A survey of net expenses for emergency primary health care among the municipalities was conducted by Statistics Norway for the reporting year 2023.

It is common among municipalities to combine different forms of arrangements for the emergency primary health care during day and night. A main distinction is found between municipalities that have emergency primary health care solely for their own municipality (one-municipality service) and municipalities that provide the service as an intermunicipal cooperation. 4 out of 5 municipalities organize the service as an intermunicipal cooperation, and 1 out of 5 as a one-municipality service. Intermunicipal cooperation is the most ordinary form of organization, when looking at both counties, population size and centrality. Geographical location, population size, and proximity to neighboring municipalities are all factors that affect how a municipality choose to organize its' emergency primary health care service. One-municipality service, both day and night, is common in the most and least central municipalities. For the latter mentioned, this can e.g. be a result of geography impeding inhabitants to travel to a neighboring municipality.

Currently there is not a function in the municipal accounts specifically for emergency primary health care, hence several municipalities had difficulties reporting their net operational expenses for this service. It was particularly problematic for daytime emergency primary health care expenses, which can be intricately linked to regular general practitioner activity during the day. However, most municipalities were able to report a figure or an estimate. The survey shows that in general, it is most expensive to operate emergency primary health care in municipalities that are least central and have few inhabitants. Net expenses are lowest in one-municipality emergency health care services in the most inhabited municipalities, where there is no dependence on intermunicipal cooperation to achieve economies of scale. For municipalities with 2 000 – 50 000 inhabitants, intermunicipal cooperation is most inexpensive. Statistics Norway has assessed, although there are some uncertainties, that the data on municipal net operational expenses for emergency primary health care service in the 2023-survey, is of sufficient quality to provide a rough estimate for overall expenses for the municipalities. Estimated net operational expenses for emergency primary health care for the municipalities were approximately NOK 3.6 billion in 2023.

Government spending on emergency primary health care was approximately NOK 880 million in 2023. This includes reimbursements and grants. Reimbursement expenses per inhabitant were largest in Finnmark, in the least inhabited and least central municipalities. Inhabitants pay a user fee for emergency primary health care services. Overall inhabitants’ expenses for this service were around NOK 254 million in 2023. In sum, municipal, government and inhabitants’ expenses amounted to NOK 4.8 billion in 2023. The survey shows that the municipalities paid more than three quarters of the total expenses. The government covered just over 18 percent and the inhabitants just above 5 percent of the expenses for emergency primary health care.

In the survey of emergency primary health care expenses among the municipalities, conducted by Statistics Norway for the reporting year 2023, the municipalities were also asked to provide information about how they had arrived at the expense figures reported. Also, they were asked to assess if they would be able to provide and report expense figures of decent quality, if emergency primary health care was to have its own accounting function in the future. Results from this part of the survey and assessments on whether emergency primary health care expenses should have a separate accounting function in the municipal accounts will be presented in chapter 7.