Eye
Here you will find analyses of geographical variation in the use of health services related to the eye.
Here you will find analyses of geographical variation in the use of health services related to the eye.
Number of contacts per 1,000 inhabitants, 50 years and older
Nationally, the number of contacts per year increased from 61,000 in 2015 to approximately 138,000 in 2023. The number of contacts was more than doubled from 2015 to 2023 while the number of patients in treatment was doubled in the same period. This means that the number of contacts per patient increased from 5.5 in 2015 to 6.3 in 2023. This is in accordance with the findings of Husum et al. 2023, who examined the use of injection treatment from 2011 to 2021.
Injection treatment is relevant for patients with age-related macular degeneration (AMD), diabetic retinopathy, and vein occlusion. Nationally, the proportion of contacts with the diagnosis AMD decreased from about 78 % in 2015 to 73 % in 2023. However, in some referral areas, the proportion of contacts with the diagnosis AMD has increased during the period. In the catchment areas of Bergen and Stavanger, the proportion of contacts with a diagnosis of diabetic retinopathy or vein occlusion was very low in 2023.
The two most used drugs are bevacizumab and aflibercept. Bevacizumab has significantly lower costs and is the first choice in most places (Husum et al. 2023). Nationally, the proportion of contacts with the drug aflibercept increased from 46 % in 2015 to 56 % in 2020, and then decreased to 50 % in 2023. The proportion of contacts with aflibercept was highest in the Sørlandet referral area (67.5 % of contacts) and lowest in the Stavanger referral area (38 % of contacts) in 2023.
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 contacts for patients aged 50 years or older registered with a primary or secondary diagnosis of age-related macular degeneration, AMD (H35.3), venous occlusion (H34.8 or H34.9), or diabetic retinopathy (H36.0, E10.3, or E11.3) in combination with procedure code CKD05.
The drug aflibercept is identified using a special code (1LA05 or S01LA05).
When a contact is registered with two or more of the relevant diagnosis codes (e.g., AMD as the primary condition and venous occlusion as the secondary condition), the primary diagnosis is chosen.
The place of treatment is divided into three categories:
In order to compare the catchment areas and between years, the rates have been adjusted for gender and age. The adjustment was done using the direct method with the 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 per 1,000 inhabitants, 50 years and older
The number of patients in treatment increased by approximately 1,300 per year from 2015 to 2023, from 11,043 patients in 2015 to 21,911 patients in 2023. The reason for the patient growth is that this is a treatment for chronic conditions like age-related macular degeneration, and that the number of new patients each year exceeds the number of patients who discontinue their treatment. If the number of patients in treatment continues to increase in the coming years, changes in the organization of services may be needed to ensure access to good and equitable treatment.
Most of the patients were between 70 and 90 years old. The rate for women was 11,7 pastients pr 1 000 women and the rate for men was 9,5 patiens pr 1 000 men in 2023. There is significant geographical variation in the patient rate. This is in agreement with Husum et al. 2023, who suggest that the observed variation may be related to overtreatment in some areas and undertreatment in others. The authors point to a need for clearer management, national guidelines, and a national quality register in the field.
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 patients aged 50 years or older registered with a primary or secondary diagnosis of age-related macular degeneration, AMD (H35.3), venous occlusion (H34.8 or H34.9), or diabetic retinopathy (H36.0, E10.3, or E11.3) in combination with procedure code CKD05.
If the patient has moved between two catchment areas within a year, the residence is defined as the residence/catchment area where the patient had the most contacts during the year.
In order to compare the catchment areas and between years, the rates have been adjusted for gender and age. The adjustment was done using the direct method with the 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.