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Document no. 3:6 (2001-2002) - Performance-based financing of somatic hospitals

An investigation by the Office of the Auditor General shows that a good many hospitals lack information absolutely essential for the performance-based financing scheme to function as planned. Among other things, this applies to information on resource utilisation and patients on waiting lists. In the assessment of the Office of the Auditor General, this has reduced the ability to fully exploit the potential of the financing scheme to treat more patients.
Published 2/14/2002 12:00 PM

Document no. 3:6 (2001-2002) – The Office of the Auditor General’s investigation of performance-based financing of somatic hospitals was submitted to the Storting on February 14th. Performance-based financing (PBF), introduced in 1997, means that the hospitals are remunerated for each patient treated.

The Office of the Auditor General underscores how important it is for the Ministry of Health and Social Affairs to see to it that better management and reporting systems for operating hospitals are put in place as quickly as possible. Many hospitals’ management reports lack information on patients on waiting lists, resource utilisation and the quality of treatment. In the judgement of the Office of the Auditor General, access to such information is absolutely necessary to enable hospitals to be run in a sufficiently efficient manner.

The availability of medical services is closely linked to the waiting period for the individual patient. Despite this, half of the hospitals’ management reports lack information on patients on waiting lists. It is fair to ask whether the lack of attention in management reports to patients on waiting lists has led to a needlessly long waiting period for many patients.

Since records of patient stays affect the refunds the hospitals receive, they may unintentionally impact the extent to which various patient groups receive treatment. The Office of the Auditor General’s investigation shows that the quality of medical records at hospitals is unsatisfactory. Every third patient stay has been recorded with the wrong main diagnosis.

In its reply the Ministry of Health and Social Affairs emphasises that substantial changes are now underway in the organisation and management of specialist health services. In its work in future the Ministry will include the viewpoints and evaluations that the Office of the Auditor General has presented. This also applies to the further efforts to develop financing schemes that will now take place.


This report is available in Norwegian at the Office of the Auditor General’s website – www.riksrevisjonen.no – or can be ordered from the university bookshop Akademika, tel.+47 22 11 67 70.

Riksrevisjonen, Storgata 16, P.O. Box 8130 Dep, 0032 Oslo, Norway

Phone: +47 22 24 10 00

Org.nr: 974 760 843