Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Jan Hartvigsen, University of Southern Denmark,
- Second opponent: Professor Sella Aarrestad Provan, University of Innland Norway (INN),
- Third member and chair of the evaluation committee: Associate Professor Espen Saxhaug Kristoffersen, University of Oslo
Chair of the Defence
Professor emeritus Tor Iversen, University of Oslo
Principal Supervisor
Professor Hilde Stendal Robinson, University of Oslo
Summary
Musculoskeletal disorders (MSDs) are very common and a major cause of sick leave and disability pension in Norway. Although most patients start with primary healthcare, we know little about how they move through the system. Using national health registers, this thesis examines healthcare use, patient pathways and treatment trajectories.
The aims were to: (i) describe trends in healthcare use and patient pathways for all MSD patients and for three common diagnoses spine pain, osteoarthritis and fibromyalgia; (ii) identify treatment trajectories and assess whether education and country of origin influence them; and (iii) compare neck and back pain patients treated in primary versus specialist care.
The thesis includes three studies from 2014–2018. Papers 1 and 2 link KUHR and NPR data to analyse patient pathways and identify treatment trajectory classes over two years. Paper 3 compares patients in primary care (FYSIOPRIM) and specialist care (NNRR).
About one-quarter of Norwegians consult primary care due to MSDs annually, and 7% consult specialist care. Most patients only visit their GP. Four treatment trajectory classes were identified: low (75%), stable (10%), descending (9%) and high use (5%). Lower education and non Norwegian country of origin were associated with low use and higher education and Norwegian country of origin with higher use. Patients in specialist care reported higher pain, more disability and poorer health related quality of life than patients in primary care.
MSDs account for substantial healthcare use, with large variations. Socioeconomic factors influence care use, suggesting inequalities. Patients referred to specialist care typically have more complex problems, indicating appropriate referral patterns.
Additional information
Contact the research support staff.