Here you will find analyses of geographical variation in the use of healthcare services withing orthopedics in Norway. The analyses include, among other things, updated figures from the Orthopaedic Healthcare Atlas and the Day Surgery Atlases (1 and 2).
Number of surgeries for carpal tunnel syndrome per 1,000 inhabitants
An average of approximately 7,400 operations for carpal tunnel syndrome are performed annually. The annual number of operations was minimally affected by the pandemic. There was a slight decrease for women in 2020, and 2021 was a peak year for both sexes compared to the other years in the period 2015–2023.
There is significant geographic variation in operation rates. In the catchment areas with the highest rates, approximately three times as many operations per 1,000 inhabitants are performed compared to the areas with the lowest rates. In 2023, the number of operations per 1,000 inhabitants ranged from 0.9 in Lovisenberg to 2.7 in Nordland.
The Oslo area (OUS, Lovisenberg, and Diakonhjemmet HF) consistently has the lowest rates throughout the period. Innlandet and Østfold HF have had the highest rates during the period. The low rate in Østfold HF in 2023 is likely due to incomplete reporting from private specialists. In the catchment areas of UNN and Førde HF, rates have risen sharply over the past three years.
Women undergo surgery more often than men, and the proportion of surgeries performed on women was 61 % in 2023.
The number of primary hip prosthesis insertions per 1,000 inhabitants aged 50 years and older
On average, 8,225 hip prosthesis implantations were performed per year on patients aged 50 years and older. The number of surgeries increased by 27 %, from 7,441 in 2015 to 9,466 in 2023. The number of contacts per year saw a significant decline during the pandemic. After the pandemic, the numbers have risen higher than pre-pandemic levels.
Measured by the number of surgeries per 1,000 inhabitants, there has been only a slight change during the period. This rate increased by 5 %, from 4.4 to 4.6. During the same period, the number of residents in Norway aged 50 years and older increased by 16 %. This indicates that the rise in the number of surgeries is largely due to population growth.
Women undergo surgery more frequently than men, with 65 % of the operations performed on women in 2023. The average age was approximately the same for both genders in 2023, around 70 years.
Number of insertions of primary knee prostheses per 1,000 inhabitants
For patients aged 50 and older, 5,857 knee prostheses were implanted in 2015, increasing to 8,154 in 2023. This corresponds to a 39% increase. There was a slight decline in the number of operations during the pandemic year 2020. Following the pandemic, the level is higher than it was pre-pandemic. The proportion of partial knee prostheses has shown a clear increase over the period, from 12% in 2015 to 16% in 2023.
There is geographic variation in operation rates. In the catchment areas with the highest rates, more than twice as many operations per 1,000 inhabitants are performed compared to the areas with the lowest rates. In 2023, the rates ranged from 2.1 in the Lovisenberg HF catchment area to 4.8 in Førde. The ratio between total and partial prostheses also varies significantly across the different catchment areas. In 2023, the proportion of patients receiving partial prostheses ranged from less than 5% in Helgeland and Sørlandet to 32% at Diakonhjemmet and St. Olav.
Women are operated on more frequently than men, with women accounting for 57% of operations in 2023. The average age was approximately the same for both genders in 2023, just under 70 years.
Number of surgeries for Hallux valgus and Hammertoe per 1,000 inhabitants
The number of surgeries has decreased throughout the period, from 5,400 in 2015 to 3,100 in 2023. Women accounted for approximately 80 % of the surgeries in 2023, and the decline in the number of surgeries during the period is mainly due to fewer surgeries on women.
There is significant geographical variation in surgery rates. The catchment areas with the highest rates perform about three times as many surgeries per 1,000 inhabitants compared to the catchment areas with the fewest surgeries, classifying the variation as unwarranted. The catchment areas for Stavanger and Bergen HF have consistently low rates, while the catchment areas for Finnmark and UNN HF have consistently high rates.
More than half of the surgeries are performed in their own health trusts, and about 20 % are performed privately for the country as a whole, but there are significant differences between catchment areas. In 2023, about half of the surgeries were performed privately in the catchment areas for Finnmark and St. Olav HF, while no surgeries were performed privately in the catchment areas for Vestre Viken and Telemark HF.
