Content
About the statistics
Definitions
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Name and topic
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Name: Municipal health care service
Topic: Health
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Responsible division
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Division for Health, care and social statistics
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Definitions of the main concepts and variables
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Man-year
These data are intended to embrace all kinds of activities within the home based services and the institutions, and are not only restricted to health care functions. The data also contain administration and management personnel and as far as the institutions are concerned, kitchen and cleaning functions etc. The personnel are registered on the basis of their formal education by December 31st. The figures are reported in man-years, which means that the total numbers of part-time employees are converted into number of full time employees. Thus the total number of man-years is based on the assumption of stability among the personnel during the year. Employees without the specified education are recorded in collective groups.
Man-years - positions
For personnel, the recording unit is hours per week, and applies to hours set for those with permanent full-time or part-time positions. The number of hours per week is recalculated into man-years (full-time positions) by dividing the number of contract working hours per week. In practice this means that we have divided by 36 hours for physiotherapists and 37.5 hours for Doctors, and 35.5 for the other occupational groups.
Organisation
Organisation means the forms of association the individual physicians and physiotherapists have with the municipality. Municipalities offer practitioners four possible forms of association. The two most common forms are fixed salary and contract.
Physicians and physiotherapists with fixed salaries
Physicians and physiotherapists with fixed salaries are municipal employees, in municipal medical officer or physiotherapist positions advertised by the municipality. These positions may be full or part-time. The municipalities cover all expenses of the positions, but the National Insurance scheme provides fixed grants to the municipalities per position. The duties of these fixed-salary physicians and physiotherapists are set by municipal instructions.
Physicians and physiotherapists with municipal contracts
Physicians and physiotherapists with municipal contracts are basically private practising physicians and physiotherapists who sign an agreement with the municipality or borough. The provisions of this agreement are based on an agreement between the Norwegian Association of Local Authorities, Ministry of Health and Care Services and the physicians' and physiotherapists' organizations. The agreement implies that all physicians are obliged to participate in the medical duty service and municipal responsibilities such as care of the elderly and preventive medicine. How much the individual doctor is to perform these duties and the opening hours of the curative practice are defined in the specific agreements between the individual practitioner and the municipality/borough. The basis of the income of physicians and physiotherapists with municipal agreements is National Insurance reimbursements, patient co-payments and a fixed amount (operating grant) from the municipality as compensation for the agreement. Physicians and physiotherapists with combinations of fixed salary part-time positions and part-time contract practice are regarded as practitioners with a municipal contract.
Physicians and physiotherapists without municipal contracts
There are also practitioners with private practices who do not have a contract with the municipality. For the individual patient, it is of no financial significance if you go to a mandatory practitioner, doctor with fixed salary or doctor with a municipal contract. Physicians without a municipal contract may, with certain limitations, take as high a co-payment as the patient is willing to pay.
Following changes in sections 5-4, 5-7 and 5-8 of the National Insurance Act of 1 July 1998, national insurance reimbursements are no longer to be paid to private practising health professionals who do not have an operating agreement with the municipality or county. Exceptions have been made for general practitioners pending the introduction of the regular GP scheme.
Vacant authorised posts/ positions
Authorised posts or fixed-salary positions that are vacant at December 31st due to leave, illness or other reasons, are regarded as filled if the absence is less than four months, otherwise it is regarded as vacant.
Overtime
From the statistical year 1994, data on man-years worked by physicians also include hours worked under extended working time agreements pursuant to the central union federation special agreement between the Norwegian Association of Local Authorities and the Norwegian Medical Association. This agreement permits, for up to one year at a time, the signing of an agreement on extended working hours beyond 37.5 hours per week. Overtime work beyond this is not included.
Users of home based services
The figures cover all users of home help and home nursing or both services that were registered as active users at the end of the year. In general every person receiving services is regarded as one user, with one exception; households consisting of two or more persons receiving help are regarded as one user.
Institutions
These are defined as a group of buildings where parts of the floorage are shared between residents, the household is common and care personnel are present 24 hours a day. This definition embraces all kinds of institutions falling under the law mentioned above and are as follows: nursing homes, old peoples homes, combined nursing and old peoples homes and in addition various municipal dwellings with full-time services.
Dwellings for the aged and disabled
This category includes other kinds of municipal dwellings reserved for persons in need of help because of old age or handicap. They are also offered to mentally retarded persons who have left the traditional institutions according to a major reform concerning this group of disabled in 1991. These dwellings are not included in the institution-category, as they do not have a full-time service offer, and the residents own or pay rent for the dwelling. Some of them have care and nursing services during parts of the day. The other dwellings do not have this offer, and the residents are instead users of the home based services in the same way as other ordinary users. Many of these flats are adjusted for functionally disabled residents and some of them do also have to some extent common floorage and household.
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Standard classifications
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The 429 municipalities are grouped into 16 groups by population and economic conditions. The classification is based on Audun Langørgen and Rolf Aaberge (2011): Classification of municipalities by population and economic conditions of 2008. Report 2011/8, Statistics Norway. In the calculation of average figures for the county, municipalities are divided into 19 counties by the current standard for municipality classification (two first digit).
Regional statistics
The counties are divided into five groups. The classification is identical to subdivisions of counties in health regions apart from that there is established a separate group for Oslo.