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HELSEVEL-Gode og effektive helse-, omsorgs- og velferdstjenester

Prioritizing Care: emerging dilemmas in the Norwegian care service landscape (PriCare)

Alternative title: PriCare

Awarded: NOK 14.6 mill.

In the PriCare project, the main goal is to develop new knowledge and insight into the (re) design of the health and care service in Norwegian municipalities, with a special focus on dilemmas, consequences and prioritization challenges for the entire care chain. After collecting both quantitative and qualitative data in 2019, the activities in 2020 have been analyses and writing. For the quantitative part of the project, we have investigated trends in development of the municipal health and care services. The results show that the services in the municipality are becoming increasingly specialized where services are targeted toward different patient groups and different needs. This development is especially seen in larger municipalities with a sufficient volume to be able to carry out such specialization. This means that the services in the municipalities are increasingly moving from being a generalist service to becoming a specialized service. We continue to analyse different typologies for service provision and will further look at how different ways of arranging the services have an impact on the allocation and quality of services. The qualitative part of the project focuses on understanding how priorities in the services are made and explained. Several articles shedding light on, among other things, management, design of priorities among municipal leaders and principles, values and dilemmas that emerge in municipal prioritization work are in process.

Over the past decade, there have been shifts in the care service responsibilities, tasks, focus and organization, creating a new care service landscape. The municipalities have considerable autonomy in designing their services, leading to heterogeneous care service provision models. To develop services within budget limits, municipal leaders and local politicians are facing tough priorities. This project will produce novel insight into the (re)design of Norwegian municipal care services by exploring the care service landscape, the inherent prioritizing dilemmas and consequences for the service chain. The care services have steadily expanded; most of this growth has taken place in the home care services. At the same time, there has been an increased focus on short-term stays in nursing homes. In the home care services, there has also been increased focus on the reorganisation of services. Moreover, there is an increased focus on new types of services delivery, such as home care reablement and use of welfare technology. In this landscape of services in change, we lack knowledge of how service development unfolds in different municipalities, how municipalities prioritize giving rise to new service provision models, altered distribution and desirable and undesirable consequences for service delivery. In this project, we will explore these questions. The empirical analyses will build on a combination of data sources including register data (IPLOS and KOSTRA), a survey among Norwegian municipalities and a case study in a selection of municipalities representing different care service delivery models. In the case study, we will draw on field observations, document analysis and interviews with municipal managers, politicians, healthcare professionals, and users as well as their next of kind. The project will build a database and methodology suitable for continuous analysis of service trends in the municipal care service landscape.

Publications from Cristin

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HELSEVEL-Gode og effektive helse-, omsorgs- og velferdstjenester