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Abstract Background In this study we investigated the distribution of self-reported health care utilisation by education and household income in a county population in Norway, in a universal public health care system based on ideals of equal access for all according to need, and not according to wealth. Methods The study included 24,147 women and 20,608 men aged 20 years and above in the third Nord-Trøndelag Health Survey (HUNT 3) of 2006–2008. Income-related horizontal inequity was estimated through concentration indexes, and inequity by both education and income was estimated as risk ratios through conventional regression. Results We found no overall pro-rich or pro-educated socioeconomic gradient in needs-adjusted utilisation of general practitioner or inpatient care. However, we found overall pro-rich and pro-educated inequity in utilisation of both private medical specialists and hospital outpatient care. For these services there were large differences in levels of inequity between younger and older men and women. Conclusion In contrast with recent studies from Norway, we found pro-rich and pro-educated social inequalities in utilisation of hospital outpatient services and not only private medical specialists. Utilisation of general practitioner and inpatient services, which have low access threshold or are free of charge, we found to be equitable.

Background: In countries with gatekeeping and equitable access to general practitioners (GPs), social inequalities in GP-patient interaction could be an important mechanism by which inequalities in access to medical specialists arise. The aim of this study was to investigate whether socioeconomic inequalities in experiences with general practice are associated with socioeconomic inequalities in access to specialist services. Methods: The study included 6,067 participants in the third survey of the Nord-Trøndelag Health Study (HUNT3, 2006–08) who were asked to evaluate their experiences with primary care and their regular general practitioner in Norway. Self-reported data on health status and number of visits to GP and specialist services in the last 12 months were included in the study. Socioeconomic status was measured by education and household income and rescaled to relative index of inequality (RII). Relative risks were calculated using Poisson regression. Results: We found that a majority of patients reported positive experiences with general practice. Low socioeconomic status (SES) and male gender were associated with negative experiences. Patient experiences both directly and indirectly related to referrals were associated with the probability and quantity of specialist utilization: perception of low subjective influence on decisions about choice of medical care was associated with lower probability and quantity of specialist utilization, whereas desire to change the regular GP or to use GPs other than the regular GP and critical evaluations of the GP were associated with higher specialist consultation frequency. However, the level of education-related inequity in access to specialists was not sensitive to adjustment by survey responses. Conclusion: Patient experiences with general practice were associated with the patients’ level of utilization of specialist services. There are socioeconomic inequalities in patient experiences with general practice, however the aspects measured in this study do not explain the observed socioeconomic inequity in access to specialists. [ABSTRACT FROM AUTHOR]

Background: Many asylum seekers arrived in Norway during autumn 2015, and there has been a call for more knowledge regarding the health of this group. The aim of this exploratory literature review was to investigate the state of knowledge about asylum seekers' health and use of healthcare services in Norway., Material and Method: We conducted two literature searches for the periods 2007-2017 and 2017-2019 in 12 databases using the keywords 'refugees' and related terms, with a filter for research undertaken in or about Norway and published in Norwegian or English. The title and summary were read first, after which relevant articles were read in full text. Publications concerning asylum seekers in Norway and related to health and/or use of health services were included., Results: A total of 28 publications met the criteria for inclusion: 22 peer-reviewed articles and six reports. The most common topics were mental health and infectious diseases. Other topics that the studies dealt with were nutrition, functional impairment and healthcare services., Interpretation: Little research has been undertaken on asylum seekers' health and use of healthcare services. Research on asylum seekers' health in Norway primarily concerns mental health and infectious diseases, and there is little research on other somatic disorders.