Geographic variation in access to health care in Norway has been documented in a broad spectrum of services, especially by the Norwegian health care Atlases. Furthermore, several decades ago Wennberg reported on small area variations in health care delivery, which could not be explained by corresponding variations in need. relatively wealthy and/or highly educated people visit more specialists and have more access to sophisticated therapies. Several studies report socioeconomic differences in utilisation of health care, e.g. However, an increasing number of studies indicate that this principle is not adequately met, in Norway as in other Western countries. It is a fundamental principle in this system that equal needs should be met by equal services regardless of e.g., socioeconomic status (SES) or place of residence. Norway has a universal health care system and in-hospital treatment is free of charge. In addition, one private hospital in the South-East RHA is performing the procedure as a subcontractor for the regional health authority. In Norway, only five hospitals are performing AF ablations, one in each of the four RHAs. By 2013, Norway was near the top in Europe in number of AF ablations performed per million inhabitants. This led to a substantial increase in the number of radiofrequency ablation procedures performed within the national health care system. In 2010 the Norwegian Ministry of Health and Care Services instructed the regional health authorities (RHA) to increase the capacity for catheter ablation of AF, as there was an increasing discrepancy between demand and capacity for catheter ablation in Norway. However, more recently, catheter ablation has also increasingly been considered as first-line therapy in selected individuals. The procedure was primarily indicated for patients without structural heart disease, where rhythm control is the strategy of choice and in whom medical therapy has failed. Over the last two decades, catheter ablation has evolved as an important treatment option for many patients with symptomatic AF, with reasonable success rates, low complication rates and acceptable cost-effectiveness. Thus, AF has become an important public health issue and a significant contributor to health care cost in the Western world. The prevalence of AF has been increasing over the last decades, and is expected to increase further over the next 30 to 50 years. However, geographic variation related to differences in clinical practice and provider preferences implies a need for clearer guidelines, both at the specialist level and at the referring level.Ītrial fibrillation (AF) is the most common cardiac arrhythmia, with significant influence on quality of life, morbidity and mortality. Some of the geographic variation may reflect differences in ablation capacity. Conclusionsĭifferences in health literacy, patient preference and demands are probably important causes of socioeconomic variation, and studies on how socioeconomic status influences the choice of treatment are warranted. Olavs Hospital Trust had around three times as high ablation rates as patients living in the referral area of Finnmark Hospital Trust. Patients living in the referral area of St. Atrial fibrillation patients with high level of education and high income were more frequently treated with ablation, and the education effect increased with increasing age. Substantial socioeconomic and geographic variation was documented. Survival analysis, by Cox regression with attained age as time scale, separately by gender, was applied to examine the associations between ablation probability and educational level, income level, place of residence, and follow-up time. National population-based data on individual level of all Norwegians aged 25 to 75 diagnosed with atrial fibrillation from 2008 to 2017 were used to study the proportion treated with catheter ablation. The aim of this study was to analyse whether there are patient related or geographic differences in the use of catheter ablation among atrial fibrillation patients in Norway.
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