Centre for Care Research, Gjøvik University College, Teknologiveien 22, 2802 Gjøvik, Norway.
Int J Integr Care. 2011 Jan;11(Spec 10th Anniversary Ed):e127. doi: 10.5334/ijic.581. Epub 2011 Oct 7.
The Norwegian health care system is well organized within its two main sectors-primary health and long-term care on the one hand, and hospitals and specialist services on the other. However, the relation between them lacks mediating structures.
Enhancing coordination between primary and secondary health care has been central in Norwegian health care policy in the last decade. In 2003 a committee was appointed to identify coordination problems and proposed a lot of practical and organisational recommendations. It relied on an approach challenging primary and secondary health care in shared geographical regions to take action. However, these proposals were not implemented. In 2008 a new Minister of Health and Care worked out plans under the key term "Coordination Reform". These reform plans superseded and expanded the previous policy initiatives concerning cooperation, but represented also a shift in focus to a regulative and centralised strategy, including new health legislation, structural reforms and use of economic incentives that are now about to be implemented.
The article analyses the perspectives and proposals of the previous and the recent reform initiatives in Norway and discusses them in relation to integrated care measures implemented in Denmark and Sweden.
挪威的医疗体系在其两个主要领域——一方面是初级保健和长期护理，另一方面是医院和专科服务——组织得非常好。然而，它们之间的关系缺乏中介结构。
在过去十年中，加强初级保健和二级保健之间的协调一直是挪威医疗保健政策的核心。2003 年，一个委员会被任命来确定协调问题，并提出了许多实际和组织上的建议。它依赖于一种方法，即在共享地理区域的初级保健和二级保健方面采取行动，挑战这两者。然而，这些建议并没有得到实施。2008 年，一位新的卫生和护理部长在“协调改革”这一关键术语下制定了计划。这些改革计划取代并扩大了之前关于合作的政策举措，但也将重点转向了一种监管和集中化的策略，包括新的卫生立法、结构改革和经济激励措施的使用，这些措施现在即将实施。
本文分析了挪威前几次和最近的改革举措的观点和建议，并将其与丹麦和瑞典实施的综合护理措施进行了讨论。
