More for less: Why is Norway special? Issues in comparing health costs and outcomes

According to data from the OECD Finland spent only about half as much as Norway on health care per capita in 2005. At the same time Finland did not do dramatically worse than Norway on many measures of health. In general, data from OECD seem to indicate t hat the relationship between health expenditure and outcome is not simply that higher expenditure equals better outcome. The current proposal starts from this simple observation and the puzzle it creates: Why is there such a large gap between expenditures and outcomes? Research on this question is important because it allows us to distinguish between differences between countries that are caused by true inefficiencies and differences that are caused by other and perhaps external factors. Instead of trying to give a complete answer to the question of what is the best system, we propose a more modest approach: trying to identify some important mechanisms and evaluating some proposed explanations. The main issues of the project are: 1. Macro-comparison: To establish the empirical importance of three macro explanations for the measured differences between health care costs and outcomes in the OECD with particular emphasis on the Nordic countries 1.1 Wage and price differences 1.2 Different priorities and inc omplete output indicators 1.3 Genes (with specific attention to hearth disease and osteoporosis) Within each area, we have access to data and methods that will allow us expand the knowledge. 2. Micro-comparison: Identify reasons for differences of costs and outcomes in the treatment of acute myocardial infarction in Finland and Norway. The ambition is to expand the micro-comparison also to other disease areas. This project is joint with Finnish researchers and becomes a pioneer project in applying the ne w Norwegian Patient Register to health economics research. We have together with European colleagues proceeded with an application to the EU 7th framework programme.