Heart
Here you will find analyses of geographical variation in the use of health services related to the heart.
Here you will find analyses of geographical variation in the use of health services related to the heart.
Number of consultations for heart failure per 1,000 inhabitants, 75 years and older
The number of consultations for heart failure has increased from 9,800 in 2015 to just over 23,000 in 2024, a rise of 136%. During the same period, the number of people in Norway aged 75 and older increased by approximately 30%.
In about 30% of consultations in 2024, the patient was a woman.
There is significant geographical variation in consultation rates. In the catchment areas with the highest rates, nearly three times as many consultations per 1,000 inhabitants are performed compared to those with the lowest rates. In 2024, the rate ranged from 21.9 in Førde to 88.1 in Østfold.
The rate for Finnmark remained between 12 and 17 from 2015 to 2022, lower than all other healthcare regions. In 2023, the rate increased to 67, followed by a slight decrease to 65 in 2024, placing it among the higher rates. A possible explanation for this is: "Finnmarkssykehuset startet etableringen av hjertesviktpoliklinikker i 2022, og har i dag slike klinikker i Kirkenes, Alta og Hammerfest." This quote is taken from finnmarkssykehuset.no/nyheter.
The number of consultations per patient was 2.3 in 2024. This figure varied between catchment areas, ranging from 1.7 in Førde and 1.8 in Bergen to 2.9 in Østfold and 3.5 in Lovisenberg.
There was no significant decline related to the pandemic; in some catchment areas, the number of consultations increased, while in others, it decreased.
The analysis is based on activity data from the Norwegian Patient Registry (NPR) for somatic specialist healthcare services. The data includes activity from public hospitals, private hospitals providing publicly funded services, and contracted specialists with public funding agreements. Comparisons with other sources suggest that reporting to NPR from contracted specialists is incomplete. For this analysis, consultations from contracted specialists account for just under 5% of the total number of consultations.
The sample includes outpatient consultations for patients aged 75 and older with a primary diagnosis of heart failure, defined by the ICD-10 codes I11.0, I13.0, I13.2, I50.0, I50.1, and I50.9.
Where the patient was treated is divided into three categories:
The total number of heart failure consultations in Norway was 50,200 in 2024. Of these, 54% were for patients younger than 75 years.
To allow comparisons between catchment areas and across years, the rates are adjusted for gender and age. The adjustment was performed using the direct method, with the country’s 2023 population as the reference population.
SKDE is solely responsible for the interpretation and presentation of the data provided by NPR. FHI/NPR is not responsible for analyses or interpretations based on these data.
Number of procedures for the implantation of pacemakers and defibrillators per 1,000 inhabitants
The number of procedures has increased over the period, from 4,300 in 2016 to 5,050 in 2023. At the same time, the rate per 1,000 inhabitants was stable during the period. The average age for pacemaker or defibrillator implantation was 75 years in 2023. Therefore, the increase in the number of procedures can largely be attributed to an aging population. Male patients accounted for approximately 65 % of the procedures in 2023. About 75% of the procedures are performed within their own health trust, but there are significant differences between the catchment areas.
There is considerable geographical variation in the number of procedures. The catchment areas with the highest rates perform about twice as many procedures per 1,000 inhabitants compared to the catchment areas with the lowest rates, and this variation is therefore classified as unwarranted. The catchment areas for Nord-Trøndelag, St. Olav, Førde, UNN, and Innlandet HF consistently have low rates, while the catchment areas for OUS and Lovisenberg HF consistently have high rates.
Nationally, 75 % of the procedures are regular pacemakers, 14 % are cardiac resynchronization therapy (CRT), and 11 % are implantable cardioverter-defibrillators (ICD). The national rate for regular pacemakers has been stable over the period, the rate for ICDs has decreased, and the rate for CRT has increased over the period except for a decline in the last year.
The analysis is based on activity data from the Norwegian Patient Register (NPR) for somatic specialist health services. The data includes activity in public hospitals and private hospitals that provide publicly funded services. Data from specialists under public funding contracts are not included, as this treatment is only provided in hospitals.
The sample consists of procedures with the codes FPK10A, FPK13A, FPK16A, FPK20A, FPK23A, FPK30A, FPK33A, FPK36A, or FPK40A in hospitals.
The analyses distinguish between regular pacemakers, biventricular pacemakers (CRT, cardiac resynchronization therapy) with or without defibrillator function, and implantable cardioverter-defibrillators (ICD). Regular pacemakers are defined by the procedure codes FPK10A, FPK13A, and FPK16A. Biventricular pacemakers (CRT) are defined by the procedure codes FPK20A, FPK23A, FPK36A, and FPK40A. Defibrillators (ICD) are defined by the procedure codes FPK30A and FPK33A.
Replacement and removal of pacemakers, batteries, or electrodes are not included in this analysis.
Where the patient is treated is divided into two categories:
Own HF, treated at one of the hospitals in the catchment area Other HF, treated at a hospital outside the catchment area
To compare catchment areas and between years, the rates are adjusted for gender and age. The adjustment is made using the direct method with the country's population in 2023 as the reference population.
SKDE is solely responsible for the interpretation and presentation of the data provided by NPR. FHI/NPR is not responsible for analyses or interpretations based on the data.
Number of patients with consultations for heart failure per 1,000 inhabitants, 75 years and older
The number of patients increased from 4,700 in 2015 to 10,200 in 2024, representing more than a doubling over the period. During the same period, the number of people in Norway aged 75 and over increased by approximately 35%.
There is significant geographical variation in patient rates in 2024. The lowest rate is in the Innlandet catchment area, with 12.5 patients per 1,000 inhabitants, and the highest in the Sørlandet catchment area, with 30.4.
In 2022,Finnmarkssykehuset began establishing heart failure outpatient clinics. The rate for Finnmark remained between 10 and 12.4 during the period from 2015 to 2022, well below the national average. In 2023, the rate rose to 19, and in 2024 to 24—figures around the national average. While the overall development between these two points resembles that of other catchment areas, the jump in Finnmark occurred in 2023, rather than gradually over time as seen elsewhere.
Almost all catchment areas have experienced a greater increase in the number of patients than in the number of residents during the period. The exception is the catchment area for Diakonhjemmet, where the number of patients has increased by 16%, while the number of residents has grown by 50%.
The number of consultations per patient was 2.3 in 2024. This figure varied between catchment areas, from 1.7 in Førde and 1.8 in Bergen to 2.9 in Østfold and 3.5 in Lovisenberg.
There was no marked decline associated with the pandemic. For some catchment areas, rates increased; for others, they decreased.
The analysis is based on activity data from the Norwegian Patient Registry (NPR) for somatic specialist health services. The data include activity from public hospitals, private hospitals providing publicly funded services, and contracted specialists with public reimbursement agreements. Comparisons with other sources suggest that reporting to the NPR from contracted specialists may be incomplete. In this analysis, consultations from contracted specialists accounted for just under 5% of the total number of consultations in 2024.
The sample includes outpatient consultations for patients aged 75 and over with a primary diagnosis of heart failure, defined by ICD-10 codes I11.0, I13.0, I13.2, I50.0, I50.1, and I50.9.
The total number of patients receiving heart failure consultations in Norway was 20,000 in 2024. Of these, 43.5% were aged 50–74, and 5.4% were aged 0–49.
To allow for comparisons between catchment areas and over time, the rates have been adjusted for age and sex. The adjustment was carried out using the direct method, with the national population in 2023 as the reference population.
SKDE is solely responsible for the interpretation and presentation of the data provided by the NPR. FHI/NPR is not responsible for any analyses or interpretations based on the data.