Journal
SOCIAL SCIENCE & MEDICINE
Volume 64, Issue 10, Pages 2129-2137Publisher
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.socscimed.2007.02.018
Keywords
Norway; health reform; decentralization; economic effects
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In recent years, decentralization of financial and political power has been perceived as a useful means to improve outcomes of the health care sector of many European Countries. Such reforms could be the result of fashionable policy trends, rather than being based on knowledge of what works. If decentralization is the favored strategy in health care, studies of countries that go against the current trend will be of interest and importance as they provide information about the potential drawbacks of decentralization. In Norway, specialized health care has recently been recentralized. In this paper, we review some of the evidence now available on the economic effects of recentralization. Although recentralization has been associated with improvements in both cost efficiency and technical efficiency this may have been caused by the increasing role of activity-based funding methods used in the allocation of health care resources. However, recentralization was also associated with an increase in the rate of growth of real resources and the proportion of total costs being met by supplementary funding. As a result, recentralization failed to address the issues of cost containment and reductions in budget deficits. (c) 2007 Elsevier Ltd. All rights reserved.
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