[Consultations with specialists in private practice in a Norwegian district].
BACKGROUND
After the Norwegian hospital reform of 2002, there has been increased acceptance of private-sector health-care providers. Still, the use of specialist services in private practice is less well documented. This article explores the use of private specialist health care in the south-east of Norway.


METHODS
The article is based on several sources of data, including data from the Norwegian Patient Register and from the National Insurance Administration on reimbursements. Also a survey was sent out to a sample of general practitioner; in-depth interviews were carried out with a sample of hospital physicians and private specialists.


RESULTS
The article shows that private specialists with contract with Helse Øst provided 151 consultations per 1000 inhabitants over the period September to November 2003, while the public outpatient clinics provided 186 consultations. The service provision varies geographically and between specialties. In one county the use of private specialists is 174 consultations per 1000 inhabitants; in another it is 80 per 1000 inhabitants. Private-sector specialists within the fields of eye, ear-nose-throat and skin provided two thirds of all outpatient services in their respective fields.


CONCLUSIONS
The results indicate that the services of specialists in private practice should be more focused on and discussed in relation to integrated healthcare and the relationship between specialised hospital services and primary healthcare.
Kjekshus
Lars Erik
LE
Forskningsprogram for ledelse og organisering i helsesektoren (HORN), Institutt for helseledelse og helseøkonomi, Det medisinske fakultet, Universitetet i Oslo, Postboks 1089 Blindern, 0317 Oslo. l.e.kjekshus@medisin.uio.no
Jørgenvåg
Ronny
R
D000553:Ambulatory Care / Q000706:statistics & numerical data; D005194:Family Practice / Q000706:statistics & numerical data; D020445:Hospitalists; D006801:Humans; D008511:Medicine / Q000706:statistics & numerical data*; D009664:Norway; D010821:Physicians, Family; D017149:Private Sector / Q000706:statistics & numerical data*; D017150:Public Sector / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012051:Reimbursement Mechanisms; D013038:Specialization; D011795:Surveys and Questionnaires