Policies addressing delayed discharges from hospital in Norway

Abstract Background Two recent initiatives in Norway that aim to address delayed discharges are the establishment of municipal emergency care beds and the formation of formal partnerships (Health Communities) between hospitals and the municipalities within their catchment area. Methods A review of academic and grey literature, media reports and relevant organisational websites. Results Since 2016, municipalities have provided municipal emergency inpatient care (as well as emergency outpatient care). Municipal emergency care beds are intended for short-term stays of a maximum of three days, allowing the municipality to organise necessary measures before the patient is transferred to their permanent residence (whether it is a private home, shared living facilities or a nursing home). A retrospective cohort study using registry data for 2010-2016 found that municipal acute units were associated with a statistically significant reduction in both aggregated mortality and hospital readmission rates. The effect was largest in the oldest patient cohort. Due to a policy initiative in 2019, Health Communities between hospitals and municipalities have been established nationwide to improve coordination, planning and development of services. Health Communities play an important role in facilitating specialist services in the community, particularly in mental health. The goal is that outreach hospitals will provide more healthcare in patients’ homes, collaborate better with municipal health and care services, both in person and virtually, and work more closely with other hospitals. Hospital outreach services have received positive evaluations. However, in most regions of Norway, the exchange of information between specialists and primary health care remains a barrier when discharging patients. Conclusions The experience in Norway illustrates the importance of mechanisms for ensuring the collaboration of hospitals with their surrounding communities.