Substantial regional differences exist in the utilization of health care within OECD countries, but knowledge remains scarce on the causes and consequences thereof. Understanding mechanisms behind the regional differences is crucial to enable the construction of efficient policies to meet the surging needs of an aging, multicultural and relatively decentralized Norwegian population.

We will provide policy relevant knowledge on effects of travel distances on regional distribution of health care personnel, on regional utilization of health care (primary and specialist) and on possible regional variation in indicators of patient recovery. Since travel distance and consequences thereof can be affected by policy, perhaps most easily by the geographic location of health care services, our suggested analyses will be directly relevant for policy design. Indeed, securing qualified personnel, and knowledge on what makes them allocate rurally, may be one of the most important challenges in meeting the expected surge in health care needs of aging OECD-populations.

We will combine several population-wide, individual-level data registers to undertake these novel analyses. Using the exact geographic location of the home of all Norwegian residents and health care providers (hospital, office of one's general practitioner, etc.), we calculate travel distance between the locations. We also know everyone's education and where they work, and we have several (admittedly imperfect) indicators of health care utilization and health outcomes, by health care provider (consultations, hospitalizations, disability benefits, employment, mortality, etc.).

More specifically, we will use unique population-wide individual-level register data to:

  1. Describe elements of costs of health care related to geography, including future regional projections.
  2. Estimate effects of costs related to travel distance from home to (and between) health care providers on demand for health care.
  3. Estimate determinants of location of health care personnel, and estimate effects of indicators of care quality and location on indicators of patient recovery.

Project manager: Ingrid Huitfeldt

Participants:

  • Simon Bensnes (Statistics Norway)
  • Rosanna Johed (Statistics Norway and University of Oslo)
  • Marte Rønning (Statistics Norway)
  • Judy Rees (Dartmouth College, USA)
  • Mark Votruba (Case Western University, USA)
  • Venke F. Haaland (University of Stavanger, Norway)
  • Anna Godøy (Institute for Research on Labor and Employment, UC Berkeley, USA)
  • Jonas Hjort (Columbia University, USA)
  • Sigurd Høye (University of Oslo, Norway)
  • Ashna Arora (Columbia University, USA)
  • Olmo Silva (London School of Economics, UK)
  • Jon Fiva (BI)
  • Astri Syse (Norwegian Institute of Public Health)
  • Kjetil Telle (Norwegian Institute of Public Health)
  • BI, Norway
  • Case Western University, USA
  • Columbia University, USA
  • Dartmouth College, USA
  • Institute for Research on Labor and Employment, UC Berkeley, USA
  • London School of Economics, UK
  • Norwegian Institute of Public Health
  • University of Oslo
  • University of Stavanger

Funder: Norwegian Research Council (prosject number 256678)

Period: 2018-2022