In Norway around 25% of personnel working in the municipal health and care services lack a relevant health-related education (i.e. are unskilled), while at the same time the care need of patients in the community is increasing. We know little about how this affects the quality of services and the safety of patients. In addition, we know little about the consequences of changes in skill mix, e.g. when higher qualified personnel are replaced with personnel with lower qualifications. With skill mix we mean the composition of the various categories of nursing staff providing direct patient care.
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