Geographical differences in municipal elder care in Norway
This scoping review addresses geographic differences in Norwegian municipal elderly care, and is based on Arksey and O’Malley’s methodological framework for scoping reviews. This summary includes 64 research studies and development works published between 2007 and 2022 with empirical relevance to the Norwegian context. The main purpose of this summary is to compile and make accessible research as well as policy documents on geographic differences in municipal health and care services related to elderly care.
The Coordination Reform of 2012 gave increased tasks for municipal elderly care and a need for more specialised expertise. Distances, climate and weather, as well as a geographically uneven population distribution and an ageing population, create geographically different conditions for different municipalities to fulfil their obligations. In addition, the municipal income system contributes to geographic variation between municipalities due to the provision of only a partial income equalisation.
There is variation in local organisation and distribution of services, and studies suggest that service recipients from rural areas are more satisfied with the services they receive.
Many older service recipients wish to remain at home. Challenges such as distances and access to relevant services, housing policy, and a lack of suitable homes complicate this; urban areas have shorter distances and better access to services than rural areas. There is also an increasing national shortage of healthcare personnel, projected to be particularly problematic in rural areas. Employees in rural areas experience small professional communities, long distances, and closely knit relationships with their local community. It is thought that welfare technology can help bridge the gap between needs and capacity.
We see a research field with papers from many research disciplines, including interdisciplinary efforts. The scope of research literature has doubled from 2018 to 2022. Most research is empirical, with slightly more use of qualitative than quantitative methods. There are few analyses on a systemic level, national studies, or case studies with both rural and urban case municipalities. Conceptualisation of geographic differences is diverse and often only made explicit in texts on rural issues.