Finansieringen av norske somatiske sykehus - Endringene i sykehusenes finansiering fra ca.1970 til 1997
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Siden 1980 har vi i Norge gjennomgått to skift i finansieringsordningen for norske somatiske sykehus. Overgangen fra liggedøgnsrefusjoner til rammefinansiering og fra sistnevnte til innsatsstyrt finansiering. Denne oppgaven ser nærmere på hva disse systemene inneholder og hvorfor de velges. Samtidig tar oppgaven sikte på å forklare finansieringssystemenes historie.The history of the financial systems of Norwegian somatic hospitals has not only been a journey of debating how the challenges of financing hospitals should be faced. It has also been an important chapter in the story of building the Norwegian state and the establishment of common arrangements for the Norwegian welfare-state. Three different systems have had their reigns. The first was based on pay per day, which meant that the hospital and its owner, the local county administrations, were given a refund by the government for each day a patient spent in the hospital. This system was in 1980 set aside for a system that based the government's grant to the local county administrations on objective criteria, such as the demographic composition in the county municipals. This system was called rammefinansiering" or framework subsidies . After many years of debates, evaluations and thoroughly reports to the Storting, many alternative financial systems were analysed because of reported weaknesses within this system. A change didn't happen before 1997 when a more reform-willing Minister of Health was appointed. The new system was called ISF or pay per performance and was a combination of the previously framework subsidies and a system called pay per piece, that was based on the American DRG-system. This study sets out to explore why Norway chooses these types of systems. By analysing public documentation, debates and other sources, I will explain why these changes happen. It's also important in this study to find out what has been done for changing the financial scheme and what were the largest weaknesses in the systems that didn't work? Through a chronological evaluation of this process I will also try to present the history of the Norwegian financial systems. Where the ideas came from and what opinion politicians and others in-concern thought of these.