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Leonardsen, Ann-Chatrin Linqvist; Nystrøm, Vivian; Moger, Tron Anders & Lurås, Hilde
(2024).
Kommunale akuttavdelinger skulle bli et alternativ til sykehusinnleggelse- men legene stoler ikke på tilbudet.
Forskning.no.
ISSN 1891-635X.
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Nystrøm, Vivian; Lurås, Hilde; Moger, Tron Anders & Leonardsen, Ann-Chatrin Linqvist
(2023).
Patient experiences and clinical outcomes of admissions to municipal acute wards versus a hospital.A multicenter randomised controlled trial in Norway.
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Nystrøm, Vivian; Lurås, Hilde; Moger, Tron Anders & Leonardsen, Ann-Chatrin Linqvist
(2023).
Finding good alternatives to hospitalisation.A data register study in five municipal acute wards in Norway.
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Moger, Tron Anders; Amundsen, Olav & Holte, Jon Helgheim
(2022).
Innovations in use of register data (INOREG) – Design of a register-based study analysing care pathways and outcomes for chronic patients.
Vis sammendrag
Abstract: In recent years there have been several political initiatives in Norway, requiring increased research into how multimorbidity and health services in the municipality affect outcomes such as work participation, disability, quality of life and hospital admissions for patients with chronic diseases. Most of this care happens outside hospitals and has been difficult to capture in large, register-based studies. Focusing on two important chronic groups, patients with chronic obstructive pulmonary disease (COPD) and musculoskeletal disorders (MSD), the INOREG project will meet this need. In the paper we present the study design utilizing register data at the individual level for patients in Oslo and Trondheim, covering specialized care, primary care, home-based and long-term care, sociodemographic and –economic data and functioning. The database is constructed from a novel linkage of national health registers to care data from Oslo and Trondheim municipalities, capturing the entire population of COPD and MSD patients in the cities, and functioning and quality of life for ca. 3800 patients treated at physiotherapy clinics in the FYSIOPRIM project. This enables construction of complete care pathways and outcomes at the individual level during 2008-2020. The results from the project will fill knowledge gaps regarding patterns of care at different levels in the health care system and the association to outcomes for these patient groups. This will help inform decision makers about how services could be organized to improve provisions and coordination of services, as well as reduce inequalities in health.
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Amundsen, Olav; Holte, Jon Helgheim; Vøllestad, Nina Køpke & Moger, Tron Anders
(2022).
INOREG-prosjektet - drøfting av resultater.
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Moger, Tron Anders; Vøllestad, Nina Køpke; Hellesø, Ragnhild; Tjerbo, Trond; Holte, Jon Helgheim & Amundsen, Olav
(2022).
INOREG workshop.
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Amundsen, Olav; Vøllestad, Nina Køpke; Moger, Tron Anders; Tjerbo, Trond & Holte, Jon Helgheim
(2022).
Is future disability benefit associated with specific combinations of health care use for musculoskeletal disorders?
Vis sammendrag
Background Musculoskeletal disorders (MSD) are one of the highest contributors to disability benefit in Norway and other OECD-countries. This is an increasing problem in most OECD countries and is a major challenge for welfare states. To be able to prevent people from falling out of the work force it is important to identify combinations of care associated with poorer outcomes and increased risk of future disability pension.
Objective Examine how combinations of health care use relate to future disability benefit, controlling for demographic, socioeconomic and clinical factors.
Methods The study combines Norwegian data registers with information on health care use, diagnosis, comorbidities, demographic, education, socioeconomic factors and disability benefits. Patients are included at the time of their first health care visit for MSD in 2013-2015 and are followed until end of 2020. Patients between 18-62 years and registered in the work force at index are included. The outcome is being registered with disability benefit minimum 12 months after index. Multivariable regression analysis is used with combinations of health care use for the first 12 months as the main explanatory variables. Combinations of health care use are identified by variables for having used GP, physiotherapy and specialist health care for MSD and creating combinations of these dichotomous variables. Other variables were included as covariates.
Results/conclusion Using specialist health care for MSD in combination with GP (OR 1.91, 95%CI 1.36-2.68) or in combination with both GP and physiotherapy services (OR 2.38, 95%CI 1.53-3.71) was associated with increased risk of future disability pension compared to seeing GP alone. Seeing physiotherapist only or in combination with GP was not associated with increased risk of future disability pension. Reasons for these associations remain to be explored.
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Moger, Tron Anders
(2022).
Predicting risk of future hospital episodes for COPD patients – Associations to outpatient care, patient comorbidities, socioeconomic and –demographic factors.
Vis sammendrag
Background Although chronic obstructive pulmonary disorder (COPD) admissions puts a substantial burden on hospitals, most of the patients’ contacts with health services are in primary care. Traditionally, primary care has been difficult to capture in population-based samples.
Aim The aim is to assess associations between hospitalizations with a respiratory or COPD diagnosis and previous primary care/outpatient contacts, continuity and compliance to recommendations in guidelines. In addition, associations to comorbidities and sociodemographic and –economic variables are studied.
Methods Patients were identified from the Norwegian Patient Register (in- and outpatient contacts, rehabilitation) and the KUHR register (consultations with GPs, contract specialists and physiotherapists), 2010-2019. Data also included the Regular General Practitioner register (characteristics of the GP and practice), long-term care data from Oslo and Trondheim (e.g. home nursing, nursing homes, need for assistance), socioeconomic and –demographic data from Statistics Norway and the Cause of Death register. At least three COPD consultations with GP or contract specialists in Oslo and Trondheim and a follow-up of one year was required. This resulted in a sample of 17,431 individuals.
Results The number of current year primary and outpatient contacts was strongly associated to next year hospitalizations with COPD or respiratory diagnoses (10-60% more hospitalizations for categories with increasing contact numbers). Effects were relatively large compared to most comorbidities and socio demographic and –economic variables. Fees indicating interaction between providers, regular spirometries, greater continuity of care with GP, and rehabilitation within a month of previous hospitalizations as opposed to later, were associated with lower numbers of next year hospitalizations, although these effects were modest.
Conclusion In a population-based sample of COPD patients, a huge variation in number of primary and specialist health care contacts is evident. An increasing number of contacts with any type of primary care provider was strongly associated with future hospitalizations, thus stressing the need for communication and coordination of care between providers for these patients.
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Moger, Tron Anders; Tjerbo, Trond; Hellesø, Ragnhild & Vøllestad, Nina Køpke
(2021).
INOREG kick-off meeting.
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Kvamme, Maria Knoph; Lie, Elisabeth; Uhlig, Till; Moger, Tron Anders; Kvien, Tore Kristian & Kristiansen, Ivar Sønbø
(2020).
Erratum: Cost-effectiveness of TNF inhibitors vs synthetic disease-modifying antirheumatic drugs in patients with rheumatoid arthritis: A Markov model study based on two longitudinal observational studies (Rheumatology (2015 54 (1226-1235) DOI: 10.1093/rheumatology/keu460).
Rheumatology.
ISSN 1462-0324.
59(4).
doi:
10.1093/rheumatology/kez609.
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Moger, Tron Anders
(2020).
When should patients be transferred from hospital to municipal care?
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Moger, Tron Anders; Häkkinen, Unto & Hagen, Terje P.
(2017).
Higher mortality among ACS patients in Finland than in Norway: Do differences in acute preparedness and scale effects in hospital treatment explain the variation?
Vis sammendrag
Background: Mortality differences following hospital treatment in Finland and Norway are similar for major diseases with acute coronary syndrome (ACS) as an important exception. For ACS, mortality in Finland is significantly higher than in Norway.
Objective: To study whether the differences in the organization of the PCI facilities, a decentralized structure with reduced emergency preparedness and small scale production in Finland vs. a centralized structure with large PCI departments performing acute services 24/7 in Norway, add to the explanations of country differences in 30 and 365 day all-cause mortality for patients hospitalized with ACS (acute myocardial infarction or unstable angina pectoris).
Data and methods: Data for patients discharged with acute myocardial infarction (ICD 10 I21 and I22) and unstable angina pectoris (ICD 10 I 20.0) from the hospital discharge registers in 2009-2014 was linked with socio-demographic variables, variables describing distances to hospitals and causes of death registers in Norway and Finland. The variables of main interest, emergency preparedness of PCI and the volume of ACS patients at hospital level were included as independent variables in logistic regression analyses.
Preliminary results: Across all years combined, Norway had lower 30 and 365 days mortality (7% vs 11%, p<0.001 and 14% vs 20%, p<0.001). However, differences for STEMI patients were smaller (30 days: 10% vs 12%, p<0.001, 365 days: 17% vs 18%, p=0.01) than for non-STEMI, undefined and unstable angina patients (30 days: 6% vs 10%, p<0.001, 365 days: 13% vs 20%, p<0.001). The average Finnish patient was first admitted to a hospital treating 540 ACS patients per year (average travel time by car: 40 min), increasing to 590 patients (travel time: 43 min) during the first episode including transfers to higher level hospitals. Corresponding numbers for Norway were 630 ACS patients per year for the first admission (travel time: 60 min) and 1240 patients (!) for the first episode (travel time: 96 min). In Finland, 48% of STEMI and 39% of non-STEMI, undefined and unstable angina patients were admitted to hospitals with an emergency PCI service during the episode. The corresponding numbers for Norway were 77% and 66%. However, more patients received PCI within 2 days in Finland than Norway (38% vs. 33%, p<0.001), and the distribution of PCIs performed during weekends was similar (23% vs. 23%, p=0.55). Both in Norway and Finland non-STEMI patients who not receive PCI have a significantly lower mortality if they are treated at hospital with PCI facility than at other hospitals (OR 0.65 in Norway and 0.73 in Finland for 365 days mortality, p<0.001). This may indicate better quality at high volume centers.
Further work: Multilevel logistic models with individual level risk adjustment and hospital level variables and random effects are going to be used to study if the reduced preparedness for PCI at some of the Finnish hospitals and differences in organization of care for ACS patients add to our understanding of mortality differences between Finland and Norway.
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Moger, Tron Anders & Swanson, Jayson O. J
(2017).
Effects of municipal care and early follow-up on readmissions and mortality for stroke patients.
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Moger, Tron Anders & Swanson, Jayson O. J
(2017).
Effekt av omsorgstjenester hos slagpasienter i Oslo.
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Swanson, Jayson O. J; Vogt, Verena; Sundmacher, Leonie; Hagen, Terje P. & Moger, Tron Anders
(2017).
Continuity of care and its effect on readmissions for COPD patients: A comparative study of Norway and Germany.
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Häkkinen, Unto; Hagen, Terje P. & Moger, Tron Anders
(2017).
Performance comparison of hip fracture pathways in two metropolitan areas - does the level of integration matter?
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Moger, Tron Anders; Häkkinen, Unto & Hagen, Terje P.
(2017).
Higher mortality among ACS patients in Finland than in Norway: Do differences in acute services and scale effects in hospital treatment explain the variation?
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Hagen, Terje P.; Iversen, Tor & Moger, Tron Anders
(2016).
T.P. Hagen og medarbeidere svarer:.
Tidsskrift for Den norske legeforening.
ISSN 0029-2001.
136(8),
s. 690–690.
doi:
10.4045/tidsskr.16.0331.
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Eek, Anne Katrine; Blix, Hege Salvesen; Viktil, Kirsten; Moger, Tron Anders & Reikvam, Åsmund
(2011).
General practioner`s experience with hospital discharge notes.
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Viktil, Kirsten; Blix, Hege Salvesen; Eek, Anne Katrine; Moger, Tron Anders & Reikvam, Åsmund
(2011).
Changes in drug regimen during hospital stay and after discharge.
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Eek, Anne Katrine; Blix, Hege Salvesen; Viktil, Kirsten Kilvik; Moger, Tron Anders & Reikvam, Åsmund
(2010).
GPs’ opinions of the hospital discharge notes – a survey among GPs.
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Viktil, Kirsten Kilvik; Blix, Hege Salvesen; Eek, Anne Katrine; Moger, Tron Anders & Reikvam, Åsmund
(2010).
The challenge of drug regimen surveillance when changing level of care. P14, Norsk Farmasøytisk Selskap. Programhefte fra Farmasidagene, Oslo 2010.
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Eek, Anne Katrine; Blix, Hege Salvesen; Viktil, Kirsten Kilvik; Moger, Tron Anders & Reikvam, Åsmund
(2010).
GP’s Opinions of the Hospital Discharge Notes – A Survey among GPs.
Pharmacoepidemiology and Drug Safety.
ISSN 1053-8569.
19,
s. 290–291.
doi:
10.1002/pds.
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Viktil, Kirsten Kilvik; Blix, Hege Salvesen; Eek, Anne Katrine; Moger, Tron Anders & Reikvam, Åsmund
(2010).
The challenge of changes in drug regimen when changing level of care.
Pharmacoepidemiology and Drug Safety.
ISSN 1053-8569.
19.
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Roaldset, John Olav; Bjørkly, Stål; Moger, Tron Anders; Bakken, Anne Margrethe & Götestam, K. Gunnar
(2008).
Lipider og serotonin som prediktorer for suicidal-, selvskade- og voldsatferd hos akutt innlagte psykiatriske pasienter.
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Blix, Hege Salvesen; Viktil, Kirsten Kilvik; Moger, Tron Anders & Reikvam, Åsmund
(2008).
Identification of drug interactions in hospitals - computer screening vs bedside recording.
Pharmacy World & Science (PWS).
ISSN 0928-1231.
30,
s. 670–671.
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Blix, Hege Salvesen; Viktil, Kirsten K; Moger, Tron A; Reikvam, Aasmund & Reikvam, Åsmund
(2008).
Drug-related problems associated with various antibiotics: Risk grading by use of a novel method.
Pharmacoepidemiology and Drug Safety.
ISSN 1053-8569.
17.
doi:
10.1002/pds.1631.
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Haugen, Marion; Bray, Freddie Ian; Grotmol, Tom; Tretli, Steinar; Aalen, Odd O. & Moger, Tron Anders
(2008).
Frailty modelling of bimodal age-incidence curves of nasopharyngeal carcinoma in low-risk populations.
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Roaldset, John Olav; Moger, Tron Anders; Bjørkly, Stål; Bakken, Anne M. & Gøtestam, K Gunnar
(2007).
Blood levels of lipids and serotonin as predictors of self harm and violence in acutely admitted psychiatric patients.
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Viktil, Kirsten Kilvik; Blix, Hege Salvesen; Moger, Tron Anders & Reikvam, Åsmund
(2007).
Use of Coxibs and traditional NSAIDs in hospitalized patients prior to rofecoxib withdrawal: utilization pattern and drug-related problems.
Pharmacoepidemiology and Drug Safety.
ISSN 1053-8569.
16.
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Blix, Hege Salvesen; Viktil, Kirsten Kilvik; Moger, Tron Anders & Reikvam, Åsmund
(2007).
The relationship between two different methods – bedside recording and computerized screening – for the identification of drug-interactions.
Pharmacoepidemiology and Drug Safety.
ISSN 1053-8569.
16.
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Nordsveen, Maren; Eek, Anne Katrine; Blix, Hege Salvesen; Viktil, Kirsten Kilvik; Moger, Tron Anders & Reikvam, Åsmund
(2007).
Hospitalised patients on warfarin therapy: concomitant aspirin/NSAIDs use and occurrence of drug-related problems.
Basic & Clinical Pharmacology & Toxicology.
ISSN 1742-7835.
101.
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Eek, Anne Katrine; Nordsveen, Maren; Viktil, Kirsten Kilvik; Blix, Hege Salvesen; Moger, Tron Anders & Reikvam, Åsmund
(2007).
Benzodiazepine use and drug-related problems in hospitalised problems with lung diseases.
Basic & Clinical Pharmacology & Toxicology.
ISSN 1742-7835.
101.
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Nordsveen, Maren; Eek, Anne Katrine; Blix, Hege Salvesen; Viktil, Kirsten Kilvik; Moger, Tron Anders & Reikvam, Åsmund
(2007).
Hospital use of warfarin and aspirin/NSAIDs in combination: frequency and problem.
Cardiovascular Drugs and Therapy.
ISSN 0920-3206.
21.
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Eek, Anne Katrine; Nordsveen, Maren; Blix, Hege Salvesen; Viktil, Kirsten Kilvik; Moger, Tron Anders & Reikvam, Åsmund
(2007).
Benzodiazepine use and drug-related problems in hospitalised patients with lung diseases.
Norsk Epidemiologi, Supplement.
ISSN 0803-4206.
17.
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Nordsveen, Maren; Eek, Anne Katrine; Blix, Hege Salvesen; Viktil, Kirsten Kilvik; Moger, Tron Anders & Reikvam, Åsmund
(2007).
Co-prescribing of warfarin and NSAIDs/aspirin – frequency and problems.
Norsk Epidemiologi, Supplement.
ISSN 0803-4206.
17.
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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).
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Häkkinen, Unto; Engel-Andreasen, Christopher; Hagen, Terje P.; Goude, Fanny; Moger, Tron Anders & Kruse, Marie
[Vis alle 8 forfattere av denne artikkelen]
(2018).
Performance comparison of patient pathways in Nordic capital areas. A pilot study.
THL.
ISSN 978-952-343-134-8.
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Haugen, Marion & Moger, Tron Anders
(2011).
Using frailty models to account for heterogeneity and associations in cancer epidemiology and insurance.
Faculty of medicine, University of Oslo.
ISSN 978-82-8264-160-9.
Vis sammendrag
M.Sc. Marion Haugen og medarbeidere har studert nye metoder for å forklare variasjon i individuell risiko for nasofarynkskreft (kreft i overgangen mellom nese og svelg) og komplekse avhengighetsstrukturer i familiedata. Metoden for familiedata er anvendt på føflekkreft. Tid til oppsigelse av bilforsikringer med samme eier er analysert med en eksisterende metode fra forløpsanalyse som tar hensyn til eventuell avhengighet.
I forløpsanalyse inkluderes variabler slik som f.eks. kjønn og alder for å undersøke deres effekt og for å modellere ulik risiko for individer (observert heterogenitet). I medisinske studier kan økonomiske årsaker gjøre det umulig å måle alle relevante variabler. Dersom variabler utelates eller er ukjente kan dette resultere i at noen individer har høyere risiko enn andre (uobservert heterogenitet). Risikoen kan også variere mellom grupper, f.eks. viser flere sykdommer en overopphopning av tilfeller innen familier. Ved analyse av slike data brukes gjerne metoder som gir avhengighet i tid til hendelse.
For visse populasjoner har de observerte aldersspesifikke insidensrater for nasofarynkskreft én liten topp i de sene tenårene og én topp rundt pensjonsalder. En bimodal modell gir signifikant bedre tilpasning til dataene enn en modell med kun én topp. For føflekkreft kan man for hvert individ tenke seg tre nivåer av avhengighet: individuelt miljø, genetikk og felles miljø. Den nye metoden gir nivåenes bidrag til variasjonen i familiær risiko. Forsikringskunder reagerer ulikt på prisendringer, noen er mindre lojale enn andre. Observerbare variabler kan ikke forklare hele denne variasjonen. Den anvendte metoden gir ulik risiko for kunder, men lik risiko for biler til en kunde.
Modellering av ulik risiko innen populasjoner er ofte nødvendig for å få riktig fortolkning av resultater fra forløpsanalyse. De anvendte metodene har vist seg nyttige til dette.