Regional projections of demand for health and care services, 2017-2035

The Health and Long-Term Care (HC) sector in Norway is of a considerable size. In 2017 it employed 310,000 man-years, which equals 13 percent of total employment. Based on reasonable assumptions the HC-employment is expected to grow as the population increases and ages - by 2035 it may sum up to over 410,000 man-years (Hjemås et al. 2019). Most services in the HC sector are provided locally; either within the municipality or in the hospital referral areas. This motivates investigation of how the increased demand for HC services is distributed across the country.

In this report, employment in health care is projected for the hospital referral areas from 2017 to 2035. The projections are based on the following assumptions: 1) the man-years required to produce the HC-servicers demanded by an average person of a given gender and age is the same in all regions and equal to the labor requirement at the national level in 2017. 2) the demographic development is the same as in Statistics Norway’s regional population projections from 2018. The aim of the analysis is to improve the informational basis for decisions on capacity extensions in the HC-sector, including the regional HC-labor demand, by examining how regional population dynamics affects the local demand for health care.

The HC-demand depends on both population size and composition, especially with respect to age and location. The population pattern in Norway is becoming increasingly centralized and life expectancy is rising. This causes population ageing, with especially many projected elderly people in central areas. The use of HC-resources increases significantly with age. This causes the central locations in Norway to have the highest projected growth in health care employment.

Non-central areas have the highest proportion of elderly people in 2017 and projected for 2035. Regional differences in old age dependency ratios, the number of elderly people relative to people of typical working age, may have implications for local recruitment to the HC-sector.

The hospital referral areas of Ahus and Oslosykehusene, as well as other central areas such as Bergen and Vestre Viken, face he strongest projected increase in HC-man-years from 2017 to 2035, amounting to 33-44 per cent. Non-central areas such as Sogn og Fjordane, Finnmark and Helgeland face the slowest projected growth of about 25 per cent. The projected growth is particularly large in the municipal nursing and care services.