Ragnar Frisch Centre for Economic Research, Gaustadalléen 21, 0349, Oslo, Norway.
Norwegian Institute of Public Health and Department of Health Management and Health Economics, University of Oslo, Postboks, 1089 Blindern, 0317, Oslo, Norway.
Soc Sci Med. 2023 Sep;333:116116. doi: 10.1016/j.socscimed.2023.116116. Epub 2023 Jul 31.
The allocation of public care services should be determined by individual needs, but can be influenced by economic factors. This paper examines the impact of economic incentives on the allocation of public nursing home care in the Norwegian long-term care system. In Norway, municipalities and city districts have economic incentives for choosing nursing home care for high-income individuals in need of care and home-based care in sheltered housing for low-income individuals. The study uses a theoretical model and empirical data from the municipality of Oslo to determine if nursing home spots are allocated based on income, which would be financially advantageous for the city districts. We do not find evidence that the economic incentives of the care provider play a role in the allocation of nursing homes. Thus, in this setting, needs seem to be the dominant factor for allocation of nursing home care, while economic incentives seem to play no significant role. The clear legal mandate to provide services based on needs only is likely an important factor in this.
公共医疗服务的分配应该根据个人需求来决定，但也可能受到经济因素的影响。本文考察了经济激励对挪威长期护理系统中公共养老院护理分配的影响。在挪威，市政府和市区对于有经济激励选择养老院护理的高收入有需要的个人，以及对于低收入有经济激励选择庇护性住房的个人。本研究使用了一个理论模型和来自奥斯陆市的实证数据，以确定养老院床位是否根据收入分配，这对市区来说在经济上是有利的。我们没有发现证据表明护理提供者的经济激励在养老院的分配中起作用。因此，在这种情况下，需求似乎是分配养老院护理的主要因素，而经济激励似乎没有发挥重要作用。这种情况下，明确基于需求提供服务的法律授权可能是一个重要因素。
