Forhold ved norske akuttmottak, fra et helseadministrativt synspunkt

Objective This paper looks at how the emeergency departments (EDs) in Norway are organized, their function and what challenges lies ahead in their future. It will also be discussed how other countries organize their emergency department, and how the doctors work within the department. Background The Norwegian board of Health Supervision criticized in 2007 almost all of the 27 emergency departments they had controlled. Many lacked efficient management and consistent treatment. They recognized that managing an ED contains many challenges and are somewhat different from other departments in a hospital. The Office of the Auditor General of Norway made many of the same remarks in their rapport from 2005/06. Method This literature study studies rapports from Norwegian health offices and committees, and literature on how other countries have organized their EDs. Trends in the international community when it comes to organizing EDs, and specially emergency medicine as an own specialty for doctors has been studied. Results Norway has 54 EDs with a wide range of organizational structures. Some are organized under medical department, others by themselves. Due to Norway’s scattered population, the size of the EDs vary from small local hospitals to University hospitals. Among the proposed measures was to follow international trend and make emergency medicine an own specialty. A committee from 2007, concluded that an own specialty was not the way to improve emergency care in local hospitals, despite the obvious international trend. Norwegian topography, distances and organization of health care made it difficult to directly implement international measures. Interpretation In recent years ED in many countries have looked towards the Anglo-American system. It is difficult to categorize Norway to either the Anglo-American system or the Franco-German system. Doctors in the ED are not specialists, nor working there regularly. This is a unique organisational structure for doctors in hospital departments. There is definitely more research that should be done on this matter, especially the need for emergency medicine as an own specialty in the larger hospitals in Norway, and effect-studies on which measurements for improvements to implement in EDs