[National health resources for highly specialised medicine].
BACKGROUND
In order to monitor quality and efficiency in the use of health resources for highly specialised medicine, a National Professional Council has since 1990 advised the Norwegian health authorities on the establishing and localisation of such services.


METHODS
A comprehensive review of both the quality, economy and the geographical distribution of patients in each specialised service has been carried out.


RESULTS
33 defined national programmes were centralised to one hospital only and distributed among seven university hospitals. Eight multiregional programmes were centralised to two hospitals only and included four university hospitals. In 2001, a total of 2711 new patients were treated in these programmes. The system seems to have secured a sufficient patient flow to each programme so as to maintain quality. However, a geographically skewed distribution of patients was noted, particularly in some of the national programmes.


CONCLUSIONS
In a small country like Norway, with 4.5 million inhabitants, a centralised monitoring of highly specialised medicine seems both rational and successful. By the same logic, however, international cooperation should probably be sought for the smallest patient groups.
Bratlid
Dag
D
Det medisinske fakultet, Norges teknisk-naturvitenskapelige universitet, 7006 Trondheim. dag.bratlid@ntnu.no
Rasmussen
Knut
K
D002497:Centralized Hospital Services / Q000592:standards / Q000706:statistics & numerical data; D002983:Clinical Competence; D003695:Delivery of Health Care / Q000191:economics / Q000458:organization & administration / Q000592:standards / Q000706:statistics & numerical data; D004470:Economics, Medical; D006291:Health Policy / Q000191:economics; D006295:Health Resources / Q000191:economics / Q000458:organization & administration / Q000592:standards / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000191:economics / Q000458:organization & administration / Q000592:standards / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000191:economics / Q000458:organization & administration / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D007391:International Cooperation; D008511:Medicine / Q000458:organization & administration / Q000592:standards / Q000706:statistics & numerical data; D009664:Norway; D012041:Regional Medical Programs / Q000191:economics / Q000458:organization & administration / Q000592:standards / Q000706:statistics & numerical data; D013038:Specialization