An interdisciplinary intervention for children with complex health complaints; a feasibility study of selection criteria.

Background: There is a need for re-designing the health service for children suffering from complex and compound health complaints. Based on a previous register study, we have developed criteria to select patients with complex health complaints eligible for an Intervention with an interdisciplinary professional team. The team consists of a pediatrician, a psychologist and a physiotherapist.

Assessing competence needs for doctors in the emergency department duty rosters: an observational study.

Background: The purpose of our investigation is to analyze if emergency epidemiology is randomly variable or predictable. If emergency admissions show a predictable pattern, we can use it for multiple planning purposes, especially defining competence needs for duty roster personnel.

Method: An observational study of consecutive emergency admissions at Haukeland University Hospital in Bergen over six years.

Bridging the Gap for Children With Compound Health Challenges: An Intervention Protocol.

During the last decades, there is a major shift in the panorama of diseases in children and adolescents. More children are referred to the specialized health care services due to less specific symptoms and more complex health challenges. These children are particularly difficult to care for in a "single-disease" oriented system.

Interdisciplinary Approaches Suggested for Children With Multiple Hospital Referrals Presenting With Non-specific Conditions.

To describe the care patterns of patients with repeated referrals to both mental and somatic specialist healthcare, and to study their diagnostic processes. In a previous register study patients aged 6-12 years referred to Haukeland University Hospital from 2013 to 2015, we found 922 children with at least three referrals including both somatic and mental health services. Of these, more than one in four (250) were randomly selected and observed from their first hospital episode ever and further after inclusion followed during their next three referrals or until July 2017.

Long Waiting Times for Elective Hospital Care - Breaking the Vicious Circle by Abandoning Prioritisation.

Background: Policies assigning low-priority patients treatment delays for care, in order to make room for patients of higher priority arriving later, are common in secondary healthcare services today. Alternatively, each new patient could be granted the first available appointment. We aimed to investigate whether prioritisation can be part of the reason why waiting times for care are often long, and to describe how departments can improve their waiting situation by changing away from prioritisation.

Complex care pathways for children with multiple referrals demonstrated in a retrospective population-based study.

Aim: To identify children with complex medical needs by examining their patterns of hospital care.

Methods: We conducted a retrospective population-based study on 18 577 patients aged 6-12 years from the Haukeland University Hospital register over a 3-year period (from 2013 to 2015). Data were structured to examine the temporal patterns and sequences of referrals, care episodes and diagnoses, including flow across medical specialties.

Norwegian Priority Setting in Practice - an Analysis of Waiting Time Patterns Across Medical Disciplines.

Background: Different strategies for addressing the challenge of prioritizing elective patients efficiently and fairly have been introduced in Norway. In the time period studied, there were three possible outcomes for elective patients that had been through the process of priority setting: (i) high priority with assigned individual maximum waiting time; (ii) low priority without a maximum waiting time; and (iii) refusal (not in need for specialized services). We study variation in priority status and waiting time of the first two groups across different medical disciplines.

Intermediate care in nursing home after hospital admission: a randomized controlled trial with one year follow-up.

Background: Intermediate care is intended to reduce hospital admissions and facilitate early discharge. In Norway, a model was developed with transfer to intermediate care shortly after hospital admission. Efficacy and safety of this model have not been studied previously.

Patterns of mental health care utilisation: distribution of services and its predictability from routine data.

Objectives: Explore if a multi-dimensional analytic approach to routinely registered data provides a comprehensive way to characterise utilisation patterns, and to test if the patients' functional status is a predictor for the use of services.

Method: We linked register contact data during a two-year period, including all types of specialised mental health services, in the population of a Norwegian county. Cox regression was applied in the models for prediction of admission and readmission.

Characteristics of anorexia nervosa-related deaths in Norway (1992-2000): data from the National Patient Register and the Causes of Death Register.

Objective: This study investigated demographic and diagnostic characteristics of individuals whose medical record or death certificate indicated the presence of anorexia nervosa at the time of death.

Method: Two national registers, the National Patient Register (NPR) and the Causes of Death Register (CODR), were examined in Norway for anorexia nervosa-related deaths occurring across a 9-year period (1992-2000).

Results: The medical record or death certificate listed anorexia nervosa as a diagnosis or cause of death for 66 individuals.

[The epidemic of Caesarean section: has it reached Norway?].

Background: Women's right to decide on the mode of delivery is discussed, as well as the management of term breech deliveries. Obstetric practice may have changed as a consequence of ongoing debates. National caesarean section rates were stable at 12-13% during the 1990s, but no information has been provided about the development over the last two years.

Measuring readmissions: focus on the time factor.

Objective: To assess the effects of choosing different time-intervals of observation when using unplanned readmissions as an outcome indicator.

Design: A conceptual model was developed based on the risk curve. The model assigned readmissions above a background level as 'related' to the earlier episode of illness.

Do hospital length of stay and staffing ratio affect elderly patients' risk of readmission? A nation-wide study of Norwegian hospitals.

Objective: To test whether there is an association between hospital operating conditions such as average length of stays (LOS) and staffing ratio, and elderly patients' risk of readmission.

Data Sources: The main data source was a national patient database of admissions to all acute-care Norwegian hospitals during the year of 1996.

Study Design: It is a cross-sectional study, where Cox' regression analysis was used to test the factors acting on the probability of early unplanned readmission (within 30 days), and later occuring ones.

Accessibility and distribution of the Norwegian National Air Emergency Service: 1988-1998.

Objective: To evaluate the accessibility and distribution of the Norwegian National Air Emergency Service in the 10-year period from 1988 to 1998.

Material And Methods: The primary material was annual standardized activity data that included all helicopter missions. A multivariate model of determinants for use of the helicopter service was computed by linear regression.

[Can case-mix explain differences in involuntary admissions?].

Background: The proportion of patients admitted involuntarily varies considerably among Norwegian psychiatric hospitals. We tested the hypothesis that these variations are the result of differences in case-mix.

Material And Methods: The observed differences in involuntary admissions to Norwegian psychiatric hospitals were compared to those expected on the basis of their case-mix, as predicted by our multivariate model (multinomial logistic regression).

Operating conditions of psychiatric hospitals and early readmission--effects of high patient turnover.

Objective: To study the association between hospitals' operating conditions and the risk of early readmission. The hypothesis was that high patient turnover might lead to a rise in the risk of readmission soon after discharge (within 30 days).

Method: A multivariate model including hospital and patient variables was tested using Cox's regression analysis, adjusting for clustering effects.

Prevalence of eating disorders in Norwegian general hospitals 1990-1994: admissions per year and seasonality.

Objective: To study the occurrence of eating disorders in patients admitted to somatic hospitals.

Method: For all, approximately 3.3 million, admissions to Norwegian general hospitals in the period 1990-1994, admissions with the primary diagnoses for the eating disorders anorexia nervosa (AN) and bulimia nervosa (BN) were selected.

Management of early prostatic cancer in the Nordic countries: variations in clinical policies and physicians' attitudes toward radical treatment options.

To explore the treatment of patients with early localized prostatic carcinoma, we surveyed the departments of urology and general surgery in Denmark, Finland, Norway, and Sweden. Clinical policies and physicians' attitudes toward the radical treatment options varied widely between the countries. A correlation seems to exist between practice patterns and national attitudes toward special technologies.

[Air ambulance services in Norway].

Norway has ten bases for helicopters manned by aeromedical doctors, five for fixed-wing aircraft, and five for search-and-rescue helicopters. In 1992 there were 4,197 helicopter missions and 4,078 patients were transported by plane, figures representing 20 and 30 per cent increases, respectively, as compared with 1988. In addition, the teams used motor transport to cater to 1,699 patients at locations close to the helicopter bases.

[Prostate cancer in Scandinavia. Variations in practice and attitude to radical treatment].

Some controversy persists as to the optimal assessment and treatment of prostate cancer, a lack of consensus reflected in differences in clinical practice. Our survey among departments of urology and general surgery in the Nordic countries showed Danish physicians to be the most conservative, while the most active intervention strategies were found in Finland.

[Consequences of diagnostics with magnetic tomography].

Physicians referring patients to examinations by magnetic resonance tomography (MT) were asked to answer almost identical questionnaires before and after the examination. The questions referred to diagnosis and planned patient management. Impact of MT was measured by examining the changes in patient diagnoses and planned management after the MT scans.