Terje P. Hagen

Terje P. Hagen
University of Oslo · Department of Health Management and Health Economics

MSc, PhD

About

125
Publications
20,397
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1,707
Citations
Citations since 2016
41 Research Items
888 Citations
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2016201720182019202020212022020406080100120140
2016201720182019202020212022020406080100120140
Introduction
Skills and Expertise
Additional affiliations
May 1998 - present
University of Oslo
Position
  • Professor (Full)

Publications

Publications (125)
Article
Background To understand the impact of the COVID-19 pandemic on mortality, this study investigates overall, sex- and age-specific excess all-cause mortality in 20 countries, during 2020. Methods Total, sex- and age-specific weekly all-cause mortality for 2015–2020 was collected from national vital statistics databases. Excess mortality for 2020 wa...
Article
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Purpose: The 'Outcomes & Multi-morbidity in Type 2 Diabetes' (OMIT) is an observational registry-based cohort of Norwegian patients with type 2 diabetes (T2D) established to study high-risk groups often omitted from randomised clinical trials. Participants: The OMIT cohort includes 57 572 patients with T2D identified via linkage of Norwegian Dia...
Article
Full-text available
Background: Understanding the impact of the burden of COVID-19 is key to successfully navigating the COVID-19 pandemic. As part of a larger investigation on COVID-19 mortality impact, this study aims to estimate the Potential Years of Life Lost (PYLL) in 17 countries and territories across the world (Australia, Brazil, Cape Verde, Colombia, Cyprus...
Technical Report
Full-text available
Studien som ligger til grunn for rapporten, belyser årsaker til kostnadsvekst i kommunale pleie- og omsorgstjenester basert på data fra KOSTRA (2015-2019), Kommunalt pasientregister (2017-2020), og intervjuer med ledere i 15 kommuner. Rapporten viser hvilke tjenesteområder som har hatt størst vekst, og til hvilke typer brukere og hvilke aldersgrupp...
Article
The elderly account for the majority of medical spending in many countries, raising concerns about potentially unnecessary spending, especially during the final months of life. Using a well-defined starting point (hospitalization for an initial acute myocardial infarction) with evidence-based postevent treatments, we examined age trends in treatmen...
Preprint
Full-text available
Background Understanding the impact of the burden of COVID-19 is key to successfully navigating the COVID-19 pandemic. As part of a larger investigation on COVID-19 mortality impact, this study aims to estimate the Potential Years of Live Lost (PYLL) in 17 countries and territories across the world (Australia, Brazil, Cape Verde, Colombia, Cyprus,...
Article
Full-text available
Background: This study aimed to investigate overall and sex-specific excess all-cause mortality since the inception of the COVID-19 pandemic until August 2020 among 22 countries. Methods: Countries reported weekly or monthly all-cause mortality from January 2015 until the end of June or August 2020. Weekly or monthly COVID-19 deaths were reporte...
Article
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Background Reducing the economic impact of hip fractures (HF) is a global issue. Some efforts aimed at curtailing costs associated with HF include rehabilitating patients within primary care. Little, however, is known about how different rehabilitation settings within primary care influence patients’ subsequent risk of institutionalization for long...
Technical Report
Full-text available
FINANSIERING AV FASTLEGEORDNINGEN MEKANISMER – UTFORDRINGER – MULIGHETER – LØSNINGER Birgit Abelsen, Geir Godager, Terje P. Hagen. KS FoU og Helseøkonomisk analyse AS
Article
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Low levels of neonatal health services utilization and high neonatal deaths are often concentrated among socially and economically disadvantaged groups, especially in low-income countries. Therefore the aim of this study was to assess inequity in the use of neonatal health services in Southwest Ethiopia. A community-based cross-sectional study was...
Technical Report
Full-text available
Omsorg 2050 er et Excel-basert verktøy som gjør det enkelt å framskrive behovene for kommunale omsorgstjenester i enkeltkommuner. Formålet med denne rapporten er å gi en beskrivelse av dette framskrivningsverktøyet. De viktigste endringer i forhold til forrige versjon, Omsorg 2040 er at omsorgsbehovet framskrives til år 2050, og at verktøyet er til...
Article
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Background: Many older people live at home, often with complex and chronic health and social care needs. Integrated care programs are increasingly being implemented as a way to better address these needs. To support older people living at home, it is also essential to maintain their safety. Integrated care programs have the potential to address a...
Article
Aims: This article describes and discusses the extension of performance measurement using an episode-based approach so that the measurement includes primary care, and social and long-term-care services. By using data on incident stroke patients from the capital areas of four Nordic countries, this pilot study: (a) extended the disease-based perform...
Article
Full-text available
Integrated care programmes are increasingly being put in place to provide care to older people living at home. However, knowledge about further improving integrated care is limited. In fourteen integrated care sites in Europe, plans to improve existing ways of working were designed, implemented and evaluated to enlarge the understanding of what wor...
Article
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Introduction: The topic of patient safety, which is traditionally viewed as preventing harm stemming from healthcare treatment, has been extensively researched in hospital and institutional settings. However, less attention has been given to addressing safety at home even though an increasing number of older people receive care and support at home,...
Article
The Norwegian healthcare coordination reform (Samhandlingsreformen) was implemented from January 1, 2012. In addition to providing municipalities with funding to strengthen their health infrastructure, it required municipalities to pay hospitals a daily fee for patients who, having been declared ready for discharge and in need of municipal health s...
Article
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Finland and Norway have health care systems that have a varying degree of vertical integration. In Finland the financial responsibility for all patient treatment is placed at the municipal level, while in Norway the responsibility for patients is divided between the municipalities (primary and long-term care) and state-owned hospitals. From 2012, t...
Article
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Mortality following hospital treatment in Finland and Norway is similar for major diseases, with acute coronary syndrome (ACS) as an important exception. For ACS, the mortality is significantly higher in Finland than in Norway. We study whether a decentralized structure with reduced emergency preparedness and small-scale production in Finland vs. a...
Article
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In Surnadal, a municipality in Mid-Norway, Holistic Patient Care at Home (HPH) is the framework for delivering health services to community-dwelling residents. Its goal is to seamlessly provide the right services at the right time and place. In collaboration with the European project SUSTAIN, Surnadal is promoting person-centeredness and care coord...
Article
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Objectives To compare the socioeconomic status (SES) and case-mix among day surgical patients treated at private for-profit hospitals (PFPs) and non-profit hospitals (NPs) in Norway, and to explore whether the use of PFPs in a universal health system has compromised the principle of equal access regardless of SES. Design A retrospective, explorato...
Article
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Background: This study compares continuity of care between Germany - a social health insurance country, and Norway - a national health service country with gatekeeping and patient lists for COPD patients before and after initial hospitalization. We also investigate how subsequent readmissions are affected. Methods: Continuity of Care Index (COCI...
Article
Aims: To analyse whether the Norwegian Central Government's goal of subsidizing 12,000 places in nursing homes or sheltered housing using an earmarked grant was reached and to determine towards which group of users the planned investments were targeted. Methods: Data from the investment plans at municipal level were provided by the Norwegian Hou...
Article
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Objectives To compare the quality of care—using unplanned acute hospital readmissions as a quality measure—among patients treated at private for-profit hospitals (PFPs), private non-profit hospitals (PNPs) and public hospitals (PUBs) in Norway. Design A retrospective comparative study using the Norwegian Patient Register. Readmissions were evaluat...
Article
Setting prices for elective patient treatments in private for-profit (PFP) hospitals in traditional tax-funded health systems is challenging since both the organisation of these hospitals and the tasks they perform differ considerably from what we find in public hospitals. From the year 2000, Norway became one of a few countries to gradually implem...
Article
Background: Cost containment is a major policy challenge and one of the key drivers of health care reform. In this article, we focus on the role cost control has played as a reform driver in the Norwegian hospital sector between 1980 and 2014. Methods: We use data on aggregate expenditure as well as on activity changes from year to year. We also...
Article
Background Although health care reforms may improve efficiency at the macro level, less is known regarding their effects on the utilization of health care personnel. Following the 2002 Norwegian hospital reform, we studied the productivity of the physician workforce and the effect of personnel mix on this measure in all nineteen Norwegian hospitals...
Article
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Objectives: To investigate whether implementation of municipal acute bed units (MAUs) resulting from the Norwegian Coordination Reform (2012) was associated with reductions in hospital admissions, particularly for the elderly. Design: A municipality-based retrospective comparative cohort study using monthly population-based registry data analyse...
Article
Objectives: Growing numbers of patients with terminal heart failure and a shortage of heart donors have increased use of short- and long-term mechanical circulatory support (MCS). Few studies have analyzed survival rates and healthcare costs for heart transplantation (HTx), with or without extracorporeal membrane oxygenation (ECMO) and left ventri...
Article
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Activity-based financing of Norwegian hospitals was implemented in 1997. An earlier study shows that when the activity-based component increases, the average length of stay for the elderly is reduced. If this reduction entails premature discharge, an increased activity-based component may have the undesirable side effect of increasing readmission r...
Article
BACKGROUND: In 2014, the government introduced elements of quality-based funding (pay-for-performance) for the hospital sector. Survival is included as a quality indicator. If such quality indicators are to be used for funding purposes, it must be established that the observed variations are caused by conditions that the hospital trusts are able to...
Article
Percutaneous coronary interventions (PCI) on acute myocardial infarction (AMI) patients have increased substantially in the last 12-15 years because of its clinical effectiveness. The expansion of PCI treatment for AMI patients raises two questions: How did PCI utilization rates vary across European regions, and which healthcare system and regional...
Article
It is not known whether inequality in access to cardiac procedures translates into inequality in mortality. In this paper, we use a path analysis model to quantify both the direct effect of socio-economic status on mortality and the indirect effect of socio-economic status on mortality as mediated by the provision of cardiac procedures. The study l...
Article
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Objectives Studies link area features such as neighbourhood socioeconomic deprivation to poor health outcomes. However, there is a paucity of research based on representative data investigating the effects of area-level health services on mortality. This study examines the extent to which municipal health services account for municipal variation in...
Article
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Background Physician dual practice, a combination of public and private practice, has attracted attention due to fear of reduced work supply and a lack of key personnel in the public system, increase in low priority treatments, and conflicts of interest for physicians who may be competing for their own patients when working for private suppliers. I...
Article
The aim of this paper is to study how regional demography and accessibility patterns influence the cost of providing ambulance services. A secondary aim is to project future costs and demand for ambulance services based on population projections. We use data from south-east Norway, an area with both urban and rural areas. Our results show that acce...
Chapter
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forstå og å lede helsetjenesten er krevende. Intet enkelt fag kan gripe kom-pleksiteten. Innsikt fra mange fag er nødvendig når helsetjenesten skal ledes og når myndighetene skal forme helsepolitikken. En slik tverrfaglig tilnaerming har vaert en ledetråd for forskning og utdanning ved det som startet som Senter for helseadministrasjon i 1986. I 19...
Article
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Planned Workshop Integrated service delivery and the role of hospitals Risto Miettunen, (Governor in IHF and chairman of the session) Chief Executive Officer Kuopio Abstract Public health and primary care have a huge impact on the demand of hospital services which is reflected in regional differences. In general, hospitals have strategies based on...
Article
Previous studies of gender differences in relation to medical specialization have focused more on social variables than hospital-specific factors. In a multivariate analysis with extended Cox regression, we used register data for socio-demographic variables (gender, family and having a child born during the study period) together with hospital-spec...
Article
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Background Whether activity-based financing of hospitals creates incentives to treat more patients and to reduce the length of each hospital stay is an empirical question that needs investigation. This paper examines how the level of the activity-based component in the financing system of Norwegian hospitals influences the average length of hospita...
Article
Aims: In Norway, it is the responsibility of the country's 429 municipalities to provide long term care (LTC) services to their residents. Recent years have seen a sharp rise in the number of LTC users under the age of 65. This article aims to explore the effect of this rise on LTC expenditure. Methods: Panel data models are used on data from mu...
Article
Full-text available
Background: The current study was undertaken to examine total hospital costs per patient of a consecutive implantation series of two 3rd generation Left Ventricle Assist Devices (LVAD). Further we analyzed if increased clinical experience would reduce total hospital costs and the gap between costs and the diagnosis related grouped (DRG)-reimbursem...
Data
Appendix. Regression analysis results.
Article
Background: The aim was to investigate possible gender differences in the years of life lost after acute myocardial infarction (MI) and to explore how smoking affects life expectancy in the two genders. Methods: In the years 1998-2005, 2281 patients (36.8% women) who were discharged from or died in hospital following a diagnosis of MI were inclu...
Article
In industrialized countries, female physicians have up to 10h lower labor supply a week than male physicians. At the same time, the number of female physicians is increasing. The question analyzed in this article is whether these differences in labor supply for female and male hospital physicians persist in a modern welfare society, such as Norway,...
Article
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Priority setting in population health is increasingly based on explicitly formulated values. The Patients Rights Act of the Norwegian tax-based health service guaranties all citizens health care in case of a severe illness, a proven health benefit, and proportionality between need and treatment. This study compares the values of the country's healt...
Article
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There has been a marked increase in the number of Caesarean sections in many countries during the last decades. In several countries, Caesarean sections are carried out in more than 20 per cent of births. These high Caesarean section rates give cause for concern, both from an economic and a medical perspective. A general opinion among epidemiologis...
Data
Full-text available
The questionnaire used in the patient choice and mobility survey. Questionnaire (in Norwegian).
Article
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Waiting times for elective care have been considered a serious problem in many health care systems. A topic of particular concern has been how administrative boundaries act as barriers to efficient patient flows. In Norway, a policy combining patient's choice of hospital and removal of restriction on referrals was introduced in 2001, thereby creati...
Article
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The incidence of myocardial infarction (MI) in Norway has decreased substantially over the last two decades, according to recent publications based on data from the Norwegian Patient Registry. To better understand the development of cardiovascular disease over time we have investigated the development of MI mortality in light of the decrease in MI...
Article
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An increase in the number of older adults may raise the demand for health and care services, whereas decreasing prevalence of disability and functional limitations among them might counteract this demographic effect. However, the trends in health are inconsistent between studies and countries. In this article, we estimated the trends in mild disabi...
Article
We have shown previously that smoking causes a first myocardial infarction (MI) to occur significantly more prematurely in women than in men. The aim of the study was to investigate mortality after MI with special emphasis on the impact of smoking and gender. The study included 2,281 consecutive patients (36.8% women) who died or were discharged fr...
Article
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Formålet med denne rapporten er å beskrive de nordiske lands tjenesteprofiler innenfor de kommunale omsorgstjenestene. Med tjenesteprofil menes blant annet antall brukere og type brukergrupper, tjenestens organisering og tjenestens driftskostnader, samt fordelingen mellom hjemmebasert versus institusjonsbasert omsorg. Datagrunnlag og definisjoner v...
Article
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Norge, som alle andre vestlige land, står foran en periode med betydelig økning i antall eldre. Økningen både i antall og andel eldre blir feilaktig beskrevet som en ”eldrebølge”. Beskrivelsen er feilaktig fordi flere eldre ikke er et forbigående fenomen. Det er ingen bølge. Økningen i antall eldre fortsetter så langt prognosene til nå er laget, ti...
Article
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The objective of the study was to analyse the number of AMI (acute myocardial infarctions) registered in the period 1991 - 2007, with special emphasis on the development after 1999, and with this background discuss changes in incidence. We analysed data from NPR (the Norwegian Patient Register), on patients discharged from hospitals in the period 1...
Article
Full-text available
For policy-makers the heterogeneity of hospital response to reforms is of crucial concern. Even though a reform may entail a positive effect on average efficiency, policy-makers will consider the reform as less attractive if the variation in hospital efficiency increases. The reason is that increased variance of efficiency across hospitals is likel...
Article
In the 1990s, the Norwegian hospital sector was characterized by soft budgetary constraints and increasing budget deficits. This was one of the main antecedents of the 2002 hospital reform, where the central state took over ownership of the hospitals from the counties. Arguably, the centralization of ownership, financing and production would harden...
Article
The main objective is to describe and analyse hospital costs of the extracorporeal membrane oxygenation (ECMO) procedure. STUDY SAMPLE AND METHODOLOGY: Between January and December 2007, 14 ECMO patients were consecutively included in the study. Costs at the patient level were registered prospectively, while overhead costs were registered retrospec...
Article
The purpose of this study was to compare and contrast total hospital costs and subsequent reimbursement of implementing a new program using a third-generation left ventricular assist device (LVAD) in Norway. Between July 2005 and March 2008, the total costs of treatment for 9 patients were examined. Costs were calculated for three periods-the pre-i...