Kjekshus, Lars Erik (2005):
Vil reformen med statlige, regionale helseforetak føre til effektivitetsforbedringer i norske sykehus?
Norsk statsvitenskapelig tidsskrift, Årgang 2005, Nr. 01 (53-76)
Publikasjonstype:
Tidsskriftsartikkel
Omtale:
http://www.idunn.no/?marketplaceId=2000&languageId=1&siteNodeId=1402125
Antall sider:
24
ISSN-nummer:
0801-1745
Publiseringsspråk:
Norsk
Land publikasjonen kommer fra:
Norge
NSD-referanse:
2720
Disse opplysningene er sist endret:
19/9 2007
Spesifikke virksomheter publikasjonen omhandler:
- Sosial- og helsedepartementet
- Helse Nord RHF
- Helse Midt-Norge RHF
- Helse Vest RHF
- Helse Sør RHF
- Helse Øst RHF
- Helsedepartementet
- Helse- og omsorgsdepartementet
Horisontal dimensjon:
- Helseforetak
Publikasjonens datagrunnlag:
- Sekundærdata
- Kvantitativ
Land som er gjenstand for studien:
- Norge
Verkemiddel i den konstituerande styringa:
- 1.1 Organisering generelt
- 1.2 Endring i tilknytningsform
- 1.4 Finansiering
Studieoppdrag:
- Forskning
Studietype:
- Effektstudie/implikasjoner/resultater
Type effekt:
- Kostnadseffektivitet
Sektor (cofog):
- Spesialisert medisinsk behandling I
- Generelle sykehustenester I
- Spesialiserte sykehustenester I
Sammendrag:
Will the Norwegian hospital reform with state ownership and regional hospital enterprises lead to efficiency and effectiveness improvement in Norwegian hospitals? Predictions from selected theories and experiences so far.
The hospital system was from 1.1.2002 transformed from county ownership to state ownership and hospitals were organized as enterprises. This reform was described by the Ministry of health as a tool to achieve increased efficiency in Norwegian health care system. This article analyses the reform by three theoretical approaches with references to national and foreign experiences. The article also relates the hospital reform to other reforms in the health care sector. The principal-agent approach predicts that because of how the reform has been implemented it will not enhance efficiency. An instrumental perspective predicts that efficiency could have been affected if the reform had led to scale effect by merging hospitals. However, the hospitals mergers have not yet led to profound organizational changes partly due to interference from central political government. Institutional theory would describe the reform as being ambiguous and inconsistent and predicts that the reform would not have practical implications. The overall conclusion is that because how the reform has developed, it would not be followed by an increase in efficiency and effectiveness.