Publikasjoner

• Galizzi, Matteo; Godager, Geir; Li, Jing; Linnosmaa, Ismo; Tammi, Timo & Wiesen, Daniel (2024). Economics of Healthcare Provider Altruism. I Zimmermann, Klaus F. (Red.), Handbook of Labor, Human Resources and Population Economics. Springer. ISSN 978-3-319-57365-6. doi: 10.1007/978-3-319-57365-6_357-1. Fulltekst i vitenarkiv
• Godager, Geir & Scott, Anthony (2024). Physician behavior and health outcomes. I Zimmermann, Klaus F. (Red.), Handbook of Labor, Human Resources and Population Economics. Springer. ISSN 978-3-319-57365-6. doi: 10.1007/978-3-319-57365-6_268-1. Fulltekst i vitenarkiv Vis sammendrag

  There is increasing empirical evidence of patient harmand resource waste from overdiagnosis, over-treatment, medical errors, and the underuse of effective care. This chapter reviews recent literature on physician behaviour and health outcomes. Research on the economics of physician behaviour takes a classical economic perspective based on using financial incentives to solve information problems in healthcare markets. The evidence on payment methods, competition and market organisation, and information interventions is summarised. Incentives matter, but may matter less in the presence of altruistic motives amongst most physicians, as well as the presence of complex multi-tasking decision environments. More contemporary research on physician behaviour has taken a behavioural perspective where it is acknowledged that physician decision making can be biased even in cases where incentive and information problems are absent. The large health services research literature on professional behaviour change incorporates behavioural and psychological perspectives yet integration into economic models of physician behaviour is still in its early stages. Though research on incentives continues to dominate the health economics literature, evidence suggests that behavioural approaches are important not only in understanding incentives, but in changing physicians’ behaviour using non-pecuniary interventions.

• Aars, Ole Kristian; Godager, Geir; Kaarbøe, Oddvar Martin & Moger, Tron Anders (2024). Sending emails to reduce medical costs? The effect of feedback on general practitioners’ claiming of fees. Journal of Behavioral and Experimental Economics. ISSN 2214-8043. 109. doi: 10.1016/j.socec.2024.102178.
• Hagen, Terje P.; Aarflot, Morten & Tjerbo, Trond (2024). Pasienter nyinnlagt i sykehjem – alder, tilstand og funksjonsnivå. Michael. ISSN 1893-9651. 21(1), s. 23–38. Fulltekst i vitenarkiv Vis sammendrag

  Sykehjemmene er en hjørnestein i kommunehelsetjenesten. De siste årene er antall sykehjemsplasser blitt redusert. Har det skjedd endringer i populasjonen av pasienter som er i langtidsopphold i sykehjemmene? Hensikten med denne artikkelen er å gi en nærmere beskrivelse av pasientpopulasjonen i kommunale helseinstitusjoner der sykehjemsplasser utgjør mer enn 95 % av plassene. Våre hovedfunn, basert på individdata fra Kommunalt pasient- og brukerregister fra perioden 2017–2021, er at det skjer en foryngelse av sykehjemsbeboerne, men at 70 % av dem fortsatt er 80 år eller eldre. I de eldre aldersgruppene som legges inn i langtidsopphold, finner vi overvekt av pasienter med hjerte- og karlidelser, nevrologiske lidelser og demens, mens psykiske og nevrologiske lidelser er de største sykdomsgruppene i de lavere aldersgruppene. Funksjonsevnen til eldre som er nyinnlagt, er noe redusert over tid. Det kan indikere at terskelen for å få langtidsplass er hevet for denne gruppen. Nyinnlagte pasienter i de lavere aldergruppene har imidlertid dårligere funksjonsevne enn de eldre. Våre resultater indikerer at inntakene til sykehjemmene reflekterer prioriteringskriteriene når vi betrakter landet samlet. Kommunenes utgifter til institusjonene ser ikke ut til å øke som følge av at andelen yngre pasienter som får langtidsplass, øker.

• Hagen, Terje P. & Zelko, Erika (2024). Exploring End-of-Life Care for Patients with Breast Cancer, Dementia or Heart Failure: A Register-Based Study of Individual and Institutional Factors. Healthcare. ISSN 2227-9032. doi: 10.3390/healthcare12090943. Vis sammendrag

  Objective: To examine variations in end-of-life care for breast cancer, heart failure, and dementia patients. Data and methods: Data from four Norwegian health registries were linked using a personal identification number. Longitudinal trends over 365 days and the type of care on the final day of life were analyzed using descriptive techniques and logistic regression analysis. Results: Patients with dementia were more commonly placed in nursing homes than patients in the two other groups, while patients with heart failure and breast cancer were more frequently hospitalized than the dementia patients. Breast cancer and heart failure patients had a higher likelihood of dying at home than dementia patients. The higher the number of general practitioners, the higher was the probability of home-based end-of-life care for cancer patients, while an increasing non-physician healthcare workers increased the likelihood of home-based care for the other patient groups. Conclusions: Diagnoses, individual characteristics, and service availability are all associated with the place of death in end-of-life care. The higher the availability of health care services, the higher also is the probability of ending the life at home.

• Cheo, Roland; Ge, Ge; Liu, Rugang; Wang, Jian & Wang, Qiqi (2023). Physician beneficence and profit-taking among private for-profit clinics in China: A field study using a mystery shopper audit. Journal of Behavioral and Experimental Economics. ISSN 2214-8043. 107. doi: 10.1016/j.socec.2023.102129. Fulltekst i vitenarkiv
• Aas, Eline; Thorjussen, Christian B. Holth & Godager, Geir (2023). The Role of Health Status and Social Capital in Cancer Mortality: Insights from Matched Register and Survey Data. Nordic Journal of Health Economics. ISSN 1892-9729. 6(1), s. 6–27. doi: 10.5617/njhe.10304. Fulltekst i vitenarkiv Vis sammendrag

  Cancer mortality has been shown to be associated with social- and human capital. Several channels have been suggested, such as early detection, better compliance to treatment and better health prior to diagnosis. In this paper we study how health status and social capital jointly affect cancer mortality and cancer severity at the time of diagnosis. The analyses are based on study sample of individuals with cancer diagnosis. Our merged dataset contain information on cancer diagnosis and death from the Cancer Registry of Norway and health status, social capital and other individual level data from several national health surveys measured before the time of diagnosis. Health status and social capital are treated as unobserved latent variables, and we apply generalized structural equation modelling framework to estimate conditional statistical associations of social capital and individual health on cancer severity and mortality. We find that health has negative, and statistically significant effect, on cancer mortality, while we cannot conclude on the association between health and cancer severity (metastasis yes/no). We cannot conclude that cancer mortality and the probability of cancer metastasis is associated nor disassociated with social capital. Our results add nuance to prior studies, which frequently report a significant association between social capital and cancer mortality.

• Erbe, Amanda Whitney; Kendzia, Dana; Busink, Ellen; Carroll, Suzanne & Aas, Eline (2023). Value of an Integrated Home Dialysis Model in the United Kingdom: A Cost-Effectiveness Analysis. Value in Health. ISSN 1098-3015. 26(7), s. 984–994. doi: 10.1016/j.jval.2023.02.009.
• Godager, Geir; Hennig-Schmidt, Heike; Li, Jing Jing; Wang, Jian & Yang, Fan (2023). Does gender affect medical decisions? Results from a behavioral experiment with physicians and medical students. Nordic Journal of Health Economics. ISSN 1892-9729. 6(1), s. 182–215. doi: 10.5617/njhe.10135. Fulltekst i vitenarkiv Vis sammendrag

  It is rarely the case in medical practice that differences between female and male physicians can be described under ceteris paribus conditions. Physicians self-select their type of practice, patients self-select physicians, and physicians are expected to account for both the context and the characteristics of their patients when providing medical treatment. As a result, reported gender differences in medical practice can have several alternative interpretations. A key question, therefore, is whether the treatment of a given patient is expected to depend on the gender of the physician. To address this question, we quantify gender effects using data from an incentivized laboratory experiment, in which Chinese medical doctors and Chinese medical students choose medical treatment under different payment schemes. We estimate preference parameters of females and males assuming decision makers have patient-regarding preferences. We cannot reject the hypothesis that gender differences in treatment choices are absent. The differences between preference parameters of females and males are not statistically significant, and there is no evidence that the degree of randomness in choices differs between genders. The absence of gender effects in the laboratory, where choice context is fixed, provides nuance to previous findings on gender differences, and highlights the general difficulty of separating individuals’ behavior from their context.

• Aas, Eline; Gomez, Monica & Tariq, Fawaz (2022). Health Technology Assessment (HTA) of GLP-1 receptor agonists and SGLT-2 inhibitors in combination with metformin as first-line treatment in patient with type 2 diabetes mellitus (T2DM) and established cardiovascular or chronic kidney disease. HERO skriftserie / Working paper. ISSN 1501-9071. 3.
• Goude, Fanny; Garellick, Göran; Kittelsen, Sverre; Malchau, Henrik; Peltola, Mikko & Rehnberg, Clas (2022). Effects of competition and bundled payment on the performance of hip replacement surgery in Stockholm, Sweden: results from a quasi-experimental study. BMJ Open. ISSN 2044-6055. 12(7). doi: 10.1136/bmjopen-2022-061077.
• HAIG, YLVA & Feiring, Eli (2022). Stakeholder views of the development of a clinical quality registry for interventional radiology: a qualitative study. BMC Health Services Research. ISSN 1472-6963. 22(44). doi: 10.1186/s12913-021-07423-y. Fulltekst i vitenarkiv
• Kjelsnes, Ashwanee A. & Feiring, Eli (2022). Models of integrated care for older people with frailty: a horizon scanning review. BMJ Open. ISSN 2044-6055. 12(4). doi: 10.1136/bmjopen-2021-060142. Fulltekst i vitenarkiv
• Bjørnelv, Gudrun Maria Waaler; Zolic-Karlsson, Zinajda; Dueland, Svein; Line, Pål Dag & Aas, Eline (2022). Cost-effectiveness of liver transplantation versus last-resort systemic therapy for colorectal liver metastases. British Journal of Surgery. ISSN 0007-1323. 109(6), s. 483–485. doi: 10.1093/bjs/znac022. Fulltekst i vitenarkiv
• Waggestad-Stoa, Malin Nuth; Traina, Gloria & Feiring, Eli (2022). Barriers and facilitators to adopting horizon scanning to identify novel integrated care models: a qualitative interview study. BMJ Innovations. ISSN 2055-8074. s. 1–7. doi: 10.1136/bmjinnov-2021-000804. Fulltekst i vitenarkiv
• Ge, Ge; Godager, Geir & Wang, Jian (2022). Exploring physician agency under demand-side cost sharing—An experimental approach. Health Economics. ISSN 1057-9230. 31(6), s. 1202–1227. doi: 10.1002/hec.4489. Fulltekst i vitenarkiv Vis sammendrag

  The assumption of patient-regarding physicians has been widely adopted in the health economics literature. Physicians' patient-regarding preferences are often described as the concern for the health benefits of medical treatments, and thus closely related to the norms and ethics of the Medical profession. In this paper, we ask whether physicians' patient-regarding preferences include a concern for their patient's consumption opportunities alongside patient's health benefits. To identify and quantify patient-regarding preferences, we design and conduct an incentivized laboratory experiment where choices determine separately the health benefit and the consumption opportunities of a real patient admitted to the nearest hospital. We find strong evidence that future physicians care about their patients' consumption opportunities.

• Moger, Tron Anders; Holen, åsne Sørlien; Hanestad, Berit & Hofvind, Solveig Sand-Hanssen (2022). Costs and Effects of Implementing Digital Tomosynthesis in a Population-Based Breast Cancer Screening Program: Predictions Using Results from the To-Be Trial in Norway. PharmacoEconomics - Open. ISSN 2509-4262. 6, s. 495–507. doi: 10.1007/s41669-022-00343-5. Fulltekst i vitenarkiv
• Ree, Anne Hansen; Mælandsmo, Gunhild Mari; Flatmark, Kjersti; Russnes, Hege Elisabeth Giercksky; Casteneda, Monica Gomez & Aas, Eline (2022). Cost-effectiveness of molecularly matched off-label therapies for end-stage cancer – the MetAction precision medicine study. Acta Oncologica. ISSN 0284-186X. 61(8), s. 955–962. doi: 10.1080/0284186X.2022.2098053. Fulltekst i vitenarkiv
• Botteri, Edoardo; Hoff, Geir; Randel, Kristin Ranheim; Holme, Øyvind; de Lange, Thomas & Bernklev, Tomm [Vis alle 16 forfattere av denne artikkelen] (2022). Characteristics of nonparticipants in a randomised colorectal cancer screening trial comparing sigmoidoscopy and faecal immunochemical testing. International Journal of Cancer. ISSN 0020-7136. 151(3), s. 361–371. doi: 10.1002/ijc.34025. Fulltekst i vitenarkiv Vis sammendrag

  Public health systems should guarantee universal access to health care services, including cancer screening. We assessed whether certain population subgroups were underrepresented among participants in colorectal cancer screening with sigmoidoscopy and faecal immunochemical testing (FIT). Between 2012 and 2019, about 140 000 individuals aged 50 to 74 years were randomly invited to once-only sigmoidoscopy or first round of FIT screening. Our study included 46 919 individuals invited to sigmoidoscopy and 70 019 to FIT between 2012 and 2017. We used logistic regression models to evaluate if demographic and socioeconomic factors and use of certain drugs were associated with participation. Twenty-four thousand one hundred and fifty-nine (51.5%) individuals attended sigmoidoscopy and 40 931 (58.5%) FIT screening. Male gender, young age, low education and income, being retired or unemployed, living alone, being an immigrant, long driving time to screening centre, and use of antidiabetic and psychotropic drugs were associated with low participation in both screening groups. Many of these factors also predicted low acceptance of colonoscopy after positive FIT. While male gender, young age and living alone were more strongly associated with nonparticipation in FIT than sigmoidoscopy, low education and income, being retired or immigrant and long driving time were more strongly associated with nonparticipation in sigmoidoscopy than FIT. In conclusion, participation was lower in sigmoidoscopy than FIT. Predictors of nonparticipation were similar between arms. However, low socioeconomic status, being an immigrant and long driving time affected participation more in sigmoidoscopy screening, suggesting that FIT may guarantee more equal access to screening services than sigmoidoscopy.

• Håvi, Gry; Feiring, Eli & Opheim, Randi (2022). «Mer enn bare en håndlanger»: oppfatninger om sykepleierens betydning for kvalitet ved koloskopi. Sykepleien Forskning. ISSN 1890-2936. 17. doi: 10.4220/Sykepleienf.2022.90030.
• Van Walsem, Marleen Regina; Frich, Jan C; Gomez Castaneda, Monica; Howe, Emilie; Pihlstrøm, Lasse & Andelic, Nada [Vis alle 7 forfattere av denne artikkelen] (2022). Health related quality of life, service utilization and costs for patients with Huntington’s disease in Norway . BMC Health Services Research. ISSN 1472-6963. 22(1), s. 1–12. doi: 10.1186/s12913-022-08881-8. Fulltekst i vitenarkiv
• Bjørnelv, Gudrun Maria Waaler; Hagen, Terje P.; Forma, Leena & Aas, Eline (2022). Care pathways at end-of-life for cancer decedents: registry based analyses of the living situation, healthcare utilization and costs for all cancer decedents in Norway in 2009-2013 during their last 6 months of life. BMC Health Services Research. ISSN 1472-6963. 22. doi: 10.1186/s12913-022-08526-w. Fulltekst i vitenarkiv
• Fystro, Joar Røkke; Hofmann, Bjørn Morten & Feiring, Eli (2022). On the person in personal health responsibility. BMC Medical Ethics. ISSN 1472-6939. 23(1). doi: 10.1186/s12910-022-00802-y. Fulltekst i vitenarkiv
• Nilsen, Heidi & Feiring, Eli (2022). Local public health projectification in practice: a qualitative study of facilitators and barriers to a public health plan implementation. Scandinavian Journal of Public Health. ISSN 1403-4948. doi: 10.1177/14034948221080402. Fulltekst i vitenarkiv
• Howe, Emilie; Andelic, Nada; Fure, Silje Christine Reistad; Røe, Cecilie; Søberg, Helene L. & Hellstrøm, Torgeir [Vis alle 12 forfattere av denne artikkelen] (2022). Cost-effectiveness analysis of combined cognitive and vocational rehabilitation in patients with mild-to-moderate TBI: results from a randomized controlled trial. BMC Health Services Research. ISSN 1472-6963. 22. doi: 10.1186/s12913-022-07585-3. Fulltekst i vitenarkiv
• Kleive, Dyre; Aas, Eline; Angelsen, Jon-Helge; Bringeland, Erling Audun; Nesbakken, Arild & Nymo, Linn Såve [Vis alle 9 forfattere av denne artikkelen] (2021). Simultaneous Resection of Primary Colorectal Cancer and Synchronous Liver Metastases: Contemporary Practice, Evidence and Knowledge Gaps. Oncology and Therapy. ISSN 2366-1070. 9(1), s. 111–120. doi: 10.1007/s40487-021-00148-2. Fulltekst i vitenarkiv
• Feiring, Eli & Solberg, Carl Tollef (2021). Priority setting of COVID-19 vaccines in Norway: Advice and process (English translation) . Michael. ISSN 1893-9651. 28, s. 49–59. Fulltekst i vitenarkiv Vis sammendrag

  In the autumn of 2020, the Norwegian Institute of Public Health invited us to participate in an external group that would be advising on COVID-19 vaccine priority-setting in Norway. The group’s mandate was to set goals for the Norwegian National Coronavirus Immunisation Programme, as well as to provide general recommendations regarding priority groups in the first phase of the vaccine deployment. The group recommended prioritising the risk group and healthcare personnel and also proposed geographical prioritisation depending on community case incidence. The group’s advisory report was part of a large-scale multidisciplinary project comprising epidemiology, medicine, infection control, computer modelling of COVID-19 vaccine efficacy and economic cost-benefit analyses. Priority setting implies that some citizens are given preference ahead of others who must wait. In Norway, as elsewhere, there is disagreement concerning the values, principles and goals determining vaccine prioritisation. In this article, we present an account of the group’s work process, advice, and rationales in more detail and identify values-based ‘trade-offs’ that pose particular challenges.

• Goude, Fanny; Kittelsen, Sverre A.C.; Malchau, Henrik; Mohaddes, Maziar & Rehnberg, Clas (2021). The effects of competition and bundled payment on patient reported outcome measures after hip replacement surgery. BMC Health Services Research. ISSN 1472-6963. 21. doi: 10.1186/s12913-021-06397-1.
• Fosse, Rina Moe; Ambugo, Eliva Atieno; Moger, Tron Anders; Hagen, Terje P. & Tjerbo, Trond (2021). Does rehabilitation setting influence risk of institutionalization? A register-based study of hip fracture patients in Oslo, Norway. BMC Health Services Research. ISSN 1472-6963. 21(1), s. 1–14. doi: 10.1186/s12913-021-06703-x. Fulltekst i vitenarkiv
• Hsu, John; Iversen, Tor; Price, Mary; Moger, Tron Anders; Tevis, Delaney & Hagen, Terje P. [Vis alle 7 forfattere av denne artikkelen] (2021). Myocardial infarction care among the elderly: Declining treatment with increasing age in two countries. Health Affairs. ISSN 0278-2715. 40(9), s. 1483–1490. doi: 10.1377/hlthaff.2021.00108. Vis sammendrag

  The elderly account for the majority of medical spending in many countries, raising concerns about potentially unnecessary spending, especially during the final months of life. Using a well-defined starting point (hospitalization for an initial acute myocardial infarction) with evidence-based postevent treatments, we examined age trends in treatments in the US and Norway, two countries with high levels of per capita medical spending. After accounting for comorbidities, we found marked decreases within both countries in the use of invasive treatments with age (for example, less use of percutaneous coronary interventions and surgery) and the use of relatively inexpensive medications (for example, less use of anticholesterol [statin] drugs for which generic versions are widely available). The treatment decreases with age were larger in Norway compared with those in the US. The less frequent treatment of the oldest of the old, without even use of basic medications, suggests potential age-related bias and a disconnect with the evidence on treatment value. Hospital organization and payment in both countries should incentivize greater equity in treatment use across ages.

• Søberg, Helene Lundgaard; Moksnes, Håkon Øgreid; Anke, Audny; Røise, Olav; Røe, Ellen-Cecilie Treu & Aas, Eline [Vis alle 20 forfattere av denne artikkelen] (2021). Rehabilitation Needs, Service Provision, and Costs in the First Year Following Traumatic Injuries: Protocol for a Prospective Cohort Study. JMIR Research Protocols. ISSN 1929-0748. 10(4), s. 1–10. doi: 10.2196/25980. Fulltekst i vitenarkiv
• Ge, Ge & Godager, Geir (2021). Predicting strategic medical choices: An application of a quantal response equilibrium choice model. Journal of Choice Modelling. ISSN 1755-5345. 39, s. 1–14. doi: 10.1016/j.jocm.2021.100282. Fulltekst i vitenarkiv Vis sammendrag

  Quantal response equilibrium choice (QREC) models are structural behavioral models that account for bounded rationality and strategic interactions in analyses of games where each player’s payoff is a vector. We revisit the question of how market competition affects pro-social behavior and fit a QREC model to data from an incentivized laboratory experiment, where the participants make decisions on medical treatment for abstract patients in monopoly, duopoly and quadropoly games. Our results demonstrate that competition can cause substantial behavioral responses without any changes in pro-social preferences if one allows for the possibility that competition influences the degree of randomness in decision-making. We find that a QREC model with fixed preference parameters provides precise out-of-sample predictions of behavior in games with vector payoffs. A Monte Carlo study is performed to show that the two-step estimator is accurate.

• Aas, Eline; Iversen, Tor & Kaarbøe, Oddvar Martin (2021). The Economic Sustainability of the Norwegian Healthcare System. I Baltagi, Badi H. & Moscone, Francesco (Red.), The Sustainability of Health Care Systems in Europe . Emerald Group Publishing Limited. ISSN 978-1-83909-499-6. s. 81–101. doi: 10.1108/S0573-855520210000295010. Vis sammendrag

  The Norwegian health care system is semi-decentralized. Primary care and long-term care (LTC) are the responsibilities of the municipalities. Specialist care is the responsibility of the central government and is organised through four Regional Health Authorities (RHA). Resource use, health outcomes and severity are the three main pillars for priority setting, regularly applied in reimbursement decisions for pharmaceuticals. The sustainability of health care is challenged in Norway. The main factors are a growing elderly population with high need of complex, coordinated services, an increasing demand for newly approved drugs and advanced technology and a potential shortage of health care personnel. We present recent trials and policy reforms in Norway aimed at improving care pathways combined with cost containment. Reforms in the pharmaceutical market, both with regard to market access and reimbursement(cost-effectiveness), and regulation of prices, have resulted in cost containment. The primary care sector awaits reform initiatives to recruit and retain physicians as general practitioners. No reform in the hospital sector has had cost containment as a main focus. The sector is characterized with low productivity growth, and expenditures that have increased more than the GDP growth. Waiting times are long, and coordination between sub-sectors of health care has been poor, although the Coordination reform of 2012 has alleviated some of the challenges related to intersectoral coordination. Still, the divided responsibility for health care between the central government and the municipalities creates tensions between national ambitions and local decisions in the financing and provision of health services.

• Ge, Ge & Godager, Geir (2021). Data from an incentivized laboratory experiment on strategic medical choices. Data in Brief. ISSN 2352-3409. 35. doi: 10.1016/j.dib.2021.106926. Vis sammendrag

  This paper presents data of medical choices determining physicians’ profit and patients’ health benefit under three levels of market competition: monopoly, duopoly, and quadropoly. The data was collected from 136 German university students in an incentivised laboratory experiment. The designed experimental parameters and the formula for computing the payoff matrices of the games are described in this paper as well. This data was analyzed by Ge and Godager (2020) who employed generalized multinomial logit models to investigate the relationship between market competition and determinism in behavior under a quantal response equilibrium paradigm. This data contributes to future investigation on alternative game theoretic equilibrium concepts and the development of empirical methods for studying strategic choice behavior.

• Hagen, Terje P. (2021). Er det stordriftsfordeler i sykehus? Praktisk økonomi & finans. ISSN 1501-0074. 37(3), s. 233–241. doi: 10.18261/issn.1504-2871-2021-03-06. Vis sammendrag

  I Norge er spørsmålet om det er stordriftsfordeler i sykehus aktualisert av to forhold. For det første står landet foran sykehusutbygginger i Mjøsområdet, Drammen, Oslo og på Helgelandskysten. Et grunnleggende tema i debatten har vært om en skal bygge store sykehus eller satse på mindre, men flere enheter. Både i Mjøsområdet og i Oslo ser en i skrivende stund ut til å legge opp til større utbygginger. Den andre saken er den nylig vedtatte fordelingsmodellen mellom staten og de regionale helseforetakene der en kompenserer for ulemper forbundet med størrelse. Det paradoksale er altså at en legger opp til sykehusutbygginger som ifølge den statlige utredningen er ineffektive og som en i neste omgang må kompensere for. I artikkelen går jeg gjennom internasjonal litteratur om temaet og stiller tre spørsmål: Er det stordriftsfordeler i sykehus? Kan eventuelle stordriftsfordeler utløses gjennom sykehussammenslåinger? Hvordan påvirkes kvaliteten i sykehusbehandlingen av sykehussammenslåinger? Artikkelen er ikke en systematisk revy i streng forstand, men en gjennomgang av litteraturen som legger vekt på hvordan analysene av effektivitet og skalaeffekter har endret seg over tid og hvordan disse endringene har påvirket konklusjonene. Avslutningsvis knytter jeg trådene tilbake til den norske debatten.

• Aas, Eline; Silwal, Sanju; Cyr, Pascale-Renée; Holt, Tonje; Ormhaug, Silje Mørup & Jensen, Tine Kristin (2020). Health-related quality of life (HRQoL) in children and adolescent with post-traumatic stress symptom: A comparison of 16D and condition-specific instruments. Nordic Journal of Health Economics. ISSN 1892-9729. 8(1), s. 46–71. doi: 10.5617/njhe.6929. Fulltekst i vitenarkiv
• Hestmark, Lars; Romøren, Maria; Heiervang, Kristin S.; Weimand, Bente; Ruud, Torleif & Norvoll, Reidun [Vis alle 11 forfattere av denne artikkelen] (2020). Implementation of guidelines on family involvement for persons with psychotic disorders in community mental health centres (IFIP): protocol for a cluster randomised controlled trial. BMC Health Services Research. ISSN 1472-6963. 20:934, s. 1–15. doi: 10.1186/s12913-020-05792-4. Fulltekst i vitenarkiv
• Cheo, Roland; Ge, Ge; Godager, Geir; Liu, Rugang; Wang, Jian & Wang, Qiqi (2020). The effect of a mystery shopper scheme on prescribing behavior in primary care: Results from a field experiment. Health Economics Review. ISSN 2191-1991. 10(33). doi: 10.1186/s13561-020-00290-z. Fulltekst i vitenarkiv
• Hehenkamp, Burkhard & Kaarbøe, Oddvar Martin (2020). Location choice and quality competition in mixed hospital markets. Journal of Economic Behavior and Organization. ISSN 0167-2681. 177, s. 641–660. doi: 10.1016/j.jebo.2020.06.026.
• Skonnord, Trygve T.; Skjeie, Holgeir; Brekke, Mette; Klovning, Atle; Grotle, Margreth & Aas, Eline [Vis alle 8 forfattere av denne artikkelen] (2020). Acupuncture for acute non-specific low back pain: a randomised, controlled, multicentre intervention study in general practice—the Acuback study. BMJ Open. ISSN 2044-6055. 10. doi: 10.1136/bmjopen-2019-034157. Fulltekst i vitenarkiv
• Wang, Jian; Iversen, Tor; Hennig-Schmidt, Heike & Godager, Geir (2020). Are patient-regarding preferences stable? Evidence from a laboratory experiment with physicians and medical students from different countries. European Economic Review. ISSN 0014-2921. 125. doi: 10.1016/j.euroecorev.2020.103411. Fulltekst i vitenarkiv
• Häkkinen, Unto; Goude, Fanny; Hagen, Terje P.; Kruse, Marie; Moger, Tron Anders & Peltola, Mikko [Vis alle 7 forfattere av denne artikkelen] (2020). A performance comparison of patient pathways in Nordic capital areas – a pilot study for ischaemic stroke patients. Scandinavian Journal of Public Health. ISSN 1403-4948. doi: 10.1177/1403494819863523.

Se alle arbeider i Cristin

• Godager, Geir & Brækhus, Leni Aurora (2023). Helseøkonom positivt overrasket over «kommunetilpasset» basistilskudd. [Avis]. Dagens medisin.
• Kinge, Jonas Minet; Aas, Eline & Godager, Geir (2023). Ønsker vi virkelig å redusere kvaliteten på helsetjenesten? Dagens medisin. ISSN 1501-4290.
• Kinge, Jonas Minet; Godager, Geir & Selbæk, Geir (2023). En sterk økning i demens vil kreve store ressurser. Dagens medisin. ISSN 1501-4290. Vis sammendrag

  Demens er dyrest av alle sykdommer i Norge og utgjør en presserende helseutfordring. En aldrende befolkning gjør at forekomsten av demens er i ferd med å øke. Dessverre har vi ikke noen effektiv kur mot denne tilstanden. For å opprettholde tjenestetilbudet til personer med demens trengs betydelig økninger i bevilgningene til omsorgstjenesten.

• Zhang, Yuan; Øien, Henning & Iversen, Tor (2023). Norway - Handling the Pandemic and the Effects on Specialized Healthcare.
• Zhang, Yuan & Iversen, Tor (2023). The development of digital consultations in Norway.
• Kittelsen, Sverre; Lindaas, Nils Arne; Anthun, Kjartan Sarheim & Magnussen, Jon (2023). Economies of Scale and Scope in Norwegian hospitals.
• Kittelsen, Sverre A.C.; Lindaas, Nils Arne; Anthun, Kjartan Sarheim & Magnussen, Jon (2023). Economies of scope in Norwegian hospitals.
• Kittelsen, Sverre A.C.; Lindaas, Nils Arne; Anthun, Kjartan Sarheim & Magnussen, Jon (2023). Economies of Scale and Scope in Norwegian Hospitals,
• Ramirez Lizardi, Eduardo Alberto; Fevang, Elisabeth; Røed, Knut & Øien, Henning (2023). Parental health and caregiving decisions in the family: The effects of health shocks on adult children’s income .
• Ramirez Lizardi, Eduardo Alberto; Fevang, Elisabeth; Røed, Knut & Øien, Henning (2023). Parental health and caregiving decisions in the family: The effects of health shocks on adult children’s income.
• Ramirez Lizardi, Eduardo Alberto; Fevang, Elisabeth; Røed, Knut & Øien, Henning (2023). Parental health and caregiving decisions in the family: The effects of health shocks on adult children’s income.
• Godager, Geir (2023). Uønsket fravær av variasjon i helsesektoren. Magma forskning og viten. ISSN 1500-0788. 26(5), s. 171–178. doi: 10.23865/magma.v26.1432. Fulltekst i vitenarkiv
• Ge, Ge & Godager, Geir (2022). Imperfect quality competition in regulated health care markets .
• Ge, Ge & Godager, Geir (2022). Imperfect quality competition in regulated health care markets.
• Ge, Ge; Iversen, Tor; Kaarbøe, Oddvar Martin & Snilsberg, Øyvind (2022). The impacts of Norway’s extended free choice reform.
• Ge, Ge; Iversen, Tor; Kaarbøe, Oddvar Martin & Snilsberg, Øyvind (2022). The impacts of Norway’s extended free choice reform.
• Ge, Ge; Iversen, Tor; Kaarbøe, Oddvar Martin & Snilsberg, Øyvind (2022). The impacts of Norway’s extended free choice reform.
• Bjørnelv, Gudrun Maria Waaler; Aas, Eline; Aaltonen, Mari; Hagen, Terje P. & Forma, Leena (2022). Place of living during end-of-life according to cause of death: a comparative analysis from Finland and Norway .
• Aas, Eline & Burger, Emily Annika (2022). Økonomisk evaluering .
• Aas, Eline (2022). Økonomisk evaluering av nye tiltak: fokus på infeksjoner.
• Ge, Ge; Iversen, Tor; Kaarbøe, Oddvar Martin & Snilsberg, Øyvind (2022). The impacts of Norway’s extended free choice reform.
• Aas, Eline (2022). Cost-effectiveness analysis of precision cancer medicine: The case of MetAction.
• Aas, Eline (2022). Bruk av registerdata for utforming av prisavtaler.
• Aas, Eline (2022). Presisjonsmedisin - evaluering og finansisering.
• Aas, Eline (2022). Håndtering av usikkerhet i helseøkonomiske analyser, hvilke utfordringer og muligheter ser dere fremover? .
• Fystro, Joar Røkke & Feiring, Eli (2022). 185:poster The ideas behind charging for non-attendance in healthcare: an analysis of key policy documents in Denmark and Norway. BMJ Global Health. ISSN 2059-7908. 7. doi: 10.1136/bmjgh-2022-ISPH.53.
• Zhang, Yuan & Iversen, Tor (2022). Development of the composition of GP consultation services in Norway from 2019 to 2021.
• Godager, Geir (2022). Bounded rationality models and their application to experimental data.
• Godager, Geir (2022). Bounded rationality models and their application to experimental data.
• Godager, Geir (2022). Bounded rationality models and their application to experimental data.
• Ge, Ge; Godager, Geir; Thomas, Stephanie & Hole, Arne Risa (2021). A protocol for a choice experiment and data analysis.
• Ge, Ge & Godager, Geir (2021). Predicting strategic medical choices: An application of a quantal response equilibrium choice model.
• Ge, Ge; Iversen, Tor; Kaarbøe, Oddvar Martin & Snilsberg, Øyvind (2021). The impacts of Norway’s extended free choice reform.
• Feiring, Eli (2021). Social insurance, mutualistic insurance and genetic information. Journal of Medical Ethics. ISSN 0306-6800. doi: 10.1136/medethics-2021-107542.
• Godager, Geir (2021). Preregistration of protocols for economic experiments.
• Aas, Eline (2021). Determinants and Disparities in End-of-Life Care Costs: Evidence from Real World Data in Norway, Ireland and the United States.
• Aas, Eline (2021). Evaluering av nye tjenestetilbud.
• Hagen, Terje P. (2021). Effects of municipal acute wards on hospital admissions: Evaluation of a natural experiment using register data. Vis sammendrag

  Objectives: Norway introduced municipal acute wards (MAWs) as part of the Coordination Reform in 2012 to reduce the number of patients admitted to hospitals. The main objective of the paper is investigate whether implementation of AMUs had a causal effect on hospital admissions. Methods: We analyzed monthly admission rates in total and by age group for patients admitted with acute and elective conditions at internal medicine and surgical departments by panel data regression technics. Identification of the causal effects were made possible by utilizing the sequential implementation of the MAW. Our data covered all municipalities for the period from 2010 until the end of 2017. Preliminary results: The sequential implementation of the MAWs started summer 2012. By the beginning of 2016 close to all municipalities had an MAW up and running. The introduction of MAWs was associated with a significant reduction in acute hospital admissions. The effect was strongest for patients above 80 years of age admitted acutely to internal medicine departments. The effects were even stronger if the MAW had physician on duty 24/7 or were located close to a local emergency center. Conclusion: Our findings suggest that this type of intermediate care is a viable option in an effort to alleviate the burden on hospitals by reducing acute secondary care admission volume.

• Aas, Eline (2021). Hvordan kan helseøkonomiske analyser integreres i ortopedisk studier? .
• Aas, Eline (2021). Hvordan kan helseøkonomiske analyser integreres i kliniske studier? .
• Aas, Eline (2021). Hva kan vi gjøre for å redusere usikkerhet ved bruk av registerdata i helseøkonomiske vurderinger .
• Aas, Eline (2021). Helseøkonomi og persontilpasset medisin - paneldebatt.
• Godager, Geir (2021). Forhåndsregistrering av forskningsprotokoller i eksperimentell økonomi .
• Aas, Eline (2020). Precision Medicine: A Health Economics Perspective.
• Moger, Tron Anders (2020). When should patients be transferred from hospital to municipal care?
• Hagen, Terje P. (2020). Innovation prosjects in Health Region South-East.
• Pettersen, Klas Henning (2020). Will artificial intelligence change health care?
• Frich, Jan C (2020). Ledelse under Korona.
• Feiring, Eli (2020). Horizon scanning in health service research.
• Godager, Geir; Iversen, Tor & Snilsberg, Øyvind (2020). Norge er trolig alene om å innføre omvendt overtid for fastleger. Dagens medisin. ISSN 1501-4290. Vis sammendrag

  Norge er ikke det første landet som velger å betale større basistilskudd til allmennlegene – men trolig alene om å innføre omvendt overtid.

• Groß, Mona; Hennig-Schmidt, Heike & Wiesen, Daniel (2023). Personality and physician performance pay: Evidence from a behavioral experiment in health . Universitetet i Oslo. ISSN 978-82-7756-279-7. 2023(5).
• Abelsen, Birgit; Gaski, Margrete; Godager, Geir; Iversen, Tor; Løyland, Hanna Isabel & Pedersen, Kine [Vis alle 9 forfattere av denne artikkelen] (2022). Evaluering av pilotprosjekt med primærhelseteam og alternative finansieringsordninger: Sluttrapport for 2018-2021 (Statusrapport IV). Universitetet i Oslo. Fulltekst i vitenarkiv
• Aars, Ole Kristian; Godager, Geir; Kaarbøe, Oddvar Martin & Moger, Tron Anders (2022). Sending emails to reduce medical costs? The effect of feedback on general practitioners’ claiming of fees. Universitetet i Oslo. ISSN 1501-9071. 2022(1). Fulltekst i vitenarkiv Vis sammendrag

  Audit and feedback is used as a strategy to guide practices of health care professionals towards certain targets. The outcome of interest can be quality improvements, but also ensuring that health care workers adhere to relevant regulations. We conducted a nationwide field experiment in the Norwegian primary care sector to study the behavioral responses from giving general practitioners feedback (GPs) on their claiming of fees. The email-based feedback intervention targeted GPs who most frequently claimed fees for double consultations and provided them with a reminder of the formal regulations for double consultations. The intervention caused a 2-5 percentage point reduction in the use of the double-consultation fee, reducing the yearly health care spending of the Norwegian government by approximately €877 000 (or €1 270 per GP).

• Abelsen, Birgit; Gaski, Margrete; Godager, Geir; Iversen, Tor; Løyland, Hanna Isabell & Pedersen, Kine [Vis alle 9 forfattere av denne artikkelen] (2021). Evaluering av forsøk med primærhelseteam og alternative finansieringsordninger: Statusrapport III. Universitetet i Oslo. Fulltekst i vitenarkiv
• Godager, Geir; Hennig-Schmidt, Heike; Jing Jing, Li; Wang, Jian & Yang, Fan (2021). Does gender affect medical decisions? Results from a behavioral experiment with physicians and medical students . Universitetet i Oslo. ISSN 1501-9071. 2021(1). Fulltekst i vitenarkiv Vis sammendrag

  It is rarely the case that differences in behaviors of females and males are described under a ceteris paribus condition, and behaviors can potentially be influenced by the environment in which decisions are made. In the case of medical decisions, physicians are expected to account for patient characteristics as well as observed and unobserved contextual factors, such as whether the patient has a healthy lifestyle. Since one usually do not randomize physicians to context, reported gender differences in medical practice can have several alternative interpretations. A key question is whether the medical treatment of a given patient is expected to depend on the gender of the physician. To address this question, we quantify gender effects using data from an incentivized laboratory experiment, where Chinese medical doctors and Chinese medical students choose medical treatment under different payment schemes. We estimate preference parameters of females and males assuming decision-makers have patient-regarding preferences. We cannot reject the hypothesis that gender differences in treatment choices are absent. Preference parameters of females and males are not statistically different in a log-likelihood ratio test, and there is no evidence that the degree of randomness in choices differs between genders. The absence of gender effects in the laboratory, where choice context is fixed, provides nuance to previous findings on gender differences, and highlights the general difficulty of separating individuals’ behavior from the context they are in.

• Ge, Ge & Godager, Geir (2021). Essays in experimental health economics. Universitetet i Oslo. Fulltekst i vitenarkiv Vis sammendrag

  In order to implement effective health policy reforms, knowledge of physician preferences, and hence, their responses to policy reforms is desirable. This thesis consists of three papers aiming to address fundamental research questions on physician behavior. Paper I investigates whether the change of information scheme affects physicians’ prescribing behavior. The results suggest that preannouncing a mystery shopper audit reduces physicians’ probability of prescribing drugs to the pseudopatients. Paper II explores physicians’ response to cost-sharing borne by the patients and finds that future physicians are concerned about the influences of their medical treatment choices on patients’ consumption opportunities after co-payment. Paper III introduces a strategic decision scenario and studies physician treatment decisions under competition. The results indicate that the substantial difference in behavior between markets may be attributed to changes in individuals’ scale parameter. The scale parameter rises as markets become more competitive, implying a higher degree of determinism in behavior. The data of all three papers are collected from experiments. Under the framework of stochastic choice theory, three special cases of a generalized multinomial logit model are employed in the data analysis.

• Hagen, Terje P. & Kaarbøe, Oddvar Martin (2020). Har bedriftenes kjøp av private helseforsikringer effekter for sykefraværet? Universitetet.
• Dagsvik, John K. & Dagsvik, John k (2020). On the Equilibria in Logit Models of Social Interaction and Quantal Response Equilibrium . University of Oslo. ISSN 978-82-7756-270-4. 2020(5). Vis sammendrag

  This paper investigates the set of equilibria in models of social interaction and Quantal Response Equilibrium (QRE). First, we discuss how models of social interaction can be viewed as a special case of QRE. Subsequently, we establish criteria that characterize the set of equilibria in models of social interaction and QRE. Finally, we establish conditions for convergence of sequential stochastic game models to QRE when players learn about the aggregate behavior of the players.

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