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Related Experiment Video

Updated: Jun 18, 2026

Evaluating the Effect of Roadside Parking on a Dual-Direction Urban Street
14:55

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Published on: January 20, 2023

When Policy Meets Reality: Municipal Leaders' Views Amid Rising LTC Expenditure.

Trond Tjerbo1, Terje P Hagen1, Jon Helgheim Holte1

  • 1Department of Health Management and Health Economics, University of Oslo, Norway.

Health Services Insights
|January 19, 2026
PubMed
Summary

Long-term care costs are rising due to younger users with complex needs and workforce shortages. Municipal leaders face challenges managing these costs due to fiscal asymmetries between national policies and local budgets.

Keywords:
Norwayfiscal federalismhealth care expenditurehealth care workforcelong-term caremental health servicesmunicipal governance

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Last Updated: Jun 18, 2026

Evaluating the Effect of Roadside Parking on a Dual-Direction Urban Street
14:55

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Published on: January 20, 2023

Area of Science:

  • Health Economics
  • Public Health Policy
  • Healthcare Management

Background:

  • Long-term care (LTC) expenditure in Norway significantly outpaces GDP growth.
  • While aging is a known factor, younger users (<60 years) represent a disproportionate share of high-cost LTC users.
  • In 2019, the top 5% of high-cost users accounted for 39% of total LTC expenditures.

Purpose of the Study:

  • To investigate municipal leaders' perceptions of key drivers behind LTC expenditure growth.
  • To identify the most pressing challenges faced by municipalities in managing LTC costs.

Main Methods:

  • Semi-structured interviews were conducted with 13 municipal leaders from November 2023 to February 2024.
  • Thematic analysis was employed to explore leaders' perspectives on expenditure growth, its causes, and associated challenges.
  • Municipalities were strategically selected across KOSTRA groups to ensure demographic and financial diversity.

Main Results:

  • Municipal leaders highlighted younger users with complex mental health needs as a significant cost driver.
  • Workforce shortages were identified as forcing reliance on expensive external services.
  • Expanding rights and mandates, coupled with fiscal asymmetries, create a gap between service expectations and municipal capacity.

Conclusions:

  • LTC expenditure growth is influenced by both demographic trends and governance issues.
  • Younger users and workforce challenges directly increase costs.
  • Fiscal asymmetries hinder municipalities' ability to adapt services to available resources, exacerbating cost pressures.