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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…
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.
Misinterpretation of a negative test results in health screening may initiate less preventive effort and more future lifestyle-related disease. We predict that…
Misinterpretation of a negative test results in health screening may initiate less preventive effort and more future lifestyle-related disease. We predict that misinterpretation occurs more frequently among individuals with a low level of education compared with individuals with a high level of education.
The empirical analyses are based on unique data from a randomized controlled screening experiment in Norway, NORCCAP (NORwegian Colorectal Cancer Prevention). The dataset consists of approximately 50,000 individuals, of whom 21,000 were invited to participate in a once only screening with sigmoidoscopy. For all individuals, we also have information on outpatient consultations and inpatient stays and education. The result of health behaviour is mainly measured by lifestyle-related diseases, such as COPD, hypertension and diabetes type 2, identified by ICD-10 codes.
The results according to intention-to-treat indicate that screening does not increase the occurrence of lifestyle related diseases among individuals with a high level of education, while there is an increase for individuals with low levels of education. These results are supported by the further analyses among individuals with a negative screening test.
This research aims to explore the differences in destination image owing to culture and travel distance among international tourists to northern Norway. A…
This research aims to explore the differences in destination image owing to culture and travel distance among international tourists to northern Norway. A self-administrated survey with a structured questionnaire is deployed at North Cape – the most popular Arctic destination in Northern Norway. Concerning cultural influences on destination images, this study examines the similarities and differences in perceived images among seven cultural groups. For evaluating geographic influences, this study uses six travel regions distinguished by the distance of travel to the study site as the base for the data analysis. Similarities and differences in destination imaged owing to above two factors are revealed by correspondent analyses. For example, Reindeers and Northern Light are the two greatest reflections of Northern Norway in the mind of all respondents. Misconceptions on tourism offerings in the study region transpire among the Japanese. Lastly, this study suggests that the distance of travel may evoke a moderating effect on the destination images. That is the farther the distance traveled the further image distortion exhibited.
Organizational decision‐makers require information presented in ways that allow them to make informed decisions on the effectiveness of change interventions. Current…
Organizational decision‐makers require information presented in ways that allow them to make informed decisions on the effectiveness of change interventions. Current statistical methods do not provide enough information about the practical value of organizational interventions to decision‐makers. It is proposed that a strong hypothesis testing strategy provides a partial answer to this problem. The hypothesis testing method presented here uses Bayesian statistics to test null hypotheses other than the traditional Ho = 0. A description of the evaluation of a change project in six manufacturing plants of a large United States corporation is provided. The data from this project is used to show how both statistical and practical significance may be tested using this hypothesis testing method. The applicability of the strong hypothesis testing approach to the assessment of organizational change is then discussed, and recommendations are made for evaluations conducted in field settings.
In order to explore the theory of the spatial layout of urban sports facilities, starting with the analysis of theoretical knowledge, the current situation of public…
In order to explore the theory of the spatial layout of urban sports facilities, starting with the analysis of theoretical knowledge, the current situation of public sports facilities in the central urban area of Jinan is analyzed, the various factors affecting the planning layout are discussed, and the strategies and methods of the layout planning of public sports facilities in Jinan are summarized. The results show that the layout planning of public sports facilities should follow the corresponding patterns and principles. The layout of public sports facilities at all levels should fully consider the factors of urban public transport, urban management system, urban public functions, and reasonable service radius of public sports facilities. It can be seen that excessive pursuit of efficiency will lead to excessive service radius and poor accessibility of urban public sports facilities; excessive pursuit of fairness will result in a small and scattered layout pattern, which easily leads to idle waste.
The purpose of this paper is to investigate the information content of the variables that can help detecting external and internal imbalances in an early stage. The…
The purpose of this paper is to investigate the information content of the variables that can help detecting external and internal imbalances in an early stage. The starting point is the Scoreboard, where nine indicators are chosen in order to increase macroeconomic surveillance of all member states.
This paper provides an overview of the variables that could be informative for imbalances by focusing on EU-27 countries over the period 1960-2010. The number of chosen variables is 28, and they are aggregated in six macro-areas. Therefore, once an imbalance is observed in any of those areas, it is possible to detect in a simple way which specific variable is determining such outcome.
In general, this approach provides reliable signal to the policy-makers about the indicators that can drive imbalances within the area, shedding light on the relationship among the variables included in the analysis, too.
In fact, the empirical results underline some well-known critical issue for several countries, and is largely in line with results obtained in a variety of EC and OECD studies.
The main added value of the approach adopted in this paper is the introduction of more variables than those initially proposed by the European Commission in the construction of the Scoreboard. This provides more information about the macroeconomic situation in each country, preserving, however, the simplicity of the analysis as the variables are aggregated by homogeneous areas.
Prediction of increased risk of suicide is difficult. We had the opportunity to follow up 20 patients receiving electroconvulsive therapy (ECT) because of severe…
Prediction of increased risk of suicide is difficult. We had the opportunity to follow up 20 patients receiving electroconvulsive therapy (ECT) because of severe depression. They filled in the Antonovsky sense of coherence test (SOC) and Beck depression inventory (BDI) before and after a series of ECT treatments. Seventeen surviving patients had a mean observation time of 20.6 months, whereas the three deceased patients had 11.3 months. There was a lower mean age at onset of illness and a longer mean duration of disease in the deceased. Other clinical parameters did not differ. The surviving patients had a significant decrease on the BDI from 35 to 18 (P<0.001) and an increase on the SOC test after ECT from 2.45 to 3.19 (P<0.001), indicating both less depression and better functioning in life. The deceased had a larger change on the BDI from 32 to 13, not attaining significance because of the low number of deceased. The SOC test, however, did not increase to a purported normal level; that is, from 2.43 to 2.87. Although the SOC scale has been shown to predict mortality in substance abusers, the SOC test has not been part of earlier reviews of predictive power. Tentatively, a low pathological score on the SOC test may indicate low sense of coherence in life that might increase the propensity for suicide. These preliminary results need replication in larger studies.
SINCE the year 1940, there have appeared two major reports on the Public Library system in Great Britain. The first, “The public library system of Great Britain: a report on its present condition, with proposals for post‐war re‐organisation” by Lionel R. McColvin, appeared in 1942. It suggested sweeping changes in the organisation of the public library system, more radical and far‐reaching than those embodied in the recent recommendations of the Library Association for local government reform. On library co‐operation, the report was equally radical, though certain similarities with the recommendations of the second report are apparent.