Disease-specific health spending by age, sex, and type of care in Norway: a national health registry study

Abstract

Background Norway is a high-income nation with universal tax-financed health care and among the highest per person health spending in the world. This study estimates Norwegian health expenditures by health condition, age, and sex, and compares it with disability-adjusted life-years (DALYs). Methods Government budgets, reimbursement databases, patient registries, and prescription databases were combined to estimate spending for 144 health conditions, 38 age and sex groups, and eight types of care (GPs; physiotherapists & chiropractors; specialized outpatient; day patient; inpatient; prescription drugs; home-based care; and nursing homes) totaling 174,157,766 encounters. Diagnoses were in accordance with the Global Burden of Disease study (GBD). The spending estimates were adjusted, by redistributing excess spending associated with each comorbidity. Disease-specific DALYs were gathered from GBD 2019. Results The top five aggregate causes of Norwegian health spending in 2019 were mental and substance use disorders (20.7%), neurological disorders (15.4%), cardiovascular diseases (10.1%), diabetes, kidney, and urinary diseases (9.0%), and neoplasms (7.2%). Spending increased sharply with age. Among 144 health conditions, dementias had the highest health spending, with 10.2% of total spending, and 78% of this spending was incurred at nursing homes. The second largest was falls estimated at 4.6% of total spending. Spending in those aged 15–49 was dominated by mental and substance use disorders, with 46.0% of total spending. Accounting for longevity, spending per female was greater than spending per male, particularly for musculoskeletal disorders, dementias, and falls. Spending correlated well with DALYs (Correlation r = 0.77, 95% CI 0.67–0.87), and the correlation of spending with non-fatal disease burden (r = 0.83, 0.76–0.90) was more pronounced than with mortality (r = 0.58, 0.43–0.72). Conclusions Health spending was high for long-term disabilities in older age groups. Research and development into more effective interventions for the disabling high-cost diseases is urgently needed.

Areas of consensus on unwarranted and warranted transfers between nursing homes and emergency care facilities in Norway: a Delphi study

“…In 2019, dementia and falls were the two most expensive health conditions for the Norwegian health care system, representing 10.2% and 4.6% of estimated total health care spending, respectively [ 12 ]. According to OECD data, Norway ranks third highest in long-term care (LTC) spending per capita [ 13 ].…”

Prevalence and Determinants of Diagnosed Dementia: A Registry Linkage Study Linking Diagnosis of Dementia in the Population-Based HUNT Study to Registry Diagnosis of Dementia in Primary Care and Hospitals in Norway

“…The dementia diagnostic rate increased when we included the codes P05 and P20, but the diagnostic rate in people without dementia also increased. Still, it is possible that some family physicians use P05 and P20 as a diagnosis of dementia, since the ICPC-2 is a funding system and family physicians only need to submit one code in their refund claim to the KUHR [ 2 ]. If the family physician has not completed or is unsure about performing a dementia assessment, this can lead to reporting a lower code than P70 (such as P05 or P20), since these codes describe symptoms rather than a formal dementia diagnosis.…”

“…Due to population aging, the prevalence of dementia will increase considerably in the coming years [ 1 ]. A recent study found that dementia already accounts for the highest health spending in Norway, at approximately 32 billion a year and 10% of the total health costs [ 2 ], in addition to the informal care which forms a large part of dementia care [ 3 ].…”

A cross-sectional study of sensory-motor neuropsychological function among sewage plant and sewage net workers exposed to hydrogen sulphide when handling wastewater

“…Degenerative nervous system diseases like MS or Parkinson’s disease ( Prosperini et al 2014 ) also impair balance. Balance is gradually impaired in the elderly, and falling due to impaired balance may have severe health consequences and high costs ( Kinge et al 2023 ).…”