[What explains the growth of national insurance expenditure for primary health care?].

BACKGROUND

Fee-for-item payments are the main source of remuneration for primary care physicians in Norway. Physicians receive a major part of these payments from the National Insurance Administration. The present study describes the development in the National Insurance Administration expenditure for primary physician services in Norway from 1990 to 2000.

MATERIAL AND METHODS

The analyses were performed on accounting data from the National Insurance Administration and data on the number of physician per 10,000 population from Statistics Norway.

RESULTS

From 1990 to 2000, expenditure increased by 84%, from NOK 863.8 million to NOK 1.58 billion. Our main finding is that a substantial part of this increase can be explained by increases in the number of primary care physicians, population size, and the level of fees.

INTERPRETATION

One interpretation of our findings is that National Insurance Administration expenditure on primary physician services to some extent can be controlled by regulating the number of physicians practicing with reimbursement from the National Insurance Administration and the level of fees.