Aasland Olaf Gjerløw, Hagen Terje P, Martinussen Pål E
Legeforeningens forskningsinstitutt, Postboks 1152, Sentrum 0107 Oslo.
Tidsskr Nor Laegeforen. 2007 Sep 6;127(17):2218-21.
The Norwegian hospital reform of 2002 aimed at improving several aspects of the health-care service, i.e. the definition of responsibility between hospitals and their owners, equality in access to hospital-based health services, the quality of medical work, organisation of hospitals and productivity. This paper describes to what extent hospital-based physicians consider these aims to have been achieved.
A postal questionnaire was disseminated to 2 500 hospital-based physicians in January 2006. The questions comprised work conditions and remuneration, organisational matters and the perceived results of the 2002 hospital reform. The respondents were asked to compare the situation in 2006 with the pre-reform situation, and to assess whether the situation was closer or further away from the aims.
1,298 of the doctors responded, i.e. a response rate of 53%. The average opinion was that the aims regarding organisation, access to hospital-based health services, and quality of medical work had become more distant. 38% stated that the aim to improve the quality of medical work was more distant than before the reform as opposed to 8% who perceived it as being closer. 58% of the physicians thought productivity had increased after the reform. There were some regional differences; e.g. the physicians in the southern region experienced stronger than those in the other four regions that responsibility between hospitals and hospital owners was less defined and the quality of medical work was worse than before the reform. 49% of the respondents felt that the hospital reform had mainly had a negative impact on hospitals, whereas 18% felt that the impact had been positive.
2002年挪威的医院改革旨在改善医疗服务的多个方面，即医院与其所有者之间的责任界定、获得医院医疗服务的平等性、医疗工作质量、医院组织和生产率。本文描述了医院医生认为这些目标在多大程度上得以实现。
2006年1月向2500名医院医生发放了邮政调查问卷。问题包括工作条件和薪酬、组织事项以及对2002年医院改革成效的看法。要求受访者将2006年的情况与改革前的情况进行比较，并评估现状与目标的差距是缩小了还是扩大了。
1298名医生回复，回复率为53%。总体看法是，在组织、获得医院医疗服务以及医疗工作质量方面的目标差距扩大了。38%的人表示，改善医疗工作质量的目标比改革前差距更大，而认为差距缩小的占8%。58%的医生认为改革后生产率有所提高。存在一些地区差异；例如，南部地区的医生比其他四个地区的医生更强烈地感受到医院与医院所有者之间的责任界定不如以前明确，医疗工作质量比改革前更差。49%的受访者认为医院改革主要对医院产生了负面影响，而18%的人认为影响是积极的。
