Biomedical subjects

Rune Sørensen

Publications and source records attributed to Rune Sørensen.

5 recordsLinked to original sources

PubMed2005

[The list patient scheme and the growth insurance expenditure in general practice].

BACKGROUND: Fee-for-item payments, mainly from the National Insurance Administration, are the main source of remuneration for primary care physicians in Norway. The aim of the present study was to describe the development in the National Insurance Administration's expenditure for primary physician services before and after the introduction of a list patient scheme in 2001. MATERIAL AND METHODS: The analyses were performed on data from the National Insurance Administration and data on the number of physician in relation to population from Statistics Norway. RESULTS: During the period 1998-2003, expenditure increased by 84%, from NOK 1.37 billion to NOK 2.52 billion. The main finding is that nearly all the increase can be explained by increases in the number of physicians, population size and the level of fees. INTERPRETATION: One interpretation of our findings is that to a large extent the National Insurance Administration's expenditure on primary physician services can be controlled by regulating the number of physicians and the level of fees.

Family Practice↗

PubMed2005

[Characteristics of solo and group practices in Norwegian general practice].

BACKGROUND: The article describes changes in the size of practices after the introduction of the new Norwegian list patient system for general practitioners (GPs) and how length of patient lists, number of consultations, working hours and waiting time for an appointment vary according to the number of physicians in the practice. MATERIAL AND METHODS: The data were collected by a comprehensive questionnaire survey among general practitioners in the autumn of 2002. A total of 2306 physicians took part (response rate: 70%). RESULTS: Before the list patient system was introduced, 18% of GPs worked in solo practices. With the new system in place, the proportion went down to 15%. About 60% of GPs worked in practices with 2-4 GPs. Out of young GPs in solo practices, 78% wished to work in practices with several colleagues, while 26% of GPs in practices with more than six physicians wished to reduce the size of the practice. The number of patients on the list and the number of curative working hours per GP decreased with increasing practice size. The number of consultations per hour did not vary with the number of GPs in the practice. Waiting time for an appointment for non-emergency treatment increased with increasing practice size. INTERPRETATION: A lower service production per physician in large practices may partly be an effect of a relatively high proportion of women wanting to work fewer hours than their male colleagues. Irrespective of gender, group practices also attract GPs who want slightly reduced working hours.

Adult↗

PubMed2004

[Physicians' work situation a year after the list patient system reform].

BACKGROUND: We describe general practitioners' (GPs') degree of satisfaction with the recently introduced Norwegian list patient system, based on information provided by GPs on the number of patients on their lists and their own assessment of their work situation. MATERIAL AND METHODS: Data were collected by an extensive questionnaire survey among GPs in the list patient system during the autumn of 2002. A total of 2306 GPs returned the questionnaire (70% response rate). RESULTS: Most GPs were satisfied with the list patient system. 60% were satisfied with the number of patients on their list, 21% wanted more patients; 19% would have liked to have fewer patients. In general GPs feel that they have enough time for each patient and that it is not difficult to fit emergency cases into their daily schedule. About half of them are of the opinion that the list patient system has not given them a better insight into their patients' medical needs or better treatment options. INTERPRETATION: Most GPs were satisfied with the new system and with the number of patients on their list. The importance to patients of being assigned to one GP is highlighted by the fact that GPs think they can do a better job when the practice has a high proportion of regular patients.

Adult↗

PubMed2004

[Change in service provision and availability under the list patient system reform].

BACKGROUND: In this article, we analyse the relationship between length of patient lists and general practitioners' (GPs') service provision in order to investigate whether the list patient system reform has led to reduced accessibility and/or supplier inducement. MATERIAL AND METHODS: The data were collected from a comprehensive questionnaire survey among GPs in the list patient system in 2002 (2306 GPs) and from the National Insurance Administration in 2001 (1637 GPs). The relationship between length of patient lists and service provision was analysed using regression analysis. RESULTS: The relationship between length of patient lists and number of consultations per GP was almost proportional, as was the relationship between length of patient list and number of consultations initiated by GPs. GPs who wanted more patients on their list had fewer consultations than those who were satisfied with the length of their lists and they did not compensate by taking more laboratory tests per consultation. Analysis of the two independent sets of data gave almost identical results. INTERPRETATION: Patients' access to their GPs is independent of the length of his or her patient list. Even GPs with long lists do not ration consultations. This probably reflects efficient organisation of the practice. Our results do not support the theory that GPs induce demand for their services; one explanation is that GPs with short lists have chosen to have precisely that and have no need to induce demand.

Efficiency, Organizational↗

PubMed2003

Practice variation and physician-specific effects.

This study provides estimates of practice variation for primary physician services in Norway. Nearly all previous studies on practice variation have encompassed mainly specialist and hospital services. Thus we provide evidence for treatment variation for a health care sector where information about treatment variation is relatively scarce. Our analyses were carried out on a large set of data from individual physician practices. We estimated the extent of practice variation according to type of diagnosis and type of treatment option. The main finding is that variation in clinical practice between physicians is an important determinant of expenditure for primary physician services. Depending on the type of diagnosis, physician-specific effects explained 47-66% of the variation in expenditure for laboratory tests, 59-66% of the variation in expenditure for consultations lasting over 20min and 49-61% of the variation in expenditure for specific procedures. The age and gender of the patients explained only about 1% of the variation in expenditure. This finding supports the results from previous studies, which have shown that patients' age and gender are inadequate when used as risk adjusters. We also identified physicians who moved their practice from one municipality to another, i.e. they changed their patient population completely. Our results showed that those physicians who moved did not change practice style after they moved, i.e. that physician's style of practice is stabile. This indicates that practice style reflects a deeply rooted behaviour with respect to how to practice medicine.

Contract Services↗