Olav Amundsen

• Amundsen, Olav; Moger, Tron Anders; Holte, Jon Helgheim; Haavaag, Silje Bjørnsen; Bragstad, Line Kildal & Hellesø, Ragnhild [Show all 8 contributors for this article] (2026). Use of primary care physiotherapy and its associations with clinical and socioeconomic outcomes in musculoskeletal disorders: a cohort study. Scandinavian Journal of Primary Health Care. ISSN 0281-3432. 44(1). doi: 10.1080/02813432.2026.2660328. Full text in Research Archive Show summary

  Isolating the effects of outpatient care on hospitalisation in observational data is challenging. We estimate the effects of factors believed to influence hospital admissions in patients with COPD. The factors were related to outpatient care and social factors, motivated by recommendations in COPD guidelines and the literature. We applied linked national and municipal registry data on 25,369 COPD patients in Oslo and Trondheim 2008–2019. Yearly frequency and type of healthcare contacts (respiratory and non-respiratory, across providers), together with comorbidities, were used as proxies for patients’ health status. We constructed samples matched on the full set of proxy variables to estimate the effect of each factor on future COPD hospital admissions. Overall, 9.8% of follow up years had at least one COPD hospital admission. Findings indicated beneficial effects of several of the factors. Care interaction between general practitioner (GP) and other health providers, follow-up by GP within 30 days after COPD hospital discharge and counselling/psychotherapy by GP showed significant reductions of 2.9, 4.9 and 1.4% points in the rate of next-year COPD hospital admissions, respectively. The effects are noteworthy when extrapolated to the entire Norwegian COPD population. A reduction of 1% point could result in up to 1,500 fewer patients experiencing one or more COPD hospital admissions during a year. In the absence of detailed clinical information, creating samples that are multidimensionally matched on health service use and comorbidities as pragmatic proxies for health status could be a viable approach for estimating the effects of other factors.

• Moger, Tron Anders; Holte, Jon Helgheim; Amundsen, Olav; Haavaag, Silje Bjørnsen; Edvardsen, Anne & Bragstad, Line Kildal [Show all 9 contributors for this article] (2026). Matching on health status to estimate the effects of outpatient care and social factors in patients with COPD: a Norwegian registry‑based study. BMC Health Services Research. 26(1). doi: 10.1186/s12913-026-14285-9. Full text in Research Archive Show summary

  Isolating the effects of outpatient care on hospitalisation in observational data is challenging. We estimate the effects of factors believed to influence hospital admissions in patients with COPD. The factors were related to outpatient care and social factors, motivated by recommendations in COPD guidelines and the literature. We applied linked national and municipal registry data on 25,369 COPD patients in Oslo and Trondheim 2008–2019. Yearly frequency and type of healthcare contacts (respiratory and non-respiratory, across providers), together with comorbidities, were used as proxies for patients’ health status. We constructed samples matched on the full set of proxy variables to estimate the effect of each factor on future COPD hospital admissions. Overall, 9.8% of follow up years had at least one COPD hospital admission. Findings indicated beneficial effects of several of the factors. Care interaction between general practitioner (GP) and other health providers, follow-up by GP within 30 days after COPD hospital discharge and counselling/psychotherapy by GP showed significant reductions of 2.9, 4.9 and 1.4% points in the rate of next-year COPD hospital admissions, respectively. The effects are noteworthy when extrapolated to the entire Norwegian COPD population. A reduction of 1% point could result in up to 1,500 fewer patients experiencing one or more COPD hospital admissions during a year. In the absence of detailed clinical information, creating samples that are multidimensionally matched on health service use and comorbidities as pragmatic proxies for health status could be a viable approach for estimating the effects of other factors.

• Haavaag, Silje Bjørnsen; Obstfelder, Aud Uhlen; Hellesø, Ragnhild; Moger, Tron Anders; Amundsen, Olav & Tjerbo, Trond [Show all 9 contributors for this article] (2026). Patient Work in Long-Term Conditions. Qualitative Health Research. ISSN 1049-7323. doi: 10.1177/10497323261430632. Full text in Research Archive Show summary

  Long-term conditions are one of the major causes to morbidity and death worldwide. Management of such conditions in healthcare settings has been framed as a challenge for healthcare systems, and people living with long-term conditions often experience fragmented care. Integrated care approaches have been advocated as the solution, but few studies include the work done by patients and its significance for care processes. The present study aimed to explore the work of people with long-term conditions in the unfolding of their care trajectories. The study is based on semi-structured interviews of people living with chronic obstructive pulmonary disease and musculoskeletal disorders. The participants were all home-dwelling and living in Norway. Reflexive thematic analysis was used to guide the analysis. Theory about work as theorized by Strauss et al. was central to the analysis. The persons highlight that they feel that it is up to them to ask questions and initiate care, that they monitor their bodies to be equipped to act adequately when changes occur, and that they engage in deliberative interaction with healthcare personnel. The findings add depth to current knowledge and highlight that people living with long-term conditions participate in the unfolding of their care trajectories by doing comprehensive work. Framing what people with long-term conditions do when participating in their care trajectories as work brings forth aspects of healthcare use that may be less visible for healthcare personnel and enables addressing individual care trajectories as intertwined with patient work.

• Moger, Tron Anders; Holte, Jon Helgheim; Amundsen, Olav; Haavaag, Silje Bjørnsen; Døhl, Øystein & Bragstad, Line Kildal [Show all 9 contributors for this article] (2025). Predictors, Healthcare Utilization and Costs Related to Short-Term Stays in Patients with COPD: A Registry-Based Analysis in Norway. Clinical Epidemiology. Volume 17, p. 707–719. doi: 10.2147/clep.s521958. Full text in Research Archive Show summary

  Background: Chronic obstructive pulmonary disease (COPD) incurs significant healthcare costs, often accompanied by multimorbidity. Advanced patients may need short-term stays for rehabilitation, treatment, or respite to maintain home living. Aim: To identify predictors for a first short-term stay and study the healthcare utilization and costs compared with similar patients without a short-term stay. Patients and Methods: Data on COPD patients in the cities Oslo and Trondheim 2010–2019 and including information on specialist, primary and long-term care, diagnoses, sociodemographics and -economics were collected from national and municipal registries, resulting in a sample of 24,613 patients. Using discrete time survival models, we identified predictors for a short-term stay. We described the costs before and after admission, and the duration of living at home, compared to non-recipients matched on age, comorbidities and healthcare use. Results: Depression, anxiety, mental disorders, alcoholism, prior hospitalization and reception of home care were associated with higher odds of short-term stays. One to two GP visits for respiratory diseases, being in the top quartile for GP visits for non-respiratory diseases, visits to specialists, and physiotherapist visits for non-respiratory issues were significantly associated with lower odds of short-term institutional stay. Patients admitted to short-term stays incurred markedly higher costs both in the year before admission and during subsequent years compared to matched non-recipients, primarily due to increased use of inpatient and home care services. Conclusion: Prior receipt of home care, unlike standard outpatient services, was linked to a higher likelihood of short-term stays. This suggests that some outpatient services may delay the need for such stays, or that patients already in municipal services are more readily admitted. Additionally, patients with psychosocial issues may have greater care needs, indicating that resource allocation aligns with these needs. The findings suggest that by the time short-term stays are required, health deterioration has already become considerable.

• Moger, Tron Anders; Holte, Jon Helgheim; Amundsen, Olav; Haavaag, Silje Bjørnsen; Døhl, Øystein & Bragstad, Line Kildal [Show all 9 contributors for this article] (2024). The in- and outpatient health care use of patients with COPD before and after initiation of home care: a registry study from Norway. Scandinavian Journal of Primary Health Care. ISSN 0281-3432. 43(1). doi: 10.1080/02813432.2024.2404056. Full text in Research Archive Show summary

  Objective: Chronic obstructive pulmonary disease (COPD) is a common condition associated with age, multimorbidity and frequently involves the use of health care across levels. Understanding the factors associated with the initiation of long-term care is important when planning the future need for services. We describe healthcare use before and after the reception of any home care. We further studied the associations between healthcare use and first registered home care service and from first registered home care service to nursing home admission or death. Design and subjects: Patients residing in Oslo or Trondheim at the time of first contact with a COPD primary diagnosis, 2009–2018. Patient data were linked across national and municipal registries, covering healthcare and sociodemographics. The sample consisted of 16,738 individuals. Results: There was a marked increase in inpatient and outpatient hospital contacts in the years prior to and after the reception of any home care. Adjusted for comorbidities and sociodemographics, high numbers of GP consultations, and inpatient and outpatient hospital contacts for respiratory diagnoses were associated with a significantly higher likelihood of receiving home care the next year (hazard odds ratios > 1.3). Following the reception of home care, the type of home care service received (e.g. home nursing or short-term rehabilitation/treatment) was more important than outpatient services in predicting next-year nursing home admission or death. Conclusion: Including data on prior outpatient care when predicting future need for home care is beneficial. A high frequency (top 10%) of yearly GP, in- or outpatient hospital contacts can imply that the patient may be in need of home care in the near future.

• Amundsen, Olav; Moger, Tron Anders; Holte, Jon Helgheim; Haavaag, Silje Bjørnsen; Bragstad, Line Kildal & Hellesø, Ragnhild [Show all 8 contributors for this article] (2024). Patient characteristics and healthcare use for high-cost patients with musculoskeletal disorders in Norway: a cohort study. BMC Health Services Research. 24(1). doi: 10.1186/s12913-024-12051-3. Full text in Research Archive Show summary

  Background: A high proportion of healthcare costs can be attributed to musculoskeletal disorders (MSDs). A small proportion of patients account for most of the costs, and there is increasing focus on addressing service overuse and high costs. We aimed to estimate healthcare use contributing to high costs over a five-year period at the individual level and to examine if healthcare use for high-cost patients is in accordance with guidelines and recommendations. These findings contribute to the understanding of healthcare use for high-cost patients and help in planning future MSD-care. Methods: This study combined Norwegian registries on healthcare use, diagnoses, demographic, and socioeconomic factors. Patients (≥ 18 years) were included by their first MSD-contact in 2013–2015. We analysed healthcare use during the subsequent five years. Descriptive statistics were used to compare high-cost (≥ 95th percentile) and non-high-cost patients. Total healthcare contacts and costs for high-cost patients were examined stratified by number of hospitalisations and surgical treatments. Healthcare use of General Practitioners (GPs), physiotherapy, chiropractor and Physical Medicine and Rehabilitation physicians prior to the first hospitalisation or surgical treatment for a non-traumatic MSD was registered. Results: High-cost patients were responsible for 61% of all costs. Ninety-four percent of their costs were related to hospital treatment. Ninety-nine percent of high-cost patients had at least one hospitalisation or surgical procedure. Out of the high-cost patients, 44% had one registered hospitalisation or surgical procedure, 52% had two to four and 4% had five or more. Approximately 30–50% of patients had seen any healthcare personnel delivering conservative treatment other than GPs the year prior to their first hospitalisation/surgical treatment for a non-traumatic MSD. Conclusion: Most healthcare costs were concentrated among a small proportion of patients. In contrast to guidelines and recommendations, less than half had been to a healthcare service focused on conservative management prior to their first hospitalisation or surgical treatment for a non-traumatic MSD. This could indicate that there is room for improvement in management of patients before hospitalisation and surgical treatment, and that ensuring sufficient capacity for conservative care and rehabilitation can be beneficial for reducing overall costs.

• Moger, Tron Anders; Holte, Jon Helgheim; Amundsen, Olav; Haavaag, Silje Bjørnsen; Edvardsen, Anne & Bragstad, Line Kildal [Show all 9 contributors for this article] (2024). Associations between outpatient care and later hospital admissions for patients with chronic obstructive pulmonary disease - a registry study from Norway. BMC Health Services Research. 24(1). doi: 10.1186/s12913-024-10975-4. Full text in Research Archive Show summary

  Background Although chronic obstructive pulmonary disease (COPD) admissions put a substantial burden on hospitals, most of the patients’ contacts with health services are in outpatient care. Traditionally, outpatient care has been difficult to capture in population-based samples. In this study we describe outpatient service use in COPD patients and assess associations between outpatient care (contact frequency and specific factors) and next-year COPD hospital admissions or 90-day readmissions. Methods Patients over 40 years of age residing in Oslo or Trondheim at the time of contact in the period 2009–2018 were identified from the Norwegian Patient Registry (in- and outpatient hospital contacts, rehabilitation) and the KUHR registry (contacts with GPs, contract specialists and physiotherapists). These were linked to the Regular General Practitioner registry (characteristics of the GP practice), long-term care data (home and institutional care, need for assistance), socioeconomic and–demographic data from Statistics Norway and the Cause of Death registry. Negative binomial models were applied to study associations between combinations of outpatient care, specific care factors and next-year COPD hospital admissions and 90-day readmissions. The sample consisted of 24,074 individuals. Results A large variation in the frequency and combination of outpatient service use for respiratory diagnoses (GP, emergency room, physiotherapy, contract specialist and outpatient hospital contacts) was apparent. GP and outpatient hospital contact frequency were strongly associated to an increased number of next-year hospital admissions (1.2–3.2 times higher by increasing GP frequency when no outpatient hospital contacts, 2.4-5 times higher in combination with outpatient hospital contacts). Adjusted for healthcare use, comorbidities and sociodemographics, outpatient care factors associated with lower numbers of next-year hospitalisations were fees indicating interaction between providers (7% reduction), spirometry with GP or specialist (7%), continuity of care with GP (15%), and GP follow-up (8%) or rehabilitation (18%) within 30 days vs. later following any current year hospitalisations. For 90-day readmissions results were less evident, and most variables were non-significant. Conclusion As increased use of outpatient care was strongly associated with future hospitalisations, this further stresses the need for good communication between providers when coordinating care for COPD patients. The results indicated possible benefits of care continuity within and interaction between providers.

• Amundsen, Olav; Moger, Tron Anders; Holte, Jon Helgheim; Haavaag, Silje Bjørnsen; Bragstad, Line Kildal & Hellesø, Ragnhild [Show all 8 contributors for this article] (2023). Combination of health care service use and the relation to demographic and socioeconomic factors for patients with musculoskeletal disorders: a descriptive cohort study. BMC Health Services Research. 23(1). doi: 10.1186/s12913-023-09852-3. Full text in Research Archive Show summary

  Background Patients with musculoskeletal disorders (MSDs) access health care in different ways. Despite the high prevalence and significant costs, we know little about the different ways patients use health care. We aim to fill this gap by identifying which combinations of health care services patients use for new MSDs, and its relation to clinical characteristics, demographic and socioeconomic factors, long-term use and costs, and discuss what the implications of this variation are. Methods The study combines Norwegian registers on health care use, diagnoses, comorbidities, demographic and socioeconomic factors. Patients (≥ 18 years) are included by their first health consultation for MSD in 2013–2015. Latent class analysis (LCA) with count data of first year consultations for General Practitioners (GPs), hospital consultants, physiotherapists and chiropractors are used to identify combinations of health care use. Long-term high-cost patients are defined as total cost year 1–5 above 95th percentile (≥ 3 744€). Results We identified seven latent classes: 1: GP, low use; 2: GP, high use; 3: GP and hospital; 4: GP and physiotherapy, low use; 5: GP, hospital and physiotherapy, high use; 6: Chiropractor, low use; 7: GP and chiropractor, high use. Median first year health care contacts varied between classes from 1–30 and costs from 20€-838€. Eighty-seven percent belonged to class 1, 4 or 6, characterised by few consultations and treatment in primary care. Classes with high first year use were characterised by higher age, lower education and more comorbidities and were overrepresented among the long-term high-cost users. Conclusion There was a large variation in first year health care service use, and we identified seven latent classes based on frequency of consultations. A small proportion of patients accounted for a high proportion of total resource use. This can indicate the potential for more efficient resource use. However, the effect of demographic and socioeconomic variables for determining combinations of service use can be interpreted as the health care system transforming unobserved patient needs into variations in use. These findings contribute to the understanding of clinical pathways and can help in the planning of future care, reduction in disparities and improvement in health outcomes for patients with MSDs.

• Moger, Tron Anders; Amundsen, Olav; Tjerbo, Trond; Hellesø, Ragnhild; Holte, Jon Helgheim & Vøllestad, Nina Køpke (2023). Innovations in use of registry data (INOREG) - Design of a registry-based study analyzing care pathways and outcomes for chronic patients. Nordic Journal of Health Economics. ISSN 1892-9729. 6(1), p. 129–146. doi: 10.5617/njhe.10097. Full text in Research Archive Show summary

  In recent years there have been several political initiatives in Norway, requiring more research into how multimorbidity and health care pathways in the municipality affect outcomes such as work participation, hospital admissions, disability and quality of life for patients with chronic diseases. Most of the care is provided outside hospitals and has been difficult to capture in large, registry-based studies. Focusing on two important groups, patients with chronic obstructive pulmonary disease (COPD) and musculoskeletal disorders (MSD), the INOREG project aims to reduce these knowledge gaps. In the paper we present 1) the data that are used in the project, 2) the construction of samples, variables and possible methods for analysis and 3) an example on how the data and methods will be applied. The project database is constructed from a novel linkage of national health and welfare registries. The data cover social, primary and specialized care for all COPD and MSD patients in Norway, long-term care data from Oslo and Trondheim municipalities and functioning and quality of life for ca. 2,700 patients treated at physiotherapy clinics in the FYSIOPRIM project. This enables construction of care pathways and outcomes at the individual level from 2008 through 2019. The project will fill knowledge gaps regarding the patterns of care at different levels in the health care system, and the association to outcomes for chronic patient groups. If the project is successful, it will provide improved insight on how to further develop provision and coordination of services to the decision makers, and ideally reduce inequalities in health.

• Amundsen, Olav; Starcevich, Cobie; Frisell, Even Johansen; Nordal, Tom; Williams, Sian & Mitchell, Tim [Show all 7 contributors for this article] (2021). Does body scanning through visual imagery improve perception and function in patients after anterior cruciate ligament-reconstruction? An exploratory study. Physiotherapy Theory and Practice. ISSN 0959-3985. doi: 10.1080/09593985.2021.1901328. Full text in Research Archive
• Amundsen, Olav; Vøllestad, Nina Køpke; Meisingset, Ingebrigt & Robinson, Hilde Stendal (2021). Associations between treatment goals, patient characteristics, and outcome measures for patients with musculoskeletal disorders in physiotherapy practice. BMC Musculoskeletal Disorders. 22:182, p. 1–12. doi: 10.1186/s12891-021-04048-4. Full text in Research Archive Show summary

  Sammendrag Background Goal setting is linked to person-centred care and is a core component in physiotherapy, but the associations between goal classes, patient characteristics and outcome measures for musculoskeletal disorders has not been investigated. The study’s purpose was to examine 1) how goals used in clinical practice for patients with musculoskeletal disorders (MSD) are distributed in classes based on ICF, 2) if goal classes were associated with patient characteristics and 3) whether goal classes were associated with treatment outcome. Methods Data analysis from a longitudinal observational study (N = 2591). Goals were classified in symptom, function/structure, activity/participation and non-classifiable. Associations between patient characteristics and goal classes were examined using x2 and one-way ANOVA. Association between goal classes and outcomes were examined using multiple logistic and linear regression models. Outcomes are reported at 3 months or end of treatment if prior to 3 months. Results There was a high variability in goals used for patients with MSD. 17% had symptom goals, 32.3% function/structure, 43.4% activity/participation and 7.4% non-classifiable goals. We found significant associations between goal classes and age, gender, severity, region of pain/diagnosis and emotional distress (all p < .001). Activity/participation goals were associated with better outcomes on GPE (OR 1.80, 95% CI 1.23–2.66). Non-classifiable goal was associated with poorer outcomes on pain intensity (B .87, 95% CI .32–1.43). Conclusion There is an association between goal classes and patient characteristics. Including activity/participation in the main goal was associated with better outcomes for GPE and having a non-classifiable goal was associated with poorer outcomes for pain intensity. Trial registration The project is approved by the Regional committee for Medical and Health Research Ethics in Norway (REC no. 2013/2030). https://clinicaltrials.gov/ct2/show/NCT03626389.

• Briggs, Andrew M.; Persaud, Jennifer G.; Deverell, Marie L.; Bunzli, Samantha; Tampin, Brigitte & Sumi, Yuka [Show all 13 contributors for this article] (2019). Integrated prevention and management of non-communicable diseases, including musculoskeletal health: A systematic policy analysis among OECD countries. BMJ Global Health. 4:e001806(5), p. 1–24. doi: 10.1136/bmjgh-2019-001806. Full text in Research Archive

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• Moger, Tron Anders; Vøllestad, Nina Køpke; Tjerbo, Trond; Amundsen, Olav; Holte, Jon Helgheim & Haavaag, Silje Bjørnsen [Show all 8 contributors for this article] (2025). Bruk av registerdata i analyse av tjenesteforløp for muskelskjelett- og KOLS-pasienter – et sammendrag av INOREG prosjektet. Full text in Research Archive Show summary

  Bakgrunn: Muskel-/skjelettlidelser (MSK) og kronisk obstruktiv lungesykdom (KOLS) representerer to betydelige typer av kroniske sykdommer. I et tverrfaglig forskningsprosjekt ved Institutt for Helse og Samfunn, UiO, som ble introdusert på Helsetjenestekonferansen 2022, har vi analysert tjenesteforløpene for disse pasientgruppene ved hjelp av koblede registerdata. Formål: Beskrive pasientforløpene for de to pasientgruppene, finne faktorer i forløpene assosiert med utfall som sykehusinnleggelser, hjemmetjenester, høy fremtidig tjenestebruk og uførhet. Metode: Kvantitative og kvalitative analyser av pasientforløp. Kvantitative analyser baseres på data fra nasjonale registre, fra registre i pleie- og omsorgstjenestene i Oslo og Trondheim, samt internt fysioterapiregister. Resultater: Flere viktige avvik fra anbefalt oppfølging for pasientgruppene ble oppdaget i analysene. Noen eksempler er at mer enn 50 % av MSK-pasienter fikk kirurgi, uten å ha forsøkt konservativ behandling først, og at mer enn 10 % av KOLS-pasienter ikke mottar oppfølging for luftveisdiagnoser i året før en sykehusinnleggelse med KOLS. Samtidig hadde mange av pasientene med gjentatte KOLS-innleggelser begrenset oppfølging i primærhelsetjenesten i årene etter indeksinnleggelsen. For KOLS-pasienter observerer man videre en sterk økning i fastlegekontakter i året før man mottar hjemmetjenester, som har betydning for å predikere fremtidig tjenestebruk. På den positive siden fant vi at MSK-pasienter med dårlig prognose hadde fire ganger høyere sjanse for å rapportere et godt klinisk utfall dersom de hadde høy bruk av fysioterapi, som videre var assosiert med lavere sjanse for fremtidig uførhet. For pasienter med god/middels prognose var det ingen sammenheng mellom klinisk utfall og høy frekvens av fysioterapi. For KOLS-pasienter fant vi at bruk av samhandlingstakster, kontinuitet i fastlegeoppfølging, og psykososial støtte for særlig sårbare grupper var assosiert med lavere sannsynlighet for fremtidige akutte sykehusinnleggelser for KOLS. Konklusjon: Prosjektet illustrerer mulighetene ved bruk av administrative helseregisterdata. Samtidig finnes det flere begrensninger dersom man ikke har data på tvers av tjenestene, mer detaljerte kliniske data, samt pasientrapporterte utfallsmål

• Moger, Tron Anders; Hellesø, Ragnhild; Tjerbo, Trond; Holte, Jon Helgheim; Haavaag, Silje Bjørnsen & Bragstad, Line Kildal [Show all 8 contributors for this article] (2025). INOREG workshop, perspective paper. Full text in Research Archive
• Moger, Tron Anders; Haavaag, Silje Bjørnsen; Vøllestad, Nina Køpke; Tjerbo, Trond; Holte, Jon Helgheim & Hellesø, Ragnhild [Show all 8 contributors for this article] (2025). INOREG workshop 2025. Full text in Research Archive
• Moger, Tron Anders; Vøllestad, Nina Køpke; Tjerbo, Trond; Hellesø, Ragnhild; Bragstad, Line Kildal & Holte, Jon Helgheim [Show all 8 contributors for this article] (2024). INOREG workshop 2024. Full text in Research Archive
• Amundsen, Olav; Moger, Tron Anders & Vøllestad, Nina Køpke (2024). Arbeid med registerdata - Erfaringer fra INOREG-prosjektet. Full text in Research Archive
• Amundsen, Olav; Moger, Tron Anders; Vøllestad, Nina Køpke; Tjerbo, Trond; Hellesø, Ragnhild & Bragstad, Line Kildal [Show all 8 contributors for this article] (2023). INOREG workshop 2023. Full text in Research Archive
• Amundsen, Olav (2023). Variation in use of services and patient outcome for musculoskeletal disorders. Full text in Research Archive
• Amundsen, Olav (2023). - Behandlingsmål og utfall for personer med muskelskjelettplager. Full text in Research Archive
• Vøllestad, Nina Køpke; Irgens, Pernille Marie Stähr; Myhrvold, Birgitte Lawaetz; Amundsen, Olav; Tyrdal, Mari & Robinson, Hilde Stendal (2023). Rating of current pain intensity is lower than rating of the last two wees of pain. Full text in Research Archive
• Amundsen, Olav; Vøllestad, Nina Køpke; Moger, Tron Anders; Tjerbo, Trond & Holte, Jon Helgheim (2022). Is future disability benefit associated with specific combinations of health care use for musculoskeletal disorders? Full text in Research Archive Show summary

  Background Musculoskeletal disorders (MSD) are one of the highest contributors to disability benefit in Norway and other OECD-countries. This is an increasing problem in most OECD countries and is a major challenge for welfare states. To be able to prevent people from falling out of the work force it is important to identify combinations of care associated with poorer outcomes and increased risk of future disability pension. Objective Examine how combinations of health care use relate to future disability benefit, controlling for demographic, socioeconomic and clinical factors. Methods The study combines Norwegian data registers with information on health care use, diagnosis, comorbidities, demographic, education, socioeconomic factors and disability benefits. Patients are included at the time of their first health care visit for MSD in 2013-2015 and are followed until end of 2020. Patients between 18-62 years and registered in the work force at index are included. The outcome is being registered with disability benefit minimum 12 months after index. Multivariable regression analysis is used with combinations of health care use for the first 12 months as the main explanatory variables. Combinations of health care use are identified by variables for having used GP, physiotherapy and specialist health care for MSD and creating combinations of these dichotomous variables. Other variables were included as covariates. Results/conclusion Using specialist health care for MSD in combination with GP (OR 1.91, 95%CI 1.36-2.68) or in combination with both GP and physiotherapy services (OR 2.38, 95%CI 1.53-3.71) was associated with increased risk of future disability pension compared to seeing GP alone. Seeing physiotherapist only or in combination with GP was not associated with increased risk of future disability pension. Reasons for these associations remain to be explored.

• Amundsen, Olav; Holte, Jon Helgheim; Vøllestad, Nina Køpke & Moger, Tron Anders (2022). INOREG-prosjektet - drøfting av resultater. Full text in Research Archive
• Moger, Tron Anders; Vøllestad, Nina Køpke; Hellesø, Ragnhild; Tjerbo, Trond; Holte, Jon Helgheim & Amundsen, Olav (2022). INOREG workshop 2022. Full text in Research Archive
• Amundsen, Olav & Vøllestad, Nina Køpke (2022). Registerforskning – et nyttig fugleperspektiv for klinikere? Full text in Research Archive
• Amundsen, Olav & Vøllestad, Nina Køpke (2022). Hvordan er første års helsetjenestebruk for pasienter med muskel-skjelettplager assosiert med bruk av spesialisthelsetjenesten 3 år senere? Full text in Research Archive Show summary

  Bakgrunn: Muskel-skjelettplager (MUSP) inkluderer noen av de mest prevalente lidelsene både internasjonalt og i Norge. I Norge er kostanden for helsetjenester relatert til MUSP beregnet til 14.3 mrd NOK, og den økonomiske byrden relatert til redusert arbeidsdeltakelse og sosiale ytelser er estimert til å være 69-73 mrd NOK. For å kunne håndtere den økende byrden av MUSP trengs forskning på hvordan vi kan bedre individuelle helserelaterte utfallsmål og gjøre de samfunnsmessige kostnadene bærekraftige. Dette inkluderer et behov for å identifisere og fremme behandlingsforløp som er effektive, og redusere bruken av ineffektive behandlingsforløp. Metode: Studien henter data fra offentlige konsultasjoner hos fysioterapeut og spesialisthelsetjenesten fra dataregistrene KUHR og NPR-somatikk. Studiepopulasjonen er pasienter registrert med MUSP for første gang hos fastlege/fysioterapeut i 2015. Ressursbruk hos fysioterapeut og spesialisthelsetjeneste kodes i kategoriene høy/lav/ingen. Kategoriene "høy" og "lav" kodes basert på 50-percentilen. Kategoriene brukes som hovedvariabel i logistisk regresjonsanalyse hvor utfallsmålet er høy/lav eller ingen spesialisthelsetjenestebruk 3 år senere. Det er kontrollert for alder, kjønn, utdanning, arbeidslivstilknytning og komorbiditeter. Analysene er foreløpige og under utvikling. Resultater: Høy og lav bruk av spesialisthelsetjeneste første år var assosiert med høy bruk av spesialisthelsetjeneste 3 år senere, sammenlignet med ingen bruk. (Høy: OR 1.98, 95%CI 1.60-2.46. Lav: OR 1.25 95%CI 1.01-1.57). For kombinasjoner mellom helsetjenestebruk første år har gruppene med høy spesialisthelsetjenestebruk økt risiko for høy bruk etter 3 år, men gruppen med samtidig høy bruk av fysioterapi har lavest risiko av disse (Høy spesialisthelsetjeneste ingen fysioterapi: OR 2.00, 95%CI 1.54-2.61. Høy spesialisthelsetjeneste lav fysioterapi: OR 3.00 95%CI 1.90-4.75. Høy spesialisthelsetjeneste høy fysioterapi: OR 1.47, 95%CI 1.04-2.07). Diskusjon/konklusjon Høy bruk av spesialisthelsetjeneste første år var assosiert med høy bruk 3 år senere. Samtidig høy bruk av fysioterapi kan redusere risikoen for høy bruk av spesialisthelsetjeneste i denne gruppen, noe som kan ha betydning for reduksjon i samfunnskostnad.

• Moger, Tron Anders; Amundsen, Olav & Holte, Jon Helgheim (2022). Innovations in use of register data (INOREG) – Design of a register-based study analysing care pathways and outcomes for chronic patients. Full text in Research Archive Show summary

  Abstract: In recent years there have been several political initiatives in Norway, requiring increased research into how multimorbidity and health services in the municipality affect outcomes such as work participation, disability, quality of life and hospital admissions for patients with chronic diseases. Most of this care happens outside hospitals and has been difficult to capture in large, register-based studies. Focusing on two important chronic groups, patients with chronic obstructive pulmonary disease (COPD) and musculoskeletal disorders (MSD), the INOREG project will meet this need. In the paper we present the study design utilizing register data at the individual level for patients in Oslo and Trondheim, covering specialized care, primary care, home-based and long-term care, sociodemographic and –economic data and functioning. The database is constructed from a novel linkage of national health registers to care data from Oslo and Trondheim municipalities, capturing the entire population of COPD and MSD patients in the cities, and functioning and quality of life for ca. 3800 patients treated at physiotherapy clinics in the FYSIOPRIM project. This enables construction of complete care pathways and outcomes at the individual level during 2008-2020. The results from the project will fill knowledge gaps regarding patterns of care at different levels in the health care system and the association to outcomes for these patient groups. This will help inform decision makers about how services could be organized to improve provisions and coordination of services, as well as reduce inequalities in health.

• Amundsen, Olav & Vøllestad, Nina Køpke (2022). Smerter hos voksne og bruk av helsetjenester. Full text in Research Archive
• Amundsen, Olav & Vøllestad, Nina Køpke (2022). Is future disability benefit associated with specific combinations of health care use for musculoskeletal disorders? Full text in Research Archive Show summary

  Bakgrunn og formål Musculoskeletal disorders (MSD) are one of the highest contributors to disability benefit in Norway and other OECD-countries. This is an increasing problem in most OECD countries and is a major challenge for welfare states. To be able to prevent people from falling out of the work force it is important to identify combinations of care associated with poorer outcomes and increased risk of future disability pension. The study’s objective is to examine how combinations of health care use relate to future disability benefit, controlling for demographic, socioeconomic and clinical factors. Metode The study combines Norwegian data registers with information on health care use, diagnosis, comorbidities, demographic, education, socioeconomic factors and disability benefits. Patients are included at the time of their first health care visit for MSD in 2013-2015 and are followed until end of 2020. Patients between 18-62 years and registered in the work force at index are included. The outcome is being registered with disability benefit minimum 12 months after index. Multivariable regression analysis is used with combinations of health care use for the first 12 months as the main explanatory variables. Combinations of health care use are identified by variables for having used GP, physiotherapy and specialist health care for MSD and creating combinations of these dichotomous variables. Other variables were included as covariates. Resultater Using specialist health care for MSD in combination with GP (OR 1.91, 95%CI 1.36-2.68) or in combination with both GP and physiotherapy services (OR 2.38, 95%CI 1.53-3.71) was associated with increased risk of future disability pension compared to seeing GP alone. Konklusjon Using specialist health care for MSD was associated with increased risk of future disability pension, while seeing physiotherapist only or in combination with GP was not associated with increased risk of future disability pension. Reasons for these associations remain to be explored.

• Amundsen, Olav (2026). Variation in healthcare service use and outcomes for patients with musculoskeletal disorders. Universitetet i Oslo. ISSN 9788234807718. Full text in Research Archive Show summary

  Musculoskeletal disorders (MSDs) are a leading cause of disability, reduced work participation and high healthcare costs. This thesis examines how healthcare services are used to manage MSDs in Norway and how healthcare use relates to patient characteristics, outcomes and costs. The project used population-wide registries and clinical data from primary care physiotherapy (FYSIOPRIM), matched at the individual level. Most patients were managed in primary care with few contacts, while a small proportion used multiple services and specialist care. Costs were highly skewed: The 5% with the highest five-year healthcare costs accounted for over 60% of total expenditure, mainly driven by specialist care. Many patients with non-traumatic MSDs went directly from GP to specialist care without receiving other conservative treatment. In primary care physiotherapy, a higher number of contacts were associated with better outcomes for patients with poor prognosis, whereas those with better prognosis did equally well with fewer contacts. Improvement at 12 months in primary care physiotherapy was associated to lower risk of later high-cost healthcare use and future disability pension.

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