Helge Garåsen The Trondheim Model - NSDM

documented the benefits of using multidisciplinary teams, close cooperation and
communication between primary and secondary care levels (16).
1.3 Health care consumption among older people in Norway
All Norwegian hospitals have experienced an increase in the number of admitted older people
in the last 10 years (17). In 2004 patients above 70 years of age consumed 31.2 % of all
patients’ days in hospital (18). According to Statistics of Norway the rates in use of hospital
beds among patients above 80 years of age have increased from 428.41 admittances per 1000
inhabitants in 1995 to 608.37 in 2003 (19). Patients above the age of 80, 4.7 % of the total
population (20), occupied 15.3 % of all patient days in hospitals in 2005 (19). At the same
time there has been a reduction in the average number of days in hospital for all patients
groups, from 6.8 days in 1994 to 5.2 days in 2004 (21).
The number of patients in need of primary health care is also high and increasing (22-23).
Romøren estimated in 2001, in his doctoral thesis from the municipality of Larvik, that 52 %
of the inhabitants above 80 years needed community health care, and 14 % needed extensive
care (24). In the city of Trondheim 24.7 % of persons between 80-89 and 43.0 % above 90
years of age received home care in October 2006. At the same time 11.6 % of the population
between 80-89 of age and 43.3 % above 90 were in long-term nursing homes in Trondheim
(25).
Annual reports from the municipality of Trondheim and St. Olavs University Hospital
revealed an increase in hospitalised patients in need of nursing home care from 385 patients in
2001 to 515 in 2003, an increase of 33.8 % in three years (26-28). The number of elderly
above the age of 80 in Trondheim has increased by 18.6 % from 1995 to 2005 (25,29). During
the same period the number of nursing home beds increased with 1.0 %, from 1189 to 1200
beds (28,30), and the number of individuals receiving home care services increased by 18,8%
from 2400 to 2850 individuals. In Trondheim, as in the rest of Norway, a further large
increase is expected in the number of persons above 80 years during the next two decades;
from 6345 in 2006 to 7450 (17,6 %) in 2025 (25,31).
1.4 Financing and organising of health care in Norway
Health care provision in Norway is based on a decentralised model. The state is responsible
for policy design and overall capacity and quality of health care through budgeting and
19