Publikasjoner

• Godager, Geir (2026). 7. Allmennlegetjenestene. I Berg, Ole Trond; Hagen, Terje P.; Gjefsen, Hege Marie; Godager, Geir; Hart, Rannveig Kaldager; Kinge, Jonas Minet; Holte, Jon Helgheim; Aas, Eline; Kittelsen, Sverre A.C.; Moger, Tron Anders; Tjerbo, Trond; Veggeland, Frode & Øien, Henning (Red.), Organisering og finansering av helsetjenester. Fagbokforlaget. ISSN 9788245061505. s. 151–176. doi: 10.55669/oa180907. Fulltekst i vitenarkiv Vis sammendrag

  Allmennlegetjenestene, med fastlegeordningen som bærebjelke, spiller en avgjørende rolle i det norske helsevesenet. Da fastlegeordningen ble innført i 2001, representerte den et paradigmeskifte i organiseringen og finansieringen av primærhelsetjenesten. Overgangen fra faste driftstilskudd til per capita-betaling kombinert med stykkprisbetaling endret insentivstrukturen for både leger og kommuner. Dette bidro til å snu situasjonen fram legemangel til en situasjon med pasientmangel. De økonomiske insentivene har vist seg å være kraftfulle styringsverktøy. Per capita-betalingen motiverer fastlegene til å ta listeansvar for flere pasienter, mens stykkprisbetalingen gir insentiver for aktivitet og tilgjengelighet. Kombinasjonen gjør det mulig med lavere stykkpriser enn hva som ville vært mulig dersom legene bare mottok stykkprisbetaling. For kommunene medførte fastlegeordningen at utgiftene til allmennlegetjenesten ble uavhengige av tallet på allmennleger i kommunen, noe som gjorde det mer attraktivt å opprette nye fastlegestillinger. Samspillet mellom disse faktorene bidro til reduserte ventetider og bedre kontinuitet i lege-pasient-forholdet. Etter hvert oppstod kapasitetsutfordringer og ny legemangel. Svaret på dette var å øke fastlegenes basistilskudd og å innføre et pasienttilpasset basistilskudd fra 2023. Etter disse tiltakene har kapasitetsutviklingen snudd. Tallet på fastleger har økt sterkt i årene i 2023–2025, og det har bidratt til at kapasiteten i fastlegeordningen, målt ved samlet listetak, har økt betydelig.

• Godager, Geir & Hagen, Terje P. (2026). 3. Betalingssystemer. I Berg, Ole Trond; Hagen, Terje P.; Gjefsen, Hege Marie; Godager, Geir; Hart, Rannveig Kaldager; Kinge, Jonas Minet; Holte, Jon Helgheim; Aas, Eline; Kittelsen, Sverre A.C.; Moger, Tron Anders; Tjerbo, Trond; Veggeland, Frode & Øien, Henning (Red.), Organisering og finansering av helsetjenester. Fagbokforlaget. ISSN 9788245061505. s. 39–83. doi: 10.55669/oa180903. Fulltekst i vitenarkiv Vis sammendrag

  Utformingen av betalingssystemer for helsetjenesteleverandører er et betydningsfullt helsepolitisk virkemiddel. Betalingssystemer påvirker prak-tisk talt alle aspekter ved helsetjenesten ved å skape insentiver som former leverandørenes atferd, ressursallokering og til slutt pasientutfall. Selv om helsebeslutninger drives av kliniske hensyn og profesjonsetikk, har de øko-nomiske insentivene innebygd i betalingssystemene en betydelig påvirkning. Betalingssystemene etablerer den økonomiske strukturen som kliniske beslut-ninger tas innenfor.

• Godager, Geir; Kaarbøe, Oddvar Martin; Moger, Tron Anders & Aars, Ole Kristian (2026). Content matters - sending emails to ensure appropriate use of laboratory fees. Journal of Behavioral and Experimental Economics. ISSN 2214-8043. 123. doi: 10.1016/j.socec.2026.102599. Fulltekst i vitenarkiv Vis sammendrag

  This study examines communication interventions' impact on general practitioners' (GPs) claiming of fees for laboratory tests. GPs, who recently claimed laboratory fees, were randomly assigned to two intervention groups (Mild and Strong) or a control group. Initially, both intervention groups received an email emphasizing the importance of utilizing lab tests judiciously, the range of conditions tested, and the need for patients to bear the costs of unnecessary tests. In a subsequent phase, a reminder email was sent with different content. The Mild group received a reiteration of the initial email, while the Strong group was reminded of the economic consequences and potential impact on access to other healthcare services, as stated in the ethical guidelines of the Norwegian Medical Association. Results show that the first email had no effect on either intervention group. However, the reminder email significantly influenced the Strong group, leading to a reduction in tests and conditions. Importantly, this effect differed statistically from the impact observed in the Mild group in terms of test utilization.

• Haugen, Julie & Hagen, Terje P. (2026). Comparing home-based and institutional rehabilitation for community-dwelling hip fracture patients: a matched cohort study. Osteoporosis International. ISSN 0937-941X. doi: 10.1007/s00198-026-07940-8. Fulltekst i vitenarkiv Vis sammendrag

  Home-based rehabilitation after hip fracture costs less than institutional care, but is care quality comparable? Using Norwegian registry data, we found that patients rehabilitated at home had substantially lower mortality and readmission rates. These findings suggest home-based rehabilitation may offer both economic and clinical advantages. Background While home-based rehabilitation following hip fracture typically costs less than institutional care, questions remain about care quality equivalence. Objective To compare care quality between home-based and institutional rehabilitation by examining 1-year mortality and 30-day readmission rates among hip fracture patients. Methods We identified 10,790 community-dwelling hip fracture patients aged 60+ from the Norwegian Patient Registry (2018–2019). Patients receiving institutional rehabilitation were matched with those receiving home-based care using propensity score matching. Logistic regression examined treatment effects on outcomes. Results After propensity score matching, home-based treatment was associated with lower mortality (OR = 0.44; 95% CI, 0.38–0.51) and lower readmission rates (OR = 0.56; 95% CI, 0.49–0.63) compared to treatment at institutions. Conclusion Community-dwelling hip fracture patients receiving institutional rehabilitation had higher mortality and readmission rates than those treated at home, suggesting superior care quality with home-based treatment.

• Linde, Astrid de; Grytten, Jostein Ivar; Skau, Irene & Kinge, Jonas Minet (2025). Maternity Ward Closures and Infant Health Outcomes, Maternal Health Outcomes, and Birth Procedures. Health Economics. ISSN 1057-9230. 35(2), s. 360–376. doi: 10.1002/hec.70053. Fulltekst i vitenarkiv
• Kittelsen, Sverre; Anthun, Kjartan Sarheim; Bilet, Anders M.; Jansen, Halvard S.; Lidman, Johanna & Magnussen, Jon [Vis alle 7 forfattere av denne artikkelen] (2025). Scale economies in somatic hospitals in Norway. Journal of Productivity Analysis. ISSN 0895-562X. 64(3), s. 393–404. doi: 10.1007/s11123-025-00776-0. Fulltekst i vitenarkiv Vis sammendrag

  Central policy issues in health care systems are the optimal hospital size of hospitals and the capacity utilization of existing structures. If there are economies of scale, the optimal size of hospitals will be larger and long run marginal costs will be below average costs. In a national health service with public planning and financing this has obvious policy implications for structural decisions related to both mergers and/or closing of existing hospitals and to the planning and building of new hospitals. We estimate a multiple output cost function from 133 observations of 19 Norwegian hospital trusts 2013–2019 with data on operating and capital costs as well as the number of somatic patient admissions aggregated by the weights of the diagnosis related groups (DRGs). The cost function is estimated using a) the panel data Stochastic Frontier Analysis (SFA) method with a translog functional form, and b) the non-parametric bootstrapped Data Envelopment Analysis (DEA) method with the Førsund-Hjalmarsson formula for scale elasticities. Based on tests of the variable specification we use three outputs: medical inpatients, surgical inpatients and outpatients. The long-run scale elasticities are estimated to be in the order of 1.07–1.09 for the average hospital and cost efficiencies are in the order of 85%, both significantly different from unity. Both cost efficiencies and scale elasticities are lower in university hospitals. Similar content being viewed by

• Hagen, Terje P. & Anthun, Kjartan Sarheim (2025). Sykehusenes kostnadsnivå før og etter investeringer i bygningsmassen. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 145(14). doi: 10.4045/tidsskr.24.0679. Fulltekst i vitenarkiv Vis sammendrag

  Bakgrunn Investeringer i sykehusbygg er i Norge delvis basert på forventninger om høyere kostnadseffektivitet i etterkant. Helseforetakene skal behandle pasientene til en lavere kostnad enn før investeringen, slik at gevinsten kan benyttes til å betjene kapitalkostnader. Formålet med vår analyse er å etterprøve om denne forventningen innfris. Materiale og metode Data om driftskostnader og DRG-poeng for alle helseforetak er hentet fra SAMDATA spesialisthelsetjenesten i perioden 1999–2023. Analysene gjennomføres som toveis variansanalyse (ANOVA), med logaritmen av sykehusenes kostnadsnivå som avhengig variabel. Perioden fra 1999 til ett år før implementeringen av investeringen benyttes som referanseperiode. Resultater Investeringer i bygningsmassen var assosiert med kostnadsøkninger på kort sikt. Kostnadsøkningene startet året før iverksettelsen av investeringene og var 4,9 % (95 % konfidensintervall (KI) 0,7 til 9,0) over kostnadsnivået i referanseperioden, året etter iverksettelsen av investeringene. Fra og med år fire etter investeringen var det gjennomsnittlige kostnadsnivået tilbake på referansenivået. Sensitivitetsanalyser indikerte at i prosjekter der hele bygningsmassen ble fornyet, var det ingen statistisk signifikante endringer i kostnadsnivået de tre første årene etter implementeringen, men fra fire år og utover ble det et signifikant redusert kostnadsnivå på -4,4 % (95 % KI -7,9 til -1,0). Fortolkning Forventningene om kostnadseffektivisering ble på gruppenivå ikke oppnådd ved investeringene i bygningsmasse som ble gjennomført i perioden 2003–23. Dette gir grunnlag for å stille spørsmål ved realismen i de regionale helseforetakenes investeringskalkyler.

• Henkel, Pia S.; Aas, Eline; Russnes, Hege Elisabeth Giercksky; Dyvik, Ingrid; Fagereng, Gro Live & Helland, Åslaug [Vis alle 9 forfattere av denne artikkelen] (2025). Microcosting Study of Genomic Profiling for Precision Cancer Medicine. Application from the National Infrastructure for Precision Diagnostics in Norway. Journal of Molecular Diagnostics. ISSN 1525-1578. 27(10), s. 945–953. doi: 10.1016/j.jmoldx.2025.06.006. Fulltekst i vitenarkiv Vis sammendrag

  Detailed cost analyses of genomic profiling for precision cancer medicine can inform strategic planning and cost-effectiveness analysis. A flexible costing framework was developed in this study to conduct microcosting of genomic profiling in precision cancer medicine using the broad gene panel TruSight Oncology 500 and accounting for its integration into the molecular tumor board within the national Infrastructure for Precision Diagnostics in Norway. The framework enables calculation of costs per sample, by workflow steps and cost categories. Site visits and discussions with staff at Oslo University Hospital informed the diagnostic workflow, validation of the framework, and resource use inputs. Sensitivity analysis addressed alternative resource use estimates, higher batch sizes, and investment costs for automation of the library preparation step. Total costs per sample were $2944 USD, ranging from $2366 to $4307 when considering uncertainties in estimates. Consumables and personnel were the most resource-intensive cost categories across analyses. Automating the resource-intensive library preparation step enabled a higher weekly batch size with slightly lower costs per sample ($2881) despite the additional equipment costs. The dynamic costing framework highlights how the choice of equipment and batch sizes affects sample costs and personnel needs for genomic profiling. Consumables and personnel offer the largest potential for costs savings, but potential personnel bottlenecks need to be considered when further upscaling capacity.

• Lizardi, Eduardo Alberto Ramirez; Fevang, Elisabeth; Røed, Knut & Øien, Henning (2025). Effects of Health Shocks on Adult Children's Labor Market Outcomes and Well-Being. Health Economics. ISSN 1057-9230. 34(10), s. 1804–1820. doi: 10.1002/hec.70005. Fulltekst i vitenarkiv Vis sammendrag

  Using Norwegian administrative register data, we assess the impact of unexpected health shocks hitting lone parents on offspring's labor market outcomes and well-being. We use first-time hip fractures or strokes as indicators of parental health shocks and estimate both the overall effects and the heterogeneous impacts by the survival time of the affected parent. We identify small, but significant, immediate responses in terms of an increase in physician-certified sickness absences and a higher risk of diagnosed mental disorders. The short-term effects are larger for offspring whose parents die shortly after the shock. Most of the effects fade out quickly, and the negative impacts on subsequent employment and earnings are small and only borderline statistically significant. In general, our results suggest that the responses to the deteriorating health of a parent tend to be short-lived and mostly manifest as temporary absences from work rather than complete detachment from the labor market.

• Kongstad, Line Planck; Damslund, Nicolai; Søndergaard, Jens; Godager, Geir & Olsen, Kim Rose (2025). Do Physicians Respond to Additional Capitation Payments in Mixed Remuneration Schemes? Health Economics. ISSN 1057-9230. 34(6), s. 1143–1159. doi: 10.1002/hec.4954. Fulltekst i vitenarkiv Vis sammendrag

  Mixed remuneration schemes with capitation and fee‐for‐service (FFS) payments hold financial incentives to add patients to the list and provide services to listed patients. However, as patients with complex needs tend to require longer consultations there is a risk of inequality in access if fees are not adjusted to patient characteristics. In this paper, we assess a natural experiment introducing additional capitation for GPs with a high share of complex patients (moderate scheme) and for GPs in certain geographical areas (intensive scheme). GPs are eligible if the complexity of their listed patients exceeds a threshold, but as the scheme is subject to a national budget constraint, some eligible general practitioners (GPs) are left without additional payment. For the most favored GPs, the reform distributed additional capitation at 8% of the total baseline income. We study the effects on the number of patients per GP and the number of services per patient, applying difference‐in‐difference (DiD) models. For both schemes (moderate and intensive), we find tendencies of reductions in the number of patients served and the level of service provision per patient. This also holds for complex patients indicating that the reform did not improve equity in access. The effect on income showed a 2.5% increase in the first follow‐up year but the effect became insignificant in the second year after the reform. We interpret this result as a sign that GPs trade income increases with leisure as suggested by the target income hypothesis.

• Galizzi, Matteo; Godager, Geir; Li, Jing; Linnosmaa, Ismo; Tammi, Timo & Wiesen, Daniel (2025). Economics of Healthcare Provider Altruism. I Zimmermann, Klaus F. (Red.), Handbook of Labor, Human Resources and Population Economics. Springer. ISSN 9783319573656. doi: 10.1007/978-3-319-57365-6_357-1. Fulltekst i vitenarkiv Vis sammendrag

  This chapter provides a comprehensive overview of the main theoretical notions and empirical findings on altruism among physicians and other healthcare providers. While altruism in the behavioral and experimental economics literature is typically defined as a deviation from purely self-interested behavior, the theoretical health economics literature embeds the notion of physician altruism within the doctor–patient relationship. The altruism of physicians is typically defined as the weight in the doctor’s utility function attached to patient’s health benefits, besides the self-interested monetary considerations. The chapter broadly groups the empirical evidence into three main categories of evidence: evidence from (i) survey and interview data, (ii) prescriptions records, and (iii) behavioral experiments. Across each of those groups of studies and different methods, the evidence generally supports the theoretical notion that physicians behave “altruistically” in their healthcare decisions. Some studies indicate, however, considerable heterogeneity in physicians’ altruistic preferences.

• Gil‐moltó, Maria José; Hole, Arne Risa; Andersson, Henrik & Godager, Geir (2025). The Impact of Incentives on Valuing Health Risks. Health Economics. ISSN 1057-9230. 34(10). doi: 10.1002/hec.70011. Fulltekst i vitenarkiv
• Snilsberg, Øyvind & Iversen, Tor (2025). The impact of team-based primary care on quality-related healthcare services and access to primary care: Norway's primary healthcare teams pilot program. Journal of Health Economics. ISSN 0167-6296. 101. doi: 10.1016/j.jhealeco.2025.102987. Fulltekst i vitenarkiv Vis sammendrag

  This study evaluates Norway's Primary Healthcare Teams (PHT) pilot program, which introduced team-based care in general practice clinics to improve care for patients with complex conditions. Practices hired nurses and chose between an activity-based or block funding model. This analysis examines the activity-based funding model, which incorporated fee-for-service (FFS) for nurses. Using a difference-in-differences (DID) approach, the study assesses the program's impact on quality-related primary care services, out-of-hours care, hospitalizations, general practitioners’ (GPs’) working hours, and patient list length. The findings show that PHTs increased quality-related services for target groups (primarily provided by nurses) without affecting GP working hours or list length, suggesting that added nurse capacity was used to enhance care for target patients, not expand primary care access. There is little evidence of changes in healthcare utilization outside primary care, except a possible reduction in hospitalizations for type 2 diabetes patients with ambulatory care-sensitive conditions.

• Linde, Astrid de; Grytten, Jostein Ivar; Skau, Irene & Kinge, Jonas Minet (2024). Maternity ward closures and infant health outcomes, maternal health outcomes, and birth procedures. HERO skriftserie / Working paper. ISSN 1501-9071. Fulltekst i vitenarkiv
• Hagen, Terje P. (2024). Ulikheter i tjenestetilbudet mellom norske kommuner. Tidsskrift for omsorgsforskning. ISSN 2387-5976. 10, s. 90–107. doi: 10.18261/tfo.10.2.7. Fulltekst i vitenarkiv Vis sammendrag

  I Norge benyttes kommunene til å tilby pleie- og omsorgstjenester. Intensjonen er at dette skal gi koblinger mellom lokale ønsker og tildeling av tjenestene, og bred politisk deltakelse i beslutningsprosessene. Kommunesektoren i Norge benyttes også til andre oppgaver, blant annet til å nå regionalpolitiske målsettinger ved at kommuner i næringssvake områder tildeles egne overføringer. Spørsmålet vi stiller, er om statlige prioriteringer som påvirker kommunale inntekter, i neste omgang påvirker kommunenes utgifter til pleie- og omsorgstjenestene, og sannsynligheten for at den enkelte brukeren får tildelt tjenester. En paneldataanalyse som dekker perioden 1972–2022, viser at kommunenes utgifter til pleie- og omsorgstjenestene øker med kommunenes inntekter og endringer i demografi. I tillegg er det betydelige effekter av nasjonale reformer, særlig HVPU-reformen, som ble gjennomført fra 1991. En tverrsnittsanalyse på individnivå basert på data fra 2019, viser at tildelingen av langtidsplass i sykehjem for brukere som er 70 år eller eldre, er assosiert med kommunens inntektsnivå. Brukere i kommunene med de høyeste inntektene har om lag 37 prosent større sjanse for å få sykehjemsplass enn brukere i kommuner med lavest inntektsnivå. Når det gjelder det generelle nivået på tildelte tjenester målt ved utgifter per bruker, så øker også dette med kommunenes inntekter, men variasjonen i utgifter er mindre enn variasjonen i kommunale inntekter. I tillegg til distriktspolitiske overføringer er høyinntektskommunene kjennetegnet av høye skatteinntekter fra personer, kraftproduksjon eller petroleumsvirksomhet. Vi konkluderer med at det er motsetninger mellom statens målsetting om likeverdig tjenestetilbud i pleie- og omsorgstjenestene og den store inntektsvariasjonen det er mellom kommunene. Inntektsvariasjonen kommer som følge av at noen skatteinntekter ikke jevnes ut, og at noen kommuner får store regionalpolitiske overføringer.

• Gottschlich, Katharina Natalie; Zolic-Karlsson, Zinajda; Aas, Eline; Stokke, Silje Agnethe; Bø, Lars & Torkildsen, Øivind [Vis alle 7 forfattere av denne artikkelen] (2024). Healthcare utilization and costs associated with autologous haematopoietic stem cell transplantation in Norwegian patients with relapsing remitting multiple sclerosis. Multiple Sclerosis and Related Disorders. ISSN 2211-0348. 84. doi: 10.1016/j.msard.2024.105507. Fulltekst i vitenarkiv Vis sammendrag

  Multiple sclerosis (MS) patients experience long-term deterioration of neurological function, reduced quality of life, long-lasting treatment cycles, and an increased risk of early workability loss imposing an economic burden to society. Autologous haematopoietic stem cell transplantation (AHSCT) has shown promising treatment effects for relapsing remitting MS (RRMS). This study employs a micro-costing approach to estimate healthcare utilization and costs associated with AHSCT in Norwegian RRMS patients. Patient-level data were extracted from medical journals of 30 RRMS patients receiving AHSCT treatment at Haukeland University Hospital in the period from January 2015 to January 2018. The time horizon for the analysis was from the pretransplant screening until one year after AHSCT. A correlation was found between patient body weight and total healthcare cost. The average total healthcare cost of AHSCT for RRMS patients was estimated to EUR 66 304 (95% CI: EUR 63 598 – EUR 69 010) including costs associated with the pre-AHSCT period, AHSCT treatment phases and one-year follow-up. The majority of the costs, EUR 64 329, occurred during the treatment phase and within the first 100 days after AHSCT. The results indicate that long-term healthcare cost savings may be achieved using AHSCT in selected patients with aggressive RRMS. This is due to the high costs of most used disease modifying treatments. Further research including long-term clinical data is needed to determine the cost-effectiveness of this treatment.

• Bjørnelv, Gudrun Maria Waaler; Aas, Eline; Aaltonen, Mari; Hagen, Terje P.; Thoresen, Lisbeth & Forma, Leena (2024). Place of living at end-of-life according to cause of death: a comparative analysis of all decedents 70 years or older in 2009-2013 in Finland and Norway. Annals of Palliative Medicine. ISSN 2224-5820. 13(3). doi: 10.21037/apm-23-269. Fulltekst i vitenarkiv Vis sammendrag

  Background: Time at home at end-of-life is perceived as valuable to individuals. Increasing home care is therefore often a political goal. Yet, little is known about where individuals live towards their end-of-life. Our aim was to describe where individuals reside their last 6 months of life in Finland and Norway, and how this differed by cause of death, sex, age, marital status, and income. Methods: We used individual-leveled national registry data on all decedents aged >70 years in 2009–2013 to describe the number of days individuals spent at home, in hospital, in long-term care (LTC) and short-term care (STC) facilities. We described the place of residence for all and by causes of death: cancer, diseases of the circulatory system, disease in the respiratory system, and mental and behavioral disorders (primarily dementia). We analyzed how age, marital status (indicating informal care), and income associated with place of residence. Analyses were stratified by sex and country. Results: During the last 6 months of life, decedents in Finland (n=186,017) and Norway (n=159,756) spent similar amounts of days in hospital (8 and 11 days) and in STC facilities (15 and 13 days). Finnish decedents spent more days at home (96 vs. 84 days) and fewer days in LTC facilities (64 vs. 80 days). Living arrangement differed similarly by cause of death in the two countries, e.g., decedents from cancer and mental and behavioral disorders spent 123 [113] vs. 29 [21] days at home in Finland (Norway). In both countries, for all causes of death, lower age and marital status were associated with more days at home, for both males and females. While those with higher income spent more days at home in Norway, the opposite was found in Finland. Conclusions: Older individual’s living arrangements in the last 6 months of life were similar in Finland and Norway but differed by cause of death. Younger individuals and those with access to informal care spent more days at home, compared to their counterparts. With aging populations, more individuals will likely need LTC at their end of life. Policies should align with these needs when developing future health care services.

• Hagen, Terje P. (2024). Sykehustalen 2024 – hva skjer med sykehusfinansieringen? Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 144(3). doi: 10.4045/tidsskr.24.0051. Fulltekst i vitenarkiv
• 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. Fulltekst i vitenarkiv Vis sammendrag

  Audit and feedback is employed 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 3–4 percentage point reduction in the use of the double-consultation fee, reducing the yearly health care spending of the Norwegian government by approximately €480 000 per year. This substantial and durable behavioral response found in our study sample comprising 15 % of Norwegian GPs, shows that low-cost interventions via email can have significant financial impact.

• Schlander, Michael; Harten, Wim van; Retèl, Valesca P; Pham, Phu Duy; Vancoppenolle, Julie M & Ubels, Jasper [Vis alle 25 forfattere av denne artikkelen] (2024). The socioeconomic impact of cancer on patients and their relatives: Organisation of European Cancer Institutes task force consensus recommendations on conceptual framework, taxonomy, and research directions. The Lancet Oncology. ISSN 1470-2045. 25(4), s. 152–163. doi: 10.1016/S1470-2045(23)00636-8. Fulltekst i vitenarkiv
• Lindaas, Nils Arne; Anthun, Kjartan Sarheim; Kittelsen, Sverre A.C. & Magnussen, Jon (2024). Economies of scope in the Norwegian public hospital sector. European Journal of Health Economics. ISSN 1618-7598. doi: 10.1007/s10198-024-01704-z. Fulltekst i vitenarkiv Vis sammendrag

  This study investigates the potential economies of scope in the Norwegian public hospital sector after a major structural and organizational reform. Economies of scope refers to potential cost savings occurring from the scope of production rather than the scale. We use a data driven approach to distinguish between relatively specialized and differentiated hospitals. Using registry data spanning the period 2013–2019, we use non-parametric data envelopment analysis with bootstrapping procedures to investigate the potential presence of economies of scope. This is done separately for three different dimensions of which hospital production can be either specialized or differentiated. The findings suggest that economies of scope are present in the Norwegian hospital sector, meaning that there are cost savings related to the optimal differentiation of the activity. It is difficult to conclude on how these findings relate to the reform.

• Snilsberg, Øyvind; Iversen, Tor; Jenum, Anne Karen & Zhang, Yuting (2024). Effects of a national checklist on recommended procedures among patients with type 2 diabetes. BMC Health Services Research. 24(1). doi: 10.1186/s12913-024-11940-x. Fulltekst i vitenarkiv Vis sammendrag

  Background Type 2 diabetes (T2D) is a common, potentially disabling, and costly chronic condition that requires consistent management. In 2008, Norway introduced a national checklist outlining services to include in an annual T2D exam, along with a reimbursement code for general practitioners (GPs) to bill upon completing it. This study investigates whether GP adoption of the checklist improves adherence to recommended services for T2D patients. Methods To investigate the impact of GP checklist adoption, we use Norwegian registry data from 2006 to 2021 and apply two difference-in-differences (DID) methods that account for staggered adoption timing: the two-way fixed effects (TWFE) estimator and Callaway and Sant’Anna’s DID method for variation in exposure timing (CSDID) (Callaway B. et al., J Econom 225:200–30, 2021). Results We find that installing the electronic form has modest effects on the use of some recommended procedures. Conclusions Our study suggests that using the electronic form can have a positive effect on recommended services. However, the modest impact indicates that installing the form does not necessarily translate into its active regular use. Keywords Checklist, National quality program, Physician incentives, Diabetes management, Norwegian Diabetes Register for Adults

• 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. 12(9). doi: 10.3390/healthcare12090943. Fulltekst i vitenarkiv 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.

• Hagen, Terje P.; Tjerbo, Trond & Aarflot, Morten (2024). Pasienter nyinnlagt i sykehjem – alder, tilstand og funksjonsnivå. Michael. ISSN 1893-9651. 21(1), s. 23–38. doi: 10.5617/michael.10949. 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.

• Michel, Yvonne Anne; Aas, Eline; Augestad, Liv Ariane; Burger, Emily Annika; Thoresen, Lisbeth & Bjørnelv, Gudrun Maria Waaler (2024). Healthcare use and costs in the last six months of life by level of care and cause of death. BMC Health Services Research. 24(1). doi: 10.1186/s12913-024-10877-5. Fulltekst i vitenarkiv Vis sammendrag

  Background: Existing knowledge on healthcare use and costs in the last months of life is often limited to one patient group (i.e., cancer patients) and one level of healthcare (i.e., secondary care). Consequently, decision-makers lack knowledge in order to make informed decisions about the allocation of healthcare resources for all patients. Our aim is to elaborate the understanding of resource use and costs in the last six months of life by describing healthcare use and costs for all causes of death and by all levels of formal care. Method: Using five national registers, we gained access to patient-level data for all individuals who died in Norway between 2009 and 2013. We described healthcare use and costs for all levels of formal care—namely primary, secondary, and home- and community-based care —in the last six months of life, both in total and differentiated across three time periods (6-4 months, 3-2 months, and 1-month before death). Our analysis covers all causes of death categorized in ten ICD-10 categories. Results: During their last six months of life, individuals used an average of healthcare resources equivalent to €46,000, ranging from €32,000 (Injuries) to €64,000 (Diseases of the nervous system and sense organs). In terms of care level, 63% of healthcare resources were used in home- and community-based care (i.e., in-home nursing, practical assistance, or nursing home care), 35% in secondary care (mostly hospital care), and 2% in primary care (i.e., general practitioners). The amount and level of care varied by cause of death and by time to death. The proportion of home- and community-based care which individuals received during their last six months of life varied from 38% for cancer patients to 92% for individuals dying with mental diseases. The shorter the time to death, the more resources were needed: nearly 40% of all end-of-life healthcare costs were expended in the last month of life across all causes of death. The composition of care also differed depending on age. Individuals aged 80 years and older used more home- and community-based care (77%) than individuals dying at younger ages (40%) and less secondary care (old: 21% versus young: 57%). Conclusions: Our analysis provides valuable evidence on how much healthcare individuals receive in their last six months of life and the associated costs, broken down by level of care and cause of death. Healthcare use and costs varied considerably by cause of death, but were generally higher the closer a person was to death. Our findings enable decision-makers to make more informed resource-allocation decisions and healthcare planners to better anticipate future healthcare needs.

• Häkkinen, Unto; Hagen, Terje P. & Kittelsen, Sverre (2023). 20 years of Nordic comparative health economics research. Nordic Journal of Health Economics. ISSN 1892-9729. 6(1), s. 59–79. doi: 10.5617/njhe.10133. Fulltekst i vitenarkiv Vis sammendrag

  Nordic comparative health economics research stands out internationally both by its access to excellent patient data and its long-time commitment to rigorous analyses. In this article, we present the methodological foundations and the results from two types of performance analyses – comparative analyses of health care outcomes and costs at hospital level and similar analyses at the disease level. In the concluding part, we discuss strength and weaknesses of the Nordic comparative analyses, and how we should develop Nordic comparative health economics research further.

• Godager, Geir & Scott, Anthony (2023). Physician behavior and health outcomes. I Zimmermann, Klaus F. (Red.), Handbook of Labor, Human Resources and Population Economics. Springer. ISSN 9783319573656. 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.

• 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. Fulltekst i vitenarkiv
• Kunst, Natalia; Burger, Emily Annika; Coupé, Veerle M. H.; Kuntz, Karen M. & Aas, Eline (2023). A Guide to an Iterative Approach to Model-Based Decision Making in Health and Medicine: An Iterative Decision-Making Framework. PharmacoEconomics (Auckland). ISSN 1170-7690. s. 1–9. doi: 10.1007/s40273-023-01341-z. Fulltekst i vitenarkiv
• 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 Vis sammendrag

  This study employs a mystery shopper audit on a random sample of 96 for-profit private clinics in Jinan, China. We investigate two instruments which reflect beneficence among for-profit clinicians in private practice. The first is whether physicians returned a lost wallet “accidentally” left next to the physician’s table; and the second, whether physicians prescribed antibiotics to pseudo-patients who displayed no symptoms of any illness but had complained of fever the night before. These measures quantify beneficence under two different valence framing: returning a wallet represents clinicians who “do good” at personal cost to themselves, while not prescribing antibiotics represents a choice “not to do harm” to patients. We look at the correlation between these beneficence measures and the physicians’ prescription behaviors, and their revenues from the consultation. We find that whether doctors return a lost wallet or not, and prescribe antibiotics or not, such physicians are still as likely to prescribe medications which increase their incomes.

• 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.

• Østerås, Nina; Aas, Eline; Moseng, Tuva; Bodegom-Vos, Leti van; Dziedzic, Krysia & Natvig, Bård [Vis alle 11 forfattere av denne artikkelen] (2023). Longer-term quality of care, effectiveness, and cost-effectiveness of implementing a model of care for osteoarthritis: A cluster-randomized controlled trial. Osteoarthritis and Cartilage. ISSN 1063-4584. 32(1), s. 108–119. doi: 10.1016/j.joca.2023.10.003. Fulltekst i vitenarkiv Vis sammendrag

  Objective To assess the quality of care, effectiveness, and cost-effectiveness over 12 months after implementing a structured model of care for hip and knee osteoarthritis (OA) in primary healthcare as compared to usual care. Design In this pragmatic cluster-randomized, controlled trial with a stepped-wedge cohort design, we recruited 40 general practitioners (GPs), 37 physiotherapists (PTs), and 393 patients with symptomatic hip or knee OA from six municipalities (clusters) in Norway. The model included the delivery of a 3-hour patient education and 8–12 weeks individually tailored exercise programs, and interactive workshops for GPs and PTs. At 12 months, the patient-reported quality of care was assessed by the OsteoArthritis Quality Indicator questionnaire (16 items, pass rate 0–100%, 100%=best). Costs were obtained from patient-reported and national register data. Cost-effectiveness at the healthcare perspective was evaluated using incremental net monetary benefit (INMB). Results Of 393 patients, 109 were recruited during the control periods (control group) and 284 were recruited during interventions periods (intervention group). At 12 months the intervention group reported statistically significant higher quality of care compared to the control group (59% vs. 40%; mean difference: 17.6 (95% confidence interval [CI] 11.1, 24.0)). Cost-effectiveness analyses showed that the model of care resulted in quality-adjusted life-years gained and cost-savings compared to usual care with mean INMB €2020 (95% CI 611, 3492) over 12 months. Conclusions This study showed that implementing the model of care for OA in primary healthcare, improved quality of care and showed cost-effectiveness over 12 months compared to usual care.

Se alle arbeider i NVA

• Berg, Ole Trond; Hagen, Terje P.; Gjefsen, Hege Marie; Godager, Geir; Hart, Rannveig Kaldager & Kinge, Jonas Minet [Vis alle 13 forfattere av denne artikkelen] (2026). Organisering og finansering av helsetjenester. Fagbokforlaget. ISBN 9788245061505. 414 s. doi: 10.55669/oa1809. Fulltekst i vitenarkiv Vis sammendrag

  Boken gir en bred innføring i organisering og finansiering av helsetjenester, med vekt på norske forhold. Den innledende bolken omfatter kapitler om helsetjenestesystemer og forsikringsordninger, betalingssystemer og demografiske endringer. I de følgende bolkene brukes de grunnleggende begrepene til å beskrive og analysere kommunehelsetjenesten og spesialisthelsetjenesten, samt samhandlingen mellom de to nivåene. Enkelte policy-orienterte temaer, som effektivitet og likhet i tilbudet, analyseres i egne kapitler. Den avsluttende bolken er viet komparativ helsepolitikk, med beskrivelser av land med sosialforsikringsordninger og private helseforsikringer. Utviklingen av EUs helsepolitikk beskrives i et eget kapittel. Bokens underliggende perspektiv er at organisering og finansiering er virkemidler i offentlig helsepolitikk. Dette er instrumenter som kan brukes til å redusere ulikhet i tjenestetilbudet, øke effektiviteten og heve kvaliteten. Boken inneholder oppdatert kunnskap om reformer og piloter fra de siste tiårene, også reformer i andre land som har relevans for norske forhold.

Se alle arbeider i NVA

• Hansen, Johan Andre Liseth; Lizardi, Eduardo Alberto Ramirez & Linde, Astrid de (2025). The impact of severe illness on the family: Evidence from cancer shocks. Fulltekst i vitenarkiv Vis sammendrag

  Presentasjon på ASHECon 2025

• Kinge, Jonas Minet (2025). Framskrivninger av helseutgifter og forebygging. Fulltekst i vitenarkiv
• Kinge, Jonas Minet (2025). Framskrivninger av helseutgifter i Norge: 2022-2050. Fulltekst i vitenarkiv
• Kinge, Jonas Minet (2025). Helseutgifter i dag og i framtiden: Demens som hovedutfordring. Fulltekst i vitenarkiv
• Kinge, Jonas Minet (2025). Forecasting total and cause-specific health expenditures for 116 health conditions in Norway, 2022-2050. Fulltekst i vitenarkiv
• Kinge, Jonas Minet (2025). Forecasting total and cause-specific health expenditures for 116 health conditions in Norway, 2022-2050. Fulltekst i vitenarkiv
• Kinge, Jonas Minet (2025). Konsekvenser av aldring for framtidens helsetjeneste. Fulltekst i vitenarkiv
• Aas, Eline; Kinge, Jonas Minet; Burger, Emily Annika; Pedersen, Kine; Iversen, Tor & Godager, Geir [Vis alle 14 forfattere av denne artikkelen] (2025). Feil tallgrunnlag kan koste liv i helsetjenesten. Fulltekst i vitenarkiv
• Kinge, Jonas Minet (2025). Hva vet vi om effekten av forebygging på kommunenes helsetjenester? Fulltekst i vitenarkiv
• Aas, Eline (2025). Terskelverdi. Fulltekst i vitenarkiv
• Aas, Eline (2025). Terskelverdi. Fulltekst i vitenarkiv
• Aas, Eline (2025). Precision Medicine – A Health Economics Perspective. Fulltekst i vitenarkiv
• Aas, Eline (2025). Stukturert klinikerinnspill i metodevurderinger. Fulltekst i vitenarkiv
• Aas, Eline (2025). Prioriteringsmeldingen. Fulltekst i vitenarkiv
• Aas, Eline (2025). Helseøkonomi og PROMS. Fulltekst i vitenarkiv
• Aas, Eline (2025). Cost-effectiveness analyses of medical devices. Fulltekst i vitenarkiv
• Iversen, Tor; Snilsberg, Øyvind; Jenum, Anne Karen & Zhang, Yuting (2025). Continuity and switching in primary care. Fulltekst i vitenarkiv Vis sammendrag

  This paper investigates the dual impact of continuity and discontinuity in patient-GP relationships on quality related healthcare services, focusing on patients with Type 2 Diabetes (T2D) in Norway. It challenges the traditional dichotomy in the literature by exploring the apparent contradiction that both continuity and switching GPs can improve healthcare outcomes. The research utilizes a comprehensive dataset, encompassing all Norwegian T2D patients from 2018 to 2023, to examine the outcomes of recommended services by GPs. The study's primary contribution is its simultaneous analysis of both continuity and switching using consistent data and subjects. The medical literature finds that continuity is beneficial in primary care, enhancing diagnostic accuracy, treatment quality and patient satisfaction. The study affirms this, revealing significant benefits in healthcare service provision, particularly for eye exams after 4-5 years with the same GP, and other services after 15 years. The results manifest the positive correlation between longer patient-GP relationships and the probability of receiving recommended services. The analysis also reveals that switching GPs can yield advantages when a new GP offers a higher quality of care. For patients who after forced discontinuity, are switched to GPs with superior practice styles, the likelihood of receiving recommended services, such as annual checkups, increases significantly. This result supports the hypothesis of potential health gains from a GP switch, presenting a nuanced trade-off between continuity and improvement through switching. The paper breaks new ground by demonstrating these trade-offs analytically, showing that continuity and the quality of GP practice styles both significantly impact healthcare outcomes. It emphasizes that an additional year with the same GP enhances service likelihoods while switching to a higher-performing GP can surpass this continuity benefit. Robustness checks support the findings of positive effects of both continuity and switching. The study addresses a notable gap by integrating both continuity and switching dynamics into a unified framework, thus stimulating a more balanced view on GP-patient relationships in primary care.

• Iversen, Tor; Snilsberg, Øyvind; Jenum, Anne Karen & Zhang, Yuting (2025). Continuity and switching in primary care. Fulltekst i vitenarkiv Vis sammendrag

  This paper investigates the dual impact of continuity and discontinuity in patient-GP relationships on quality related healthcare services, focusing on patients with Type 2 Diabetes (T2D) in Norway. It challenges the traditional dichotomy in the literature by exploring the apparent contradiction that both continuity and switching GPs can improve healthcare outcomes. The research utilizes a comprehensive dataset, encompassing all Norwegian T2D patients from 2018 to 2023, to examine the outcomes of recommended services by GPs. The study's primary contribution is its simultaneous analysis of both continuity and switching using consistent data and subjects. The medical literature finds that continuity is beneficial in primary care, enhancing diagnostic accuracy, treatment quality and patient satisfaction. The study affirms this, revealing significant benefits in healthcare service provision, particularly for eye exams after 4-5 years with the same GP, and other services after 15 years. The results manifest the positive correlation between longer patient-GP relationships and the probability of receiving recommended services. The analysis also reveals that switching GPs can yield advantages when a new GP offers a higher quality of care. For patients who after forced discontinuity, are switched to GPs with superior practice styles, the likelihood of receiving recommended services, such as annual checkups, increases significantly. This result supports the hypothesis of potential health gains from a GP switch, presenting a nuanced trade-off between continuity and improvement through switching. The paper breaks new ground by demonstrating these trade-offs analytically, showing that continuity and the quality of GP practice styles both significantly impact healthcare outcomes. It emphasizes that an additional year with the same GP enhances service likelihoods while switching to a higher-performing GP can surpass this continuity benefit. Robustness checks support the findings of positive effects of both continuity and switching. The study addresses a notable gap by integrating both continuity and switching dynamics into a unified framework, thus stimulating a more balanced view on GP-patient relationships in primary care.

• Snilsberg, Øyvind; Iversen, Tor; Jenum, Anne Karen & Zhang, Yuting (2025). Kontinuitet og diskontinuitet i fastlegeordningen. Fulltekst i vitenarkiv Vis sammendrag

  Bakgrunn Flere norske undersøkelser viser at kontinuitet i forholdet mellom pasient og fastlege har stor betydning for oppfølging og helseutfall blant pasientene. Vi er ikke kjent med undersøkelser som både undersøker effekten av kontinuitet og diskontinuitet i form av bytte til ny fastlege Formål Vår hypotese er at kontinuitet er positivt for oppfølging og helseutfall. Samtidig kan også diskontinuitet være positivt hvis byttet av fastlege skjer til en fastlege som er bedre enn den forrige. I studien undersøker vi hvordan kontinuitet og diskontinuitet i pasient-fastlege-forholdet påvirker om fastlegen utfører anbefalte helsetjenester til pasienter med type 2-diabetes (T2D) i Norge. Metode Ved hjelp av norske landsomfattende registerdata på individnivå fra 2018 til 2023 analyserer vi hvordan kontinuitet påvirker hvorvidt en pasient med T2D mottar anbefalte tjenester som HbA1c-tester og årskontroll. Vi undersøker også hvordan bytte til en fastlege som i større grad leverer anbefalte tjenester, påvirker om pasienten selv mottar disse tjenestene. Diskontinuitet i våre data oppstår ved at fastlegen slutter som fastlege, for eksempel ved å pensjonere seg. Diskontinuiteten er dermed eksogen for pasienten. Resultat Vi finner at flere år med samme fastlege er assosiert med høyere sannsynlighet for å motta anbefalte tjenester, særlig etter mer enn ti år. Videre finner vi at bytte til en fastlege som oftere leverer anbefalte tjenester, medfører en betydelig økning i sannsynligheten for å motta disse tjenestene. Samlet sett antyder resultatene at både kontinuitet og fastlegens egenskaper er avgjørende for om en pasient med T2D får anbefalte tjenester. Konklusjon Mens politiske tiltak ofte vektlegger kontinuitet, tyder våre funn på at bytte også kan være fordelaktig når det innebærer en overgang til en bedre fastlege. Dette understreker viktigheten av å gjøre kvalitetsinformasjon på tvers av fastleger transparent

• Godager, Geir (2025). Hypothetical Bias and Patient-Regarding Preferences: Comparing Fully Incentivized and Conventional Stated Preference Experiments. Fulltekst i vitenarkiv
• Snilsberg, Øyvind; Tyrihjell, Johannes & Godager, Geir (2025). Career Duration in General Practice: Results from a Complete Nationwide Panel of General Practitioners in Norway. doi: https:/healtheconomics.org/wp-content/uploads/2025/08/IHEA-2025-Congress-Abstract-Book.pdf. Fulltekst i vitenarkiv Vis sammendrag

  This study examines whether rising general practitioner (GP) resignations are contributing to capacity challenges in Norway's healthcare system. Using comprehensive registry data from 2001 to 2023 tracking 8,943 physicians (4,238 of whom left GP practice), we analyzed age-specific exit rates to determine if fundamental changes in GP's decision to exit the profession have occurred over the past two decades.

• Godager, Geir (2025). Economic Incentives and Primary Care Physician Service Delivery. doi: https:/healtheconomics.org/wp-content/uploads/2025/08/IHEA-2025-Congress-Abstract-Book.pdf. Fulltekst i vitenarkiv Vis sammendrag

  Organized session at 2025 World Congress on Health Economics, (iHEA 2025)

• Godager, Geir (2025). The Norwegian GP Scheme: Recent Policies and Trends. Fulltekst i vitenarkiv
• Hagen, Terje P. (2025). Finsk, dansk, svensk eller norsk løsning? Aktuelle endringer i de nordiske landenes helsetjenestesystemer. Overlegen. ISSN 1503-2663. Fulltekst i vitenarkiv
• Kinge, Jonas Minet (2024). Forecasting total and cause-specific health expenditures for 116 health conditions in Norway, 2022-2050. Fulltekst i vitenarkiv
• Kinge, Jonas Minet (2024). Forecasting total and cause-specific health expenditures for 116 health conditions in Norway, 2022-2050. Fulltekst i vitenarkiv
• Linde, Astrid de (2024). The Effect of Mergers of Out-of-Hours Care. Fulltekst i vitenarkiv
• Linde, Astrid de (2024). The Effect of Mergers of Out-of-Hours Care. Fulltekst i vitenarkiv
• Linde, Astrid de (2024). Maternity ward closures and infant health outcomes, maternal health outcomes, and birth procedures. Fulltekst i vitenarkiv
• Linde, Astrid de (2024). Maternity ward closures and infant health outcomes, maternal health outcomes, and birth procedures. Fulltekst i vitenarkiv
• Kittelsen, Sverre A.C. & Anthun, Kjartan Sarheim (2024). 3 - Scale economies in somatic hospitals in Norway. Fulltekst i vitenarkiv
• Aas, Eline (2024). Økonomisk evaluering av tiltak - hvor er vi på vei? Fulltekst i vitenarkiv
• Aas, Eline (2024). Screening in a Health Economics perspective. Fulltekst i vitenarkiv
• Aas, Eline (2024). Tilgangsavtaler. Fulltekst i vitenarkiv
• Aas, Eline (2024). Økonomisk evaluering. Fulltekst i vitenarkiv
• Kittelsen, Sverre A.C. (2024). 2 - Scale economies in somatic hospitals in Norway. Fulltekst i vitenarkiv
• Aas, Eline (2024). Paneldiskusjon - prioriteringsmeldingen. Fulltekst i vitenarkiv
• Kittelsen, Sverre A.C. (2024). 1 - Scale economies in somatic hospitals in Norway. Fulltekst i vitenarkiv
• Aas, Eline (2024). Effekten av samfunnsperspektiv på estimering av kostnadseffektivitet. Fulltekst i vitenarkiv
• Aas, Eline; Bjørnelv, Gudrun Maria Waaler; Grauer, Ann-Christin Dorothea & Bekker-Grob, Esther de (2024). Health literacy and health care utilization at end of life: Role of higher education versus type of education. Fulltekst i vitenarkiv
• Aas, Eline; Wu, Yansi; Burger, Emily Annika; Sæther, Erik Magnus; Bugge, Christoffer & Francisco, Oteiza [Vis alle 8 forfattere av denne artikkelen] (2024). Strukturert klinikerinnspill. Fulltekst i vitenarkiv
• Godager, Geir (2024). Is Patient Health a Public Good? Experimental Evidence on the Scope of Patient Regarding Preferences. Fulltekst i vitenarkiv
• Godager, Geir & Ge, Ge (2024). Markets, Morals, and Metrics: the Impact of Analyst Discretion in Health Experiments. Fulltekst i vitenarkiv
• Lizardi, Eduardo Alberto Ramirez (2024). Effects of health shocks on adult children’s labor market outcomes and well-being. Fulltekst i vitenarkiv
• Hagen, Terje P. (2024). Health care for aging populations: Better health, better aging. Fulltekst i vitenarkiv
• Hagen, Terje P. (2024). Brukerne blir yngre, psykiske lidelser øker. Fulltekst i vitenarkiv
• Lizardi, Eduardo Alberto Ramirez; Fevang, Elisabeth; Røed, Knut & Øien, Henning (2024). Effects of Health Shocks on Adult Children's Labor Market Outcomes and Well-Being. IZA Discussion Papers. Fulltekst i vitenarkiv
• Hagen, Terje P. (2024). Primærhelseteam. Fulltekst i vitenarkiv
• Hagen, Terje P. (2024). Årsaker til kostnadsvekst i pleie- og omsorgssektoren. Fulltekst i vitenarkiv
• Hagen, Terje P. (2024). Finansiering av sykehusene – hva blir veien videre? Fulltekst i vitenarkiv
• Hagen, Terje P.; Aarflot, Morten & Tjerbo, Trond (2024). Analyzing the Impact of Reduced Hospital Stays on Mortality in Primary Care Settings with Variation in Nursing Home Capacity: An Observational Study of Hip Fracture Patients from 2010-2019. Fulltekst i vitenarkiv
• Hagen, Terje P. (2024). Helse Nord - bølle, strateg eller lasaron? Fulltekst i vitenarkiv
• Linde, Astrid de (2023). Maternity ward closures and infant health outcomes, maternal health outcomes, and birth procedures. Fulltekst i vitenarkiv
• Linde, Astrid de (2023). Maternity ward closures and infant health outcomes, maternal health outcomes, and birth procedures. Fulltekst i vitenarkiv
• Linde, Astrid de (2023). Maternity ward closures and infant health outcomes, maternal health outcomes, and birth procedures. Fulltekst i vitenarkiv
• Linde, Astrid de (2023). Maternity ward closures and infant health outcomes, maternal health outcomes, and birth procedures. Fulltekst i vitenarkiv
• Linde, Astrid de (2023). Maternity ward closures and infant health outcomes, maternal health outcomes, and birth procedures. Fulltekst i vitenarkiv
• Kittelsen, Sverre; Lindaas, Nils Arne; Anthun, Kjartan Sarheim & Magnussen, Jon (2023). Economies of Scale and Scope in Norwegian hospitals. Fulltekst i vitenarkiv
• Zhang, Yuan; Øien, Henning & Iversen, Tor (2023). Norway - Handling the Pandemic and the Effects on Specialized Healthcare. Fulltekst i vitenarkiv
• Zhang, Yuan & Iversen, Tor (2023). The development of digital consultations in Norway. Fulltekst i vitenarkiv
• Kinge, Jonas Minet; Aas, Eline & Godager, Geir (2023). Ønsker vi virkelig å redusere kvaliteten på helsetjenesten? Fulltekst i vitenarkiv
• Godager, Geir & Brækhus, Leni Aurora (2023). Helseøkonom positivt overrasket over «kommunetilpasset» basistilskudd. [Journal]. Dagens medisin. Fulltekst i vitenarkiv
• Aas, Eline; Wu, Yansi; Burger, Emily Annika; Sæther, Erik Magnus; Bugge, Christoffer & Francisco, Oteiza [Vis alle 8 forfattere av denne artikkelen] (2023). Hvordan kan systematisk klinikerinnspill redusere usikkerhet og bidra til raskere innføring av nye behandlinger. Fulltekst i vitenarkiv
• Aas, Eline (2023). Økonomisk evaluering i kjølvannet av en klinisk studie. Fulltekst i vitenarkiv
• Aas, Eline (2023). God tverrsektoriell samhandling gjør at flere kan bo hjemme med verdighet lenger. Fulltekst i vitenarkiv
• Terzic, Dajana & Wangen, Knut Reidar (2026). Exploring the impact of healthcare access and centralization on colorectal cancer outcomes: spatial analyses across Norwegian regions. University of Oslo (UiO). ISSN 9788234807565. Fulltekst i vitenarkiv Vis sammendrag

  This thesis investigates place-based drivers and policies contributing to geographical differences in colorectal cancer (CRC) outcomes at the municipality and hospital levels in Norway, where substantial regional variation exists. It also examines spatial health economic factors that predict spatial dependence and interactions among networked entities (e.g., GPs, hospitals, municipalities, counties), as well as geographic clustering of unobserved place-based characteristics, using spatial methods. It lies at the intersection of health economics and epidemiology/public health. Using nationwide registry data at the municipality and hospital levels, the thesis applies advanced spatial causal models to account for spatial dependence and spatial confounding. The methods include comparisons between traditional spatial regression models and novel causal spatial approaches designed to address unmeasured spatial confounding, as well as comparisons of traditional and spatial difference-in-differences approaches. Papers 1 and 2 examine place-specific drivers, such as physician density and screening uptake, and their effects on CRC outcome. The results show that increased access to general practitioners and higher screening rates significantly reduce late-stage CRC incidence. These findings highlight the importance of improving access to physicians and screening services in underserved and rural areas. Paper 3 evaluates the hospital centralization reform—specifically, the closure of surgical treatment services in one hospital—and its impact on the quality and efficiency of nearby hospitals facing increased workloads. The findings show that neighboring hospitals improved efficiency without compromising quality. Overall, the findings emphasize the importance of accounting for spatial dimensions when analyzing regional CRC outcomes to avoid biased results and misinformed policy decisions. Tailored, place-based policies are essential to reduce disparities and improve patient outcomes.

• Hagen, Terje P.; Tjerbo, Trond & Aarflot, Morten (2024). Brukerne blir yngre, psykiske lidelser øker: Dypdykk i pleie- og omsorgstjenestene 2017-2021. Helseøkonomisk forskningsprogram ved Universitetet i Oslo. Fulltekst i vitenarkiv Vis sammendrag

  Det var en kraftig vekst i utgiftene i kommunenes pleie- og omsorgstjenester i perioden 2015-2020. Veksten flatet ut i 2020, men har i årene 2021 og 2022 igjen vært kraftig – nesten 9 prosent per år. Det er spesielt i tjenester til hjemmeboende veksten har vært sterk. I tillegg har veksten vært sterk i aldersgruppene under 80 år.Hovedmålsettingene med denne rapporten har vært å gå dypere i tre temaer: - Langtidsopphold i institusjoner: I en tidligere analyse (Andrews et al., 2021; Hagen & Tjerbo, 2023) fant vi at veksten i langtidsoppholdene kom i aldersgruppene under 80 år. Her stiller vi spørsmål om årsakene til denne endringen. Har de ‘yngre’ brukergruppene større behov enn de eldre? - Høykostnadsbrukere: I de tidligere analysene fant vi også indikasjoner på at en del yngre hjemmeboende brukere var kostnadskrevende. Her definerer vi høykostnadsbrukerne som de mottakere av pleie- og omsorgstjenester som har de 5% høyeste kostnadene og stiller følgende spørsmål: Hvor stor andel av de samlede pleie- og omsorgstjenestene kan knyttes til de 5 prosentene med høyest kostnader? Hva kjennetegner brukergruppen med høyest kostnader? - Samhandling mellom sykehus og kommuner: Hoftebruddspasientene er en særlig sårbar gruppe. Pasientene er gamle, skrøpelige og har mange tilleggssykdommer (komorbiditeter). Dødeligheten i gruppen er høy. Spørsmålene vi stiller er hvilke effekter reduksjon i sykehusenes liggetider, hardere konkurranse om sykehjemsplassene og bedre helse blant de eldre, til sammen har for pasientenes overlevelse. Klarer kommunene å kompensere for den reduserte liggetiden i sykehus?

Se alle arbeider i NVA