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Report

Commonwealth Fund survey of persons aged 55 years or more: Results from Norway and ten other countries

Norway, by the Norwegian Knowledge Centre for the Health Services, is participating in the Commonwealth Funds annual international survey of health systems. The target group for questions about various aspects of health care in 2014 was, for the first time, adults aged 55 years or more.

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  • Issued/Revised: 11.2014
  • By: Kunnskapssenteret
  • Sjetne IS, Skudal KE, Haugum M, Bjertnæs ØA, Lindahl AK, Nylenna M. Commonwealth Fund survey of persons aged 55 years or more: Results from Norway and ten other countries, Kunnskapssenteret. Report 11.2014. ISBN (digital): 978-82-8121-908-3, ISSN (digital): 1890-1298. Available at www.fhi.no/en

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Norway, by the Norwegian Knowledge Centre for the Health Services, is participating in the Commonwealth Funds annual international survey of health systems. The target group for questions about various aspects of health care in 2014 was, for the first time, adults aged 55 years or more.

The report shows the Norwegian results and comparisons with the other participating countries. The results show that there are few areas where Norway performs particularly well and many areas where one can observe better practices in the other countries. Overall, the results of this study are in line with what similar surveys have shown previously, in a slightly different population.

Judging by the shortcomings of the Norwegian health system performance compared to similar countries, the following areas stand out as in need of improvement:

• User involvement

• User orientation

• Coordination between services

• Resource utilization (better utilization of the users' own resources)

• Accessibility, in terms of reduced waiting

On the other hand, the proportion giving a positive overall assessment of health care is large in Norway. Less people than in the other countries must refrain from healthcare due to financial constraints, and more people choose to do without additional insurances.

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Background

Norway, by the Norwegian Knowledge Centre for the Health Services, is participating in the Commonwealth Fund’s (CMWF) annual international survey of health systems. The target group for questions about various aspects of health care in 2014 was, for the first time, adults aged 55 years or more.

Objective

The survey is part of CMWFs "International Health Policy" program. The aim of the program is to provide a basis for rethinking health policy and to provide input for decision-makers in the participating countries.

Method

The survey was conducted by telephone interviews in eleven countries, Australia, Canada, France, Germany, Netherlands, New Zealand, Norway, Sweden, Switzerland, UK and USA. The questionnaire was identical in all participating countries, with some local adaptation. The questionnaire included questions about access to health care, the relationship with their GP, service coordination, use of prescription drugs, the experiences of hospital admissions, chronic conditions, activities of daily living, help and assistance, health promotion, informal care, end of life care and issues concerning payment and insurance. A representative sample of the adult population aged 55 years and older were included. Norstat did the interviews in Norway. The material was weighted to make the data representative of the survey population in each participating country.

Results

The response rate varied between 60% and 16% among the countries, with the lowest in Norway. Sample sizes ranged from 7206 in Sweden, and 750 in New Zealand. Norstat made 1000 telephone interviews in Norway. The report shows the Norwegian results and comparisons with the other participating countries. The results show that there are few areas where Norway performs particularly well and many areas where one can observe better practices in the other countries. When compared with the other countries Norway is doing better in these areas:

  • Less individual limitations in the use of health care due to cost
  • A larger proportion have regular doctor
  • Improved access to out of hours health services
  • A greater percentage provide informal care to others who need it, and of those, the percentage who provide care to people outside the family is larger
  • A greater proportion choose to be without private insurance
  • A lower proportion experienced problems with paying for health care
  • Better overall assessment of health care

Compared with the other countries Norway is doing poorer in these areas:

  • Fewer get an answer the same day when they call their regular doctor's office with a question during opening hours
  • More waiting for doctor's appointment
  • Fewer finding that GP give enough time, encourage them to ask questions or explain things so they are easy to understand
  • Waiting time for an appointment with a specialist is longer  Several have experienced that GP seemed poorly updated on efforts made by specialist
  • Fewer have found that GP / regular place helps with coordination of health services
  • Fewer experienced that specialists told about treatment options and specialists involving patients in decisions about their own health care
  • Among people who use regular medication far fewer in Norway report that measures pertaining to medication review is conducted
  • Among people who have experienced discharge from the hospital, there are far fewer in Norway who have received information that are useful for coping with their condition at home
  • A lower proportion in Norway describe their health as "Good," Very Good "or" Excellent "
  • Fewer in Norway have confirmed having received information to facilitate their management of chronic conditions
  • Among people with a chronic condition, there are fewer who have a treatment plan, and the Norwegian respondents are more cautious when it comes to the benefits of the plan they have
  • Fewer in Norway has a health care professional who can provide support between doctor visits
  • More users of tobacco in Norway, and among them less have received information about health risks and advice regarding tobacco cessation
  • Expressed in number of hours, the group aged 55 years or more provide less informal care to others
  • Far fewer have taken a position on how decisions should be made if they can not express their own preferences with regard to end of life care themselves

Conclusion

Overall, the results of this study are in line with what similar surveys have shown previously. Judging by the shortcomings of the Norwegian health system performance compared to similar countries, the following areas stand out as in need of improvement:

• User involvement

• User orientation

• Coordination between services

• Resource utilization (better utilization of the users' own resources)

• Accessibility, in terms of reduced waiting

On the other hand, the proportion giving a positive overall assessment of health care is large in Norway. Less people than in the other countries must refrain from healthcare due to financial constraints, and more people choose to do without additional insurances