BACKGROUND: The purpose of this study was to analyse trends for Chlamydia trachomatis infection in a population of women seeking termination of pregnancy, and to assess whether socio-demographic characteristics are predictive of such infections. MATERIAL AND METHODS: Since 1983 women seeking abortion in the university hospital in Trondheim have been systematically tested for Chlamydia trachomatis. Data on 11,376 abortions (1985-2000) were included in the study and results were analysed with logistic regression. RESULTS: Age-adjusted prevalence of Chlamydia trachomatis decreased from 9.0% to 5.0% in 1999-2000. The prevalence was highest among the youngest women. Single and cohabiting women had a higher prevalence of chlamydial infections than married women. INTERPRETATION: Women terminating their pregnancy are an excellent population for sentinel surveillance of Chlamydia trachomatis infection because of their young age, high proportion of singles, and relative inconsistent use of contraception. Even though the prevalence of Chlamydia trachomatis has decreased over the 16-year study period, it is still high for women seeking abortion, especially in the youngest age groups.
BACKGROUND: We wanted to analyse the frequency of list patient consultations in the off-hour emergency service in Skien. MATERIAL AND METHODS: Over one year, all emergency service consultations between 4 PM and 11 PM on workdays were registered according to the general practitioner (GP) patients used and divided by the number of patients on each list. We performed a multiple linear regression analysis with number of consultations adjusted for the total patient number on the list as the dependent variable. RESULTS: We found great variation in the consultation rate among patients listed by various GPs. The consultation rate was significantly associated with the practice in which the GP worked. Quarterly feedback of the results to doctors did not change the consultation pattern. INTERPRETATION: The use of the off-hour emergency service is associated with certain practice characteristics. We assume that the variation results from differences in accessibility by telephone, in the capacity for taking in patients needing urgent attention, and in varying degree of attention to service in the practices.
BACKGROUND: Whether gender affects patient satisfaction is still debated. This article focuses on methodological issues in analysing gender differences with emphasis on factors like age and educational level. MATERIAL AND METHODS: 1,469 male and 1,226 female patients returned a questionnaire six weeks after discharge from hospital. Gender differences in satisfaction were examined by multiple regression analysis. RESULTS: The weak gender difference that occurred in overall satisfaction was due to a significant gender difference between young patients' assessment of the quality of nursing care. For patients over 35, there was no gender difference in satisfaction. INTERPRETATION: Gender differences in patient satisfaction are not straightforward, but vary according to underlying cultural and social factors.
New rules for absence with stricter requirements for documentation were introduced in upper secondary schools in the autumn of 2016. We investigated the use of general practice services and dispensing of prescription drugs among 16?–?18-year-olds in the autumn of 2016 and compared this with equivalent figures for the period 2013?–?15.
We retrieved information on consultations in general practice (GP) and dispensing of prescription drugs to 15?–?18-year-olds in the period 2013?–?16 from the Directorate of Health’s system for control and payment of health reimbursements (KUHR) and the Norwegian Prescription Database respectively. The number of consultations and dispensing of drugs were compared to previous years using Poisson regression (reference year 2015). The incidence rate ratio (IRR) was used as an outcome measure.
The number of GP consultations for 16?–?18-year-olds was 30?% higher in the autumn of 2016 than in the autumn of 2015 (IRR 1.30, 95?% confidence interval (CI) 1.29?–?1.31). In the same period, the dispensing of drugs to this age group increased by 8?% (IRR 1.08, 95?% CI 1.08?–?1.09). Among the diagnosis groups, respiratory tract infections had the largest increase (IRR 2.21, 95?% CI 2.17?–?2.25). The largest increase in drug dispensing was found for remedies for coughs and colds (IRR 1.73, 95?% CI 1.65?–?1.80).
The increase in consultations in general practice and dispensing of drugs to 16?–?18-year-olds coincided in time with the introduction of new rules for absence from school. We hold it to be highly likely that the changes were caused by the stricter rules for documentation of absence from school.
BACKGROUND: The waiting lists for hospital admission are used as arguments for more resources to hospitals. Concern is expressed that the attention given to waiting list patients has the effect that less resources are devoted to other groups of patients. This article reports on a study of whether waiting list patients are in poorer health that persons who are not on a waiting list. MATERIAL AND METHODS: A random sample of 5,000 Norwegian citizens were drawn to be included in Statistics Norway's 1998 quality and standard of life survey. Interviews were obtained with 3,449 persons. Binomial and multinomial logistic analyses were used. RESULTS: Individuals in poor health have a higher probability of being on a hospital waiting list than have persons in good health. We did not find any relationship between state of health and a patient's experienced waiting time. INTERPRETATION: Our findings reject the assertion of arbitrariness regarding the selection of patients to hospital waiting lists. The lack of effect of state of health on experienced waiting time could be interpreted in several ways.
BACKGROUND: The association between hospital capacity and waiting time for treatment is uncertain. MATERIAL AND METHODS: Waiting times for patients on waiting lists for inpatient treatment in 1998 were analysed to disclose possible associations with the hospitals' treatment resources, i.e., general costs, number of beds, doctors or nurses in relation to the population of its catchment area, and the relation between acute and elective admissions. Waiting times were calculated from the National Patient Register, which collects information on hospital stays. Resource data and data on acute admissions were taken from the SAMDATA publications for 1998. RESULTS: Median waiting time varied from 50 to 300 days among the hospitals. Statistical regression models were, however, unable to explain the variation in waiting time on the basis of any variable related to hospital resources or acute admissions that may influence the capacity for elective admissions. INTERPRETATION: To avoid breaches of the guarantees for patients guaranteed a maximum of three months on the waiting list, the median waiting time should be below 12-15 days. This goal may, however, be much too ambitious in view of the fact that the median waiting time for patients with mammary or colon cancer is about 30 days.
BACKGROUND: The decline in infant mortality is an important part of the secular decline in mortality in the western world. The major causes of the decline are subject to controversy. MATERIAL AND METHODS: Individual event records from censuses, church records and land registers from two Norwegian parishes during the years 1814-1878 were registered and linked into individual life course records. Around 15,000 infants, of whom 1500 died, were analysed in depth with Cox regression analysis. The total yearly counts of births and infant deaths from 1735 were analysed using ordinary linear regression. RESULTS: Infant mortality hovered around 23 per cent during the middle of the 18th century and fell to a level around 10 per cent by the end of the 19th century. The decline was strongest during the neonatal period. Women born during the first decade of the 19th century, a decade known for a succession of years with bad harvests, war and high infant mortality, gave birth to infants with increased neonatal mortality. INTERPRETATION: The decline in infant mortality during the first part of the 19th century can thus be attributed to an improvement in the health of the mothers dating back to their own fetal or infant stage. The decline took place in the absence of trained medical personnel.
The prescribing of drugs was studied in 378 patients living in 12 homes for the aged in the county of Aust-Agder, Norway. The mean number of regular drugs was 4.7. Out of a total of 378 patients, more than 8 drugs were prescribed to one out of four and only 13 received no drugs at all. 30% of the prescriptions referred to over-the-counter drugs. Laxatives (10.4%), vitamins (9.0%), and pscychotropics (8.2%) were the three most commonly prescribed classes of drugs. Multiple linear regression analysis showed that the most significant predictor of the number of drugs prescribed to a patient is the doctor in charge.
The Norwegian centre for quality assurance in primary health care, NOKLUS, was established in 1992 to ensure the quality of laboratory analyses performed in primary health care. This article evaluates results from the surveys of infectious mononucleosis.
From 1996 to 2000, five serum panels were sent to participating practices in order to control test-kits designed for serological rapid diagnosis of infectious mononucleosis. 648 practices participated in this external quality assessment in 2000. Target values were determined using the Paul Bunell Davidsohn test. The results obtained for each type of test and variables that might have affected the results were evaluated.
Outdated kits or kits close to the date of expiration showed poorer results than the other test-kits. The quality of the results depended mainly on the type of test-kit used and the training level of the persons performing the analyses.
The best performing tests in these surveys were Clearview IM (Unipath Limited) and Contrast Mono (Genzyme diagnostics). These two tests are among the three most frequently used tests, out of a total of thirteen, in our surveys.
Sickness absence in the Norwegian workplace doubled in the period 1993-2003. However, the extent to which the driving factors were medical or non-medical remains unclear, as does the extent to which the cause may be found in the composition of the workforce.
A differences-in-differences regression model was used to estimate the added sickness absence associated with major life events such as separation, death of spouse and pregnancy in the period 1993-2005. The data were obtained from administrative registers covering the entire Norwegian population, and include all absence periods of 16 days' duration or more reported by a doctor's medical certificate. The primary outcome measures were incidence (the proportion of absentees in a given time window) and absence (the proportion of sick days in a given time window). The level of absence among employees exposed to the specified life events was compared to control groups matched for gender, age, education and income.
In 1993, people in each of the three groups exposed to major life events had more frequent and longer periods of absence than people in the control groups. This added sickness absence increased between 1993 and 2005. The changes in added sickness absence were at times significant, particularly for pregnant women. While sickness absence among pregnant women in 1993 was 15.4 percentage points higher than in the control group, the difference had increased to 24.8 percentage points in 2005.
We find it improbable for the increase in added sickness absence to be caused by changes in the medical impact of life events or alterations in the workforce composition. We believe the increase is caused by changing attitudes among the working population and in the medical profession towards sickness absence on grounds that are not strictly medical, combined with improved social acceptance and diagnosis of mental health issues, and/or a medicalisation of natural health variations (pregnancy) and emotional distress (grief).