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Organisational changes in Norwegian Hospitals (completed)

Since the end of the last century more than 60 Norwegian hospitals have been reduced to 21 health trusts. In the same time period there have been frequent changes to the internal organization of the hospitals. We follow these changes - investigating what affects them and looking at how they affect important outcome variables such as efficiency and quality.


About the project

This project follows the internal organization of Norwegian hospitals from 1999 to 2009. Surveys of the internal organisation of Norwegian hospitals (INTORG) cover several areas of the hospital organization such as leadership structure, decentralization, use of digital equipment and the hospitals' collaboration with primary health care facilities.  INTORG gives a unique opportunity to look at differences among hospitals and changes over time.

Among the changes identified are:

  • An increased number of leadership levels
  • Increased formalization of leadership responsibilities
  • Some decentralization, - but more responsibilities are also centralized up to the regional health enterprises
  • Increased digitalization

An important discovery is also that while new structures and procedures are taking place, old structures are not automatically replaced. Instead new and old structures often seem to coexist.


INTORG is measured by a survey conducted in 1999, 2001, 2003, 2005, 2007 and 2009. The survey consists of three questionnaires:

  • General (answered by the hospital/health enterprise)
  • Surgical unit (answered by each surgical unit at each geographical location)
  • Medical unit (answered by each medical unit at each geographical location)


The project has been financed by different sources since 2001, including the Norwegian Research Council (NFR), the Health Economics Research Program at the University of Oslo (HERO), Health Organizational Research in Norway (HORN), and the Rokkan Centre in addition to internal research funds at the Department of Health Management and Health Economics at the University of Oslo and SINTEF Health Research.

Start - finish

from 2001 to date

Published Mar. 9, 2011 11:46 AM - Last modified July 27, 2016 2:11 PM


Project leader:
Lars Erik Kjekshus