Adoption of new health care services in Norway (1993-1997): specialists' self-assessment according to national criteria for priority setting

Abstract

Objectives: To identify health care services adopted in Norway in the period 1993-1997, and examine them according to proposed national guidelines for priority setting. These guidelines define core services.

Design: Two-stage self-administered questionnaire.

Setting: The Norwegian public healthcare system.

Subjects: Presidents of all relevant specialist and sub-specialist associations in the Norwegian Medical Association (n=56).

Outcome measures: Number of adopted services satisfying the priority criteria of core services, according to physician's self-assessment. Number and type of interventions suited for the priority-setting criteria.

Results: Thirty-two percent of new technologies satisfied the definition of core services according to specialists' own assessment. Of the 88 responses analysed for the second stage of our survey, fifteen answers (17%) indicated lack of applicability of the priority setting criteria. Loss of applicability was related to diagnostic and procedure-related technologies.

Conclusions: Less than one-half of the assessed technologies adopted in Norway in the period 1993-1997 satisfy proposed national criteria for priority setting. The guidelines are applicable for most interventions, but fail in most evaluations of diagnostic and procedure-related improvements. Independent and systematic evaluations of new technologies are needed within the context of priority setting.