Helge Garåsen The Trondheim Model - NSDM

Primary and secondary level care providers also need to achieve consensus on when a patient
is ready to be discharged from a general hospital. In a Swedish white paper “Døden angår oss
alla” (“Death concerns us all”) (51), it is concluded that the definition “ ready to be
discharged” or “medically finished care at a general hospital” is an administrative decision
that is dependent on several different factors; for example:
- How many beds are available?
- How many other patients are admitted?
- What kind of care is available at other general hospitals or in community care?
- The competence of the physicians and the resources at the general hospital.
- The competence of the health professionals at primary level.
The city general hospital (RiT; = St. Olavs University Hospital) and the municipality of
Trondheim developed their own set of criteria in 1994, which is still in use, defining when a
patient is ready to be discharged (53):
- Before being defined ready to be discharged the disease(s), which was the reason for
admission to the general hospital, must be examined and treated properly.
- Functional problems caused by the disease(s) must also be examined and treated
properly.
In England there have been discussions for several years on what decent level of health care
for older people might be (54). The British service framework for older people, from 2001,
has set out standards to improve the experience for older people and their carers who use
health care, social care and other services. However, care for older people in Britain is, in
2006, not yet integrated and still remains fragmented, and therefore services have made
limited progress towards the frameworks’ targets (54).
2.3 Patients’ rights
Several countries, e.g. Sweden (55) and Norway (56), have implemented legislation on
patients’ rights as far as health care provision is concerned.
The objective of the Norwegian law is to ensure that the population has equal access to health
care of good quality by granting patients individual rights in relation to health services. The
provisions of the act are intended to contribute to the promotion of a relationship based on
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