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Article ; Online: [No title information]

Fosse, Anette / Abelsen, Birgit

Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke

2024 Volume 144

Title translation	Kunnskap om vikarbruk i fastlegetjenesten.
MeSH term(s)	Humans ; Employment ; Norway ; General Practitioners ; General Practice
Language	Norwegian
Publishing date	2024-04-29
Publishing country	Norway
Document type	Journal Article
ZDB-ID	603504-8
ISSN	0807-7096 ; 0029-2001
ISSN (online)	0807-7096
ISSN	0029-2001
DOI	10.4045/tidsskr.24.0226
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Use of locums in the Regular GP Scheme 2016-22.

Rydningen, Mads / Fosse, Anette / Abelsen, Birgit / Harbitz, Martin Bruusgaard

Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke

2024 Volume 144, Issue 6

Abstract: Background: Under the Regular GP Scheme, locum GPs must be used when GPs are absent or when a patient list has no GP. We have studied the prevalence and development of locum contracts registered in the Regular GP Scheme in the period from 1 January 2016 ...

Title translation	Vikarlegebruk i fastlegeordningen 2016–22.
Abstract	Background: Under the Regular GP Scheme, locum GPs must be used when GPs are absent or when a patient list has no GP. We have studied the prevalence and development of locum contracts registered in the Regular GP Scheme in the period from 1 January 2016 to 31 December 2022. Material and methods: In this descriptive registry study, we categorised 21 418 locum contracts from the period 1 January 2016 to 31 December 2022 according to municipality and duration. We divided the municipalities into groups according to Statistics Norway's six centrality classes. Classes 1‒2 are central; 3‒4 are less central; and 5‒6 are the least central municipalities. The analysis is based on frequency tables, contingency tables and rates. Results: In the period studied, the number of registered locum contracts increased in Norway from 916 to 5003 (446 %). The increase was largest in centrality group 5‒6. The average duration of the locum positions was 195 days in centrality groups 1‒2 (95 % confidence interval (CI) 190‒200), 130 days in centrality groups 3‒4 (95 % CI 127‒134) and 67 days in centrality groups 5‒6 (95 % CI 64‒69). Centrality groups 5‒6 had twice as many locum contracts for full-time positions compared to centrality groups 1‒2, where part-time positions were more common. Locum contracts per list without a GP increased nationally from 0.5 to 4.7 in the study period. Interpretation: The GP Registry provides increasingly useful, nationwide information on the use of locum GPs. Use of locums in the Regular GP Scheme has increased significantly since 2016, and this may represent a challenge to equal access to health services. Future research should examine the causes and consequences of increased use of locum GPs.
MeSH term(s)	Norway ; Humans ; Registries ; General Practitioners ; General Practice/statistics & numerical data ; Contracts
Language	Norwegian
Publishing date	2024-04-29
Publishing country	Norway
Document type	Journal Article
ZDB-ID	603504-8
ISSN	0807-7096 ; 0029-2001
ISSN (online)	0807-7096
ISSN	0029-2001
DOI	10.4045/tidsskr.23.0676
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Educational interventions to ensure provision of doctors in rural areas - a systematic review.

Fosse, Anette / Abelsen, Birgit / Gaski, Margrete / Grimstad, Hilde

Rural and remote health

2023 Volume 23, Issue 1, Page(s) 8125

Abstract: Introduction: Recruiting doctors in rural areas is challenging. Various educational interventions have been introduced in many countries. This study aimed to explore undergraduate medical education interventions introduced to recruit doctors to rural ... ...

Abstract	Introduction: Recruiting doctors in rural areas is challenging. Various educational interventions have been introduced in many countries. This study aimed to explore undergraduate medical education interventions introduced to recruit doctors to rural areas, and the results of these interventions. Methods: We undertook a systematic search using search words 'rural', 'remote', 'workforce', 'physicians', 'recruitment' and 'retention'. We included articles meeting the following criteria: educational interventions clearly described; study population consisted of medical graduates; and outcome measures included place of work (rural/non-rural) after graduation. Results: The analysis included 58 articles and encompassed educational interventions in ten countries. There were five main types of interventions, often used in combination: preferential admission from rural areas; curriculum relevant to rural medicine; decentralised education; practice-oriented learning in rural areas; and compulsory service periods in rural areas after graduation. The majority of the studies (42) compared place of work (rural/non-rural) of doctors graduated with and without these interventions. In 26 studies, odds ratio for rural place of work was significant at a level of 5%, with odds ratios between 1.5 and 17.2. Significant differences in the proportion with a rural/non-rural place of work were shown in 14 studies, differences ranging from 11 to 55 percentage points. Discussion: Changing focus of undergraduate medical education towards development of knowledge, skills and teaching arenas that equip doctors with competencies to work in rural areas has an impact on the recruitment of doctors in rural areas. Concerning preferential admission from rural areas, we will discuss if national and local contexts makes a difference.
MeSH term(s)	Humans ; Physicians ; Education, Medical, Undergraduate ; Workforce ; Curriculum ; Learning ; Rural Health Services
Language	English
Publishing date	2023-01-10
Publishing country	Australia
Document type	Systematic Review ; Journal Article
ZDB-ID	2105620-1
ISSN	1445-6354 ; 1445-6354
ISSN (online)	1445-6354
ISSN	1445-6354
DOI	10.22605/RRH8125
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Which types of mental health/substance misuse treatment services are available in primary care for adults in rural municipalities in Norway?

Bruun, Hege / Fosse, Anette / Abelsen, Birgit

Rural and remote health

2023 Volume 23, Issue 1, Page(s) 8109

Abstract: Introduction: In Norway, the municipalities are responsible for providing primary health care, including mental health care. National rules, regulations and guidelines are the same throughout the country, but the municipalities can organise the service ... ...

Abstract	Introduction: In Norway, the municipalities are responsible for providing primary health care, including mental health care. National rules, regulations and guidelines are the same throughout the country, but the municipalities can organise the service as they see fit. In rural areas, distance and time to specialised health care, recruitment and retention of professionals, and the care needs in the community will likely play a part in how the services are organised. There is a lack of knowledge of the variation of services, and which factors affect availability, capacity and organisation of mental health/substance-misuse treatment services for adults in rural municipalities. Aim: The aim of this study is to explore how mental health/substance-misuse treatment services in rural areas are organised and assigned, and which professionals provide the services. Methods: This study will be based on collected data from municipal plans and available statistic recourses on how the services are organised. These data will be contextualised with focused interviews with leaders in primary health care. Results: The study is ongoing. Results will be presented in June 2022. Discussion: Results from this descriptive study will be discussed in light of the development of mental health/substance-misuse health care with special focus on challenges and possibilities in rural areas.
MeSH term(s)	Humans ; Adult ; Mental Health ; Cities ; Norway ; Substance-Related Disorders/epidemiology ; Substance-Related Disorders/therapy ; Primary Health Care
Language	English
Publishing date	2023-01-10
Publishing country	Australia
Document type	Journal Article
ZDB-ID	2105620-1
ISSN	1445-6354 ; 1445-6354
ISSN (online)	1445-6354
ISSN	1445-6354
DOI	10.22605/RRH8109
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Article ; Online: Tension between local, regional and national level in Norwegian handling of COVID-19.

Fosse, Anette / Abelsen, Birgit / Svensson, Anders / Konradsen, Ingvill

Rural and remote health

2023 Volume 23, Issue 1, Page(s) 8124

Abstract: Introduction: The initial phase of the COVID-19 pandemic can be described as a crisis - a threat that must be urgently addressed under conditions of deep uncertainty. We wanted to explore the tension between local, regional and national authorities ... ...

Abstract	Introduction: The initial phase of the COVID-19 pandemic can be described as a crisis - a threat that must be urgently addressed under conditions of deep uncertainty. We wanted to explore the tension between local, regional and national authorities evoked by some rural municipalities' decisions to impose local infection control measures during the first weeks of the COVID-19 pandemic in Norway. Methods: Eight municipal chief medical officers of health (CMO) and six crisis management teams participated in semi-structured and focus group interviews. Data were analyzed with systematic text condensation. Boin and Bynander's interpretation of crisis management and coordination and Nesheim et al.'s framework for non-hierarchical coordination in the state sector inspired the analysis. Results: Uncertainty in the face of a pandemic with unknown damage potential, lack of infection control equipment, patient transport challenges, vulnerable staff situation and planning of local COVID-19 beds were some of the reasons for rural municipalities imposing local infection control measures. Local CMOs' engagement, visibility and knowledge contributed to trust and safety. Differences in perspectives between local, regional and national actors created tension. Existing roles and structures were adjusted, and new informal networks arose. Discussion: Strong municipal responsibility in Norway and the quite unique arrangement with local CMOs in every municipality with legal right to decide temporary local infection control measures seemed to facilitate a fruitful balance between top-down and bottom-up decision-making. The following dialogue and mutual adjustment of perspectives led to appropriate balance between national and local measures in Norway's handling of the COVID-19 pandemic.
MeSH term(s)	Humans ; COVID-19 ; Pandemics/prevention & control ; Infection Control ; Norway/epidemiology
Language	English
Publishing date	2023-01-10
Publishing country	Australia
Document type	Journal Article
ZDB-ID	2105620-1
ISSN	1445-6354 ; 1445-6354
ISSN (online)	1445-6354
ISSN	1445-6354
DOI	10.22605/RRH8124
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Correction: Experiences with telemedicine-based follow-up of chronic conditions: the views of patients and health personnel enrolled in a pragmatic randomized controlled trial.

Sten-Gahmberg, Susanna / Pedersen, Kine / Harsheim, Ingrid Gaarder / Loyland, Hanna Isabel / Abelsen, Birgit

BMC health services research

2024 Volume 24, Issue 1, Page(s) 441

Language	English
Publishing date	2024-04-08
Publishing country	England
Document type	Published Erratum
ZDB-ID	2050434-2
ISSN	1472-6963 ; 1472-6963
ISSN (online)	1472-6963
ISSN	1472-6963
DOI	10.1186/s12913-024-10890-8
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Article ; Online: Experiences with telemedicine-based follow-up of chronic conditions: the views of patients and health personnel enrolled in a pragmatic randomized controlled trial.

Sten-Gahmberg, Susanna / Pedersen, Kine / Harsheim, Ingrid Gaarder / Løyland, Hanna Isabel / Abelsen, Birgit

BMC health services research

2024 Volume 24, Issue 1, Page(s) 341

Abstract: Background: Telemedicine is often promoted as a possible solution to some of the challenges healthcare systems in many countries face, and an increasing number of studies evaluate the clinical effects. So far, the studies show varying results. Less ... ...

Abstract	Background: Telemedicine is often promoted as a possible solution to some of the challenges healthcare systems in many countries face, and an increasing number of studies evaluate the clinical effects. So far, the studies show varying results. Less attention has been paid to systemic factors, such as the context, implementation, and mechanisms of these interventions. Methods: This study evaluates the experiences of patients and health personnel enrolled in a pragmatic randomized controlled trial comparing telemedicine-based follow-up of chronic conditions with usual care. Patients in the intervention group received an individual treatment plan together with computer tablets and home telemonitoring devices to report point-of-care measurements, e.g., blood pressure, blood glucose or oxygen saturation, and to respond to health related questions reported to a follow-up service. In response to abnormal measurement results, a follow-up service nurse would contact the patient and consider relevant actions. We conducted 49 interviews with patients and 77 interviews with health personnel and managers at the local centers. The interview data were analyzed using thematic analysis and based on recommendations for conducting process evaluation, considering three core aspects within the process of delivering a complex intervention: (1) context, (2) implementation, and (3) mechanisms of impact. Results: Patients were mainly satisfied with the telemedicine-based service, and experienced increased safety and understanding of their symptoms and illness. Implementation of the service does, however, require dedicated resources over time. Slow adjustment of other healthcare providers may have contributed to the absence of reductions in the use of specialized healthcare and general practitioner (GP) services. An evident advantage of the service is its flexibility, yet this may also challenge cost-efficiency of the intervention. Conclusions: The implementation of a telemedicine-based service in primary healthcare is a complex process that is sensitive to contextual factors and that requires time and dedicated resources to ensure successful implementation. Trial registration: The trial was registered in www. Clinicaltrials: gov (NCT04142710). Study start: 2019-02-09, Study completion: 2021-06-30, Study type: Interventional, Intervention/treatment: Telemedicine tablet and tools to perform measurements. Informed and documented consent was obtained from all subjects and next of kin participating in the study.
MeSH term(s)	Humans ; Follow-Up Studies ; Telemedicine/methods ; Delivery of Health Care ; General Practitioners ; Blood Glucose
Chemical Substances	Blood Glucose
Language	English
Publishing date	2024-03-14
Publishing country	England
Document type	Randomized Controlled Trial ; Pragmatic Clinical Trial ; Journal Article
ZDB-ID	2050434-2
ISSN	1472-6963 ; 1472-6963
ISSN (online)	1472-6963
ISSN	1472-6963
DOI	10.1186/s12913-024-10732-7
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Expanding general practice with interprofessional teams: a mixed-methods patient perspective study.

Abelsen, Birgit / Pedersen, Kine / Løyland, Hanna Isabel / Aandahl, Emilie

BMC health services research

2023 Volume 23, Issue 1, Page(s) 1327

Abstract: Background: Across healthcare systems, current health policies promote interprofessional teamwork. Compared to single-profession general practitioner care, interprofessional primary healthcare teams are expected to possess added capacity to care for an ... ...

Abstract	Background: Across healthcare systems, current health policies promote interprofessional teamwork. Compared to single-profession general practitioner care, interprofessional primary healthcare teams are expected to possess added capacity to care for an increasingly complex patient population. This study aims to explore patients' experiences when their usual primary healthcare encounter with general practice shifts from single-profession general practitioner care to interprofessional team-based care. Methods: Qualitative and quantitative data were collected through interviews and a survey among Norwegian patients. The interviews included ten patients (five women and five men) aged between 28 and 89, and four next of kin (all women). The qualitative analysis was carried out using thematic analysis and a continuity framework. The survey included 287 respondents, comprising 58 per cent female and 42 per cent male participants, aged 18 years and above. The respondents exhibited multiple diagnoses and often a lengthy history of illness. All participants experienced the transition to interprofessional teamwork at their general practitioner surgery as part of a primary healthcare team pilot. Results: The interviewees described team-based care as more fitting and better coordinated, including more time and more learning than with single-profession general practitioner care. Most survey respondents experienced improvements in understanding and mastering their health problems. Multi-morbid elderly interviewees and interviewees with mental illness shared experiences of improved information continuity. They found that important concerns they had raised with the nurse were known to the general practitioner and vice versa. None of the interviewees expressed dissatisfaction with the inclusion of a nurse in their general practitioner relationship. Several interviewees noted improved access to care. The nurse was seen as a strengthening link to the general practitioner. The survey respondents expressed strong agreement with being followed up by a nurse. The interviewees trusted that it was their general practitioner who controlled what happened to them in the general practitioner surgery. Conclusion: From the patients' perspective, interprofessional teamwork in general practice can strengthen management, informational, and relational continuity. However, a prerequisite seems to be a clear general practitioner presence in the team.
MeSH term(s)	Aged ; Humans ; Male ; Female ; Adult ; Middle Aged ; Aged, 80 and over ; Interprofessional Relations ; Qualitative Research ; Delivery of Health Care ; General Practice ; Family Practice ; Patient Care Team
Language	English
Publishing date	2023-11-30
Publishing country	England
Document type	Journal Article
ZDB-ID	2050434-2
ISSN	1472-6963 ; 1472-6963
ISSN (online)	1472-6963
ISSN	1472-6963
DOI	10.1186/s12913-023-10322-z
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Educational patterns of health behaviors and body mass index: A longitudinal multiple correspondence analysis of a middle-aged general population, 2007-2016.

Ibarra-Sanchez, Ana Silvia / Abelsen, Birgit / Chen, Gang / Wisløff, Torbjørn

PloS one

2023 Volume 18, Issue 12, Page(s) e0295302

Abstract: Social differences in body mass index and health behaviors are a major public health challenge. The uneven distribution of unhealthy body mass index and of unhealthy behaviors such as smoking, physical inactivity, and harmful alcohol consumption has been ...

Abstract	Social differences in body mass index and health behaviors are a major public health challenge. The uneven distribution of unhealthy body mass index and of unhealthy behaviors such as smoking, physical inactivity, and harmful alcohol consumption has been shown to mediate social inequalities in chronic diseases. While differential exposures to these health variables have been investigated, the extent to which they vary over the lifetime in the same population and their relationship with level of education is not well understood. This study examines patterns of body mass index and multiple health behaviors (smoking, physical activity and alcohol consumption), and investigates their association with education level among adults living in Northern Norway. It presents findings from a longitudinal multiple correspondence analysis of the Tromsø Study. Longitudinal data from 8,906 adults aged 32-87 in 2007-2008, with repeated measurements in 2015-2016 were retrieved from the survey's sixth and seventh waves. The findings suggest that most in the study population remained in the same categories of body mass index and the three health behaviors at the follow-up, with a clear educational gradient in healthy patterns. That is, both healthy changes and maintained healthy categories were associated with the highest education levels. Estimating differential exposures to mediators of health inequalities could benefit policy priority setting for tackling inequalities in health.
MeSH term(s)	Adult ; Middle Aged ; Humans ; Body Mass Index ; Health Behavior ; Socioeconomic Factors ; Educational Status ; Exercise
Language	English
Publishing date	2023-12-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0295302
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Article ; Online: Educational interventions to ensure provision of doctors in rural areas - a systematic review.

Abelsen, Birgit / Fosse, Anette / Gaski, Margrete / Grimstad, Hilde

Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke

2022 Volume 142, Issue 1

Abstract: Background: Recruiting doctors in rural areas is challenging, and various educational interventions to ensure the provision of doctors in rural areas have been introduced in many countries. This study aimed to collect knowledge about the undergraduate ... ...

Title translation	Tiltak i grunnutdanningen for å sikre leger til distrikt – en systematisk oversikt.
Abstract	Background: Recruiting doctors in rural areas is challenging, and various educational interventions to ensure the provision of doctors in rural areas have been introduced in many countries. This study aimed to collect knowledge about the undergraduate medical education interventions that have been introduced in order to recruit doctors to rural areas, and the results of these interventions. Material and method: We undertook a systematic search in the databases Cinahl, Eric, Medline and PsycInfo using the search words rural, remote, workforce, physicians, recruitment and retention. We included articles that met the following criteria: the educational interventions were clearly described, the study population consisted of medical graduates, and outcome measures included place of work (rural/non-rural) after graduation. Results: The analysis included 58 articles and encompassed educational interventions in ten countries. There were five main types of interventions, often used in combination: preferential admission from rural areas, curriculum relevant to rural medicine, decentralised education, practice-oriented learning in rural areas, and compulsory service periods in rural areas after graduation. The majority of the studies (42) compared place of work (rural/non-rural) of doctors who had graduated with and without these interventions - only two of the studies reported non-significant differences in place of work. In 26 studies, the odds ratio for rural place of work was significant at a level of 5 %, with odds ratios between 1.5 and 17.2. In 14 studies there were significant differences in the proportion with a rural/ non-rural place of work, with differences ranging from 11 to 55 percentage points. Interpretation: Changing the focus of undergraduate medical education towards the development of knowledge, skills and teaching arenas that equip doctors with competencies to work in rural areas has an impact on the recruitment of doctors in rural areas.
MeSH term(s)	Curriculum ; Education, Medical, Undergraduate ; Humans ; Learning ; Physicians ; Rural Health Services ; Workforce
Language	Norwegian
Publishing date	2022-01-10
Publishing country	Norway
Document type	Journal Article ; Systematic Review
ZDB-ID	603504-8
ISSN	0807-7096 ; 0029-2001
ISSN (online)	0807-7096
ISSN	0029-2001
DOI	10.4045/tidsskr.21.0253
Database	MEDical Literature Analysis and Retrieval System OnLINE

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