Frailty risk and treatment strategy in elderly-onset inflammatory bowel disease. A Norwegian nationwide population-based registry study.

Background/aims: To determine real-world medical and surgical treatment patterns in elderly-onset inflammatory bowel disease in a nationwide cohort, and to investigate associations between frailty and treatment choices.

Methods: Norwegian health registries were used to identify adult-onset (born 1950-1989) and elderly-onset (born 1910-1949) patients with Crohn's disease (CD) and ulcerative colitis (UC) diagnosed 2010-2017 (n = 13,006). Patients were classified as no, low and intermediate/high frailty risk after the Hospital Frailty Risk Score.

Adherence and persistence to pharmacotherapy in patients with heart failure: a nationwide cohort study, 2014-2020.

Aims: We aimed to study initiation, adherence, and long-term persistence to beta-blockers (BB), renin-angiotensin system inhibitors (RASi), and mineralocorticoid receptor antagonists (MRA) in a nationwide cohort of patients with heart failure (HF).

Methods: Patients aged 18-80 years in Norway with a first diagnosis of HF from 2014 until 2020 that survived ≥30 days were identified from the Norwegian Patient Registry and linked to the Norwegian Prescription Database. We collected information about BB, RASi [angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARB), and angiotensin receptor-neprilysin inhibitors (ARNI)], and MRA.

Therapeutic management and outcomes in inflammatory bowel diseases, 2010 to 2017 in cohorts from Denmark, Sweden and Norway.

Background: Despite the increasing use of biologics in patients with inflammatory bowel disease (IBD), real-world data about outcomes in the era of biologics remain inconclusive.

Aims: To investigate trends in surgeries, hospitalisations and medication use in patients with IBD in a multinational, population-based cohort METHODS: We included 42,894 patients with ulcerative colitis (UC) and 24,864 with Crohn's disease (CD) who were diagnosed between 2010 and 2017 in Denmark, Norway and Sweden. We extracted data about surgeries, hospitalisations and medications from national registries and compared across countries and diagnosis years.

A nationwide registry study on heart failure in Norway from 2008 to 2018: variations in lookback period affect incidence estimates.

Background: The incidence of heart failure (HF) has declined in Europe during the past two decades. However, incidence estimates from registry-based studies may vary, partly because they depend on retrospective searches to exclude previous events. The aim of this study was to assess to what extent different lookback periods (LPs) affect temporal trends in incidence, and to identify the minimal acceptable LP.

What are determinants of utilisation of pharmaceutical anticancer treatment during the last year of life in Norway? A retrospective registry study.

Objectives: The objective of this study was to investigate the use of, and predictors for, pharmaceutical anticancer treatment (PACT) towards the end of a patient's life in a country with a public healthcare system.

Design: Retrospective registry study.

Setting: Secondary care in Norway.

Factors associated with the persistence of oral 5-aminosalicylic acid monotherapy in ulcerative colitis: a nationwide Norwegian cohort study.

Background: Oral 5-aminosalicylic acid (5-ASA) is the mainstay treatment of ulcerative colitis (UC) and therapy with oral 5-ASA is associated with beneficial outcomes. We have examined factors associated with the persistence of oral 5-ASA treatment in a national cohort of UC patients.

Methods: Patients with newly diagnosed UC from 2010 to 2014 using oral 5-ASA monotherapy were identified by combining data from the Norwegian Patient Registry and the Norwegian Prescription Database.

Incidence and Prevalence of Inflammatory Bowel Disease in Norway and the Impact of Different Case Definitions: A Nationwide Registry Study.

Background: Countries have different diagnostic procedures and treatment regimens for inflammatory bowel disease (IBD) patients. In addition to differences in population characteristics, completeness of data and health registries, different follow-up time and case definitions can have a large impact on estimates of the incidence and prevalence of IBD.

Aim: The aim of this study was to use hospital and prescription data to estimate incidence and prevalence of Crohn's disease (CD) and ulcerative colitis (UC), using different case definitions.

Using fees to reduce bed-blocking: a game between hospitals and long-term care providers.

In several countries, a fee has been introduced to reduce bed-blocking in hospitals. This paper studies the implications of this fee for the strategic decisions of the hospitals and the long-term care providers. We introduce a Stackelberg game where the hospital is the leader and the care provider the follower.

Incidence, prevalence, and mortality of heart failure: a nationwide registry study from 2013 to 2016.

Aims: Large-scaled population studies of incidence and prevalence of heart failure (HF) are needed for the development of healthcare policies and priorities. The aim of this study was to estimate the incidence, prevalence, and all-cause mortality of HF in Norway from 2013 to 2016 on the basis of a national registry.

Methods And Results: Using data from the nationwide Norwegian Prescription Database, we identified all patients ≥18 years of age in Norway with at least one drug prescription with HF during 2013-2016, defined by 10th revision of the International Classification of Diseases (ICD-10) codes I50, I11, I13, or I42.

Value in Health: How It Is Defined and Used in Priority Setting and Pricing in Norway.

Value in health is a concept that has been used in many different contexts. It is used in debates about priority setting, pricing of pharmaceuticals and payment systems. In the Norwegian context, value in health in priority setting is officially defined as the quality-adjusted life-years produced by an intervention.

Cost-Effectiveness of Noninvasive Screening for Alcohol-Related Liver Fibrosis.

Background And Aims: Alcohol-related liver disease is often undetected until irreversible late-stage decompensated disease manifests. Consequently, there is an unmet need for effective and economically reasonable pathways to screen for advanced alcohol-related fibrosis.

Approach And Results: We used real-world data from a large biopsy-controlled study of excessive drinkers recruited from primary and secondary care, to evaluate the cost-effectiveness of four primary care initiated strategies: (1) routine liver function tests with follow-up ultrasonography for test-positives, (2) the enhanced liver fibrosis (ELF) test with hospital liver stiffness measurement (LSM) for positives, (3) a three-tier strategy using the Forns Index to control before strategy 2, and (4) direct referral of all to LSM.

The Cost-Effectiveness of Multigene Panel Testing for Hereditary Breast and Ovarian Cancer in Norway.

Expansion of routine genetic testing for hereditary breast and ovarian cancer from conventional testing to a multigene test could improve diagnostic yield and increase the opportunity for cancer prevention in both identified carriers and their relatives. We use an economic decision model to assess whether the current knowledge on non- mutation prevalence, cancer risk, and patient preferences justifies switching to a multigene panel for testing of early-onset breast cancer patients. We evaluated routine testing by testing, a 7-gene panel, and a 14-gene panel using individual-level simulations of annual health state transitions over a lifetime perspective.

Cost analysis of mobile radiography services for nursing home residents in Southeast Norway.

Rationale, Aims, And Objective: Telemedicine applications, such as a mobile radiography service, provide a new way of organizing healthcare services. In order to provide safe and personalised care for nursing home residents during X-ray examinations, mobile radiography services have been implemented. The objective of this study was to analyse the costs of X-ray examinations and treatments for nursing home residents when comparing hospital-based imaging with a combination of hospital-based imaging and a mobile radiography service in Southeast Norway.

Regional differences in anti-TNF-α therapy and surgery in the treatment of inflammatory bowel disease patients: a Norwegian nationwide cohort study.

Background And Aims: During the last decades, substantial progress has been made in both medical and surgical treatment of inflammatory bowel disease (IBD). The aim of this study was to determine the use of anti-TNFs and surgery during the first 3 years after diagnosis in IBD patients across the four health regions in Norway using nationwide patient registry data.

Methods: This study used nationwide data from the Norwegian Patient Registry.

Did adolescents in Norway respond to the elimination of copayments for general practitioner services?

Copayments for primary care services may lead to decreased access to and underconsumption of necessary health care for vulnerable patient groups, such as adolescents. In Norway, in 2010, adolescents aged 12 to 15 years were exempted from copayments for general practitioner (GP) services, and the aim of this study is to estimate whether being exempted from copayments led to increases in GP visits. We apply the synthetic control method using the elastic net regression as a data-driven approach to construct a relevant counterfactual from our pool of age groups not affected by the reform.

Did hospitals respond to changes in weights of Diagnosis Related Groups in Norway between 2006 and 2013?

It has been argued that activity based payment systems make hospitals focus on the diagnostic groups that are most beneficial given costs and reimbursement rates. This article tests this hypothesis by exploring the relationship between changes in the reimbursement rates and changes in the number of registered treatment episodes for all diagnosis-related groups in Norway between 2006 and 2013. The number of treatment episodes can be affected by many factors and in order to isolate the effect of changes in the reimbursement system, we exclude DRGs affected by policy reforms and administrative changes.

A new proposal for priority setting in Norway: Open and fair.

Health systems worldwide struggle to meet increasing demands for health care, and Norway is no exception. This paper discusses the new, comprehensive framework for priority setting recently laid out by the third Norwegian Committee on Priority Setting in the Health Sector. The framework posits that priority setting should pursue the goal of "the greatest number of healthy life years for all, fairly distributed" and centres on three criteria: 1) The health-benefit criterion: The priority of an intervention increases with the expected health benefit (and other relevant welfare benefits) from the intervention; 2) The resource criterion: The priority of an intervention increases, the less resources it requires; and 3) The health-loss criterion: The priority of an intervention increases with the expected lifetime health loss of the beneficiary in the absence of such an intervention.

Comparison of Site of Death, Health Care Utilization, and Hospital Expenditures for Patients Dying With Cancer in 7 Developed Countries.

Importance: Differences in utilization and costs of end-of-life care among developed countries are of considerable policy interest.

Objective: To compare site of death, health care utilization, and hospital expenditures in 7 countries: Belgium, Canada, England, Germany, the Netherlands, Norway, and the United States.

Design, Setting, And Participants: Retrospective cohort study using administrative and registry data from 2010.

European Regional Differences in All-Cause Mortality and Length of Stay for Patients with Hip Fracture.

The objective of this study was to compare healthcare performance for the surgical treatment of hip fractures across and within Finland, Hungary, Italy, the Netherlands, Norway, Scotland, and Sweden. Differences in age-adjusted and sex-adjusted 30-day and one-year all-cause mortality rates following hip fracture, as well as the length of stay of the first hospital episode in acute care and during a follow up of 365 days, were investigated, and associations between selected country-level and regional-level factors with mortality and length of stay were assessed. Hungary showed the highest one-year mortality rate (mean 39.

The effects of introducing an electronic prescription system with no copayments.

Background: To examine the impact of introducing an electronic prescription system with no copayments on the number of prescriptions, the size of prescriptions, and the number of visits and phone calls to primary physicians.

Methods: Fixed regression models using monthly data on per capita prescriptions claims and consultations between 2009 and 2013 at the municipality level, before and after the introduction of the electronic prescription system.

Results: The electronic prescription system with no copayment increased the number of prescriptions by between 6.

Are healthcare expenditures increasing faster for the elderly than the rest of the population?

The debate about whether health expenditures will increase more or less for the old is conceptually confused because the participants focus on different factors, use different assumptions and, finally, do not connect the predictions to more general theories of demand for health services. Some focus on increases in life expectancy and how this will change the distribution of end-of-life costs. Others focus on how changes in income and technology will affect the relationship between age and health spending.