not relevant.

Confidentiality

For IPLOS special rules apply for confidentiality. To protect the individual against detection, numbers less than five are being anonymised. In tables with row and column sums there are also a second anonymity used to prevent that one can calculate up to the numbers that are dotted.

Comparability over time and space

The statistical basis has undergone major changes since the statistical routine was established, but the Statistics Norway is able to present time-series for the most important health care variables back to 1987, and for nursing and care back to 1991.The statistical basis has undergone major changes since the statistical routine was established, but the Statistics Norway is able to present time-series for the most important health care variables back to 1987, and for nursing and care back to 1991.

From 2007 IPLOS is the source for statistics on users of care services in the municipalities. This means that the number of users of care services in 2007 are not directly comparable with previous year.

A new datasource; A-ordningen:

From 2015 onwards the register based employment statistics will be based on a new data source for employees. Until the end of 2014, the main data source was the Employees register, produced by the Norwegian Labour and Welfare Organization. In 2015 this reporting was coordinated with the reporting of earnings and personnel data to the Tax Administration and Statistics Norway. This common reporting system is called a-ordningen. A-ordningen provides a better data basis compared to the Ee-register, as it is more accurate on the individual level in addition to covering a greater number of employments. Furthermore, it provides more frequent statistics for wage earners and will supply highly detailed figures on the development in the labour market. These include numbers on the municipal level by age and industry. This new data source means a change in the time series.

For more information, read About the Statistics: http://www.ssb.no/en/arbeid-og-lonn/statistikker/regsys/aar/2016-05-27?fane=om#content

2018-figures compared with earlier figures

Statistics Norway has adopted a new method that provides better information on settled percentage of full-time equivalent (FTE) in 2018. The new method affects the calculation of man-years, and changes in the number of man-years, for example from 2017 to 2018 is thus not real. The new method is under development. Statistics Norway intends to publish final figures for man-years for the years 2015-2019 by new method through KOSTRA in March 2020. Read more about the new method here: https://www.ssb.no/arbeid-og-lonn/artikler-og-publikasjoner/ny-metode-gir-bedre-informasjon-om-arbeidstid

Accuracy and reliability

Sources of error and uncertainty

In the case of non-response from either municipalities or institutions the questionnaires are completed with information from the previous year or by other methods of estimation.

Another source of error is connected with the fact that the delivery of health care is extremely diverse, so the form does not always fit all municipalities. A lack of correspondence between the registrations, and the actual situation of which the form was meant to survey may consequently occur.

Sources of error can apply to many parts of the statistics, as described below:

Man-years of physicians with operating agreements

According to the instructions the figures shall show the number of hours per week on which the agreement with the municipality is based. Sometimes the hours actually worked by the doctor are entered, even though they exceed the hours on which the agreement is based.

Man-years of fixed-salary physicians

The instructions state that overtime is not to be included. Some municipalities have nevertheless included "overtime". This has been removed insofar as the municipalities have been informed that such work is included.

Physicians and physiotherapists without municipal agreement

Work performed by physicians and physiotherapists without agreements shall be reported to the medical consultant/chief municipal medical officer. Experience shows that municipalities and boroughs do not have a full overview of these operations. The labour input of practitioners without an agreement may therefore be somewhat underestimated.

Breakdown into areas of activity

It may happen that the distribution of man-years in the various areas of activity is not given for physicians, physiotherapists and auxiliaries. When this is suspected, the municipality is contacted for update.

Man-years

In the basic material from the municipalities the amount of work is given in hours per week. Recalculation to man-years is undertaken at publication. There seems, however, to be differences among the municipalities as to the hours of a full-time position in the various occupational groups.

A new datasource; A-ordningen:

From 2015 onwards the register based employment statistics will be based on a new data source for employees. Until the end of 2014, the main data source was the Employees register, produced by the Norwegian Labour and Welfare Organization. In 2015 this reporting was coordinated with the reporting of earnings and personnel data to the Tax Administration and Statistics Norway. This common reporting system is called a-ordningen. A-ordningen provides a better data basis compared to the Ee-register, as it is more accurate on the individual level in addition to covering a greater number of employments. Furthermore, it provides more frequent statistics for wage earners and will supply highly detailed figures on the development in the labour market. These include numbers on the municipal level by age and industry. This new data source means a change in the time series.

For more information, read About the Statistics: http://www.ssb.no/en/arbeid-og-lonn/statistikker/regsys/aar/2016-05-27?fane=om#content

Revision

Preliminary figures are published in March, and controlled figures are published in June. Final figures are published in March, the following year.