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

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: 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.