The function of the Norwegian municipal acute units fails to fulfill the intention of health authorities

• Main Authors: Anne-Kari Johannessen (Author), Sissel Steihaug (Author)
• Format: Book
• Published: Taylor & Francis Group, 2020-01-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 0281-3432; 1502-7724; 10.1080/02813432.2020.1717085
• Keywords: municipal acute unit; municipal healthcare; collaboration; elderly; qualitative research; Public aspects of medicine; RA1-1270
• Source: Scandinavian Journal of Primary Health Care, Vol 38, Iss 1, Pp 75-82 (2020)

Objective: The aim of the study was to explore healthcare providers' perceptions of how Norwegian municipal acute units (MAUs) possibly can reduce hospital admittance and improve service integration. Method and material: Qualitative data were drawn from individual interviews with 40 healthcare providers, including general practitioners and staff in Norwegian MAUs, purchasing offices and home-based nursing services. Interview transcripts were analysed using systematic text condensation. Setting: Two MAUs operated by 12 municipalities in eastern Norway. Results: The healthcare providers disagreed on what MAUs are and should be. Frequent discussions between providers about which patients are appropriate for MAUs, as well as time- and resource-consuming procedures for patients' admittance and discharge, have hampered the efficient operation of MAUs. Although, MAUs are operated by municipalities, the providers expressed that the units represent a new level of organisation with new boundaries for collaboration. Having many physicians in part-time positions and lacking physicians during night shifts were also characterised as problematic. Conclusion: Several healthcare providers expressed uncertainty about the appropriateness of maintaining MAUs in Norway's healthcare system, given their questionable capacity to meet Norwegians' healthcare needs. It may appear that the MAUs are designed first to identify appropriate patients instead of identifying and mapping the population's needs and, thereafter, designing optimal healthcare services.KEY POINTS As of 2016, Municipal Acute Units (MAUs) are statutory healthcare services in Norway. Exploring patients' and healthcare providers' views on MAUs can improve the services. Healthcare providers disagreed on which patients were suitable for the units The units were perceived as a new (healthcare) level, entailing a new collaboration arena, with more bureaucracy and time expenditure The patients were satisfied with their treatment and care in the MAUs and the units' proximity to their home