Background Current demographic changes affect both the level and composition of health and care needs in the population. The aim of this study was to estimate utilisation and cost for a comprehensive range of health and care services by age and gender to provide an in-depth picture of the life-span pattern of service needs and related costs. Methods Data on service use in 2010 for the entire population in Norway were collected from four high-quality national registers. Cost for different services were calculated combining data on service utilisation from the registries and estimates of unit cost. Data on cost and users were aggregated within four healthcare services and seven long-term care services subtypes. Per capita cost by age and gender was decomposed into user rates and cost per user for each of the eleven services. Results Half of the population is under 40 years of age, but only a quarter of the health and care cost is used on this age group. The age-group of 65 or older, on the other hand, represent only 15% of the population, but is responsible for almost half of the total cost. Healthcare cost dominates in ages under 80 and mental health services dominates in adolescents and young adults. Use of other healthcare services are high in middle aged and elderly but decreases for the oldest old. Use of care services and in particular institutional care increases in old age. Healthcare cost per user follows roughly the same age pattern as user rates, whereas user cost for care services typically are either relatively stable or decrease with age among adults. Gender differences in the age pattern of health and care costs are also revealed and discussed. Conclusion The type of services used, and the related cost, show a clear life-span as well as gender pattern. Hence, population aging and narrowing gender-gap in longivety calls for high policy awarness on changing health and care needs. Our study also underscores the need for an attentive and pro-active stance towards the high service prevalence and high cost of mental health care in our upcoming generations.

BackgroundAlthough reduced function of the respiratory system limits peak oxygen uptake in diseases affecting the lungs or airways, the healthy respiratory system is thought to have a spare capacity for oxygen transport and uptake, and is not considered a limiting factor for peak oxygen uptake in healthy people. However, lung function declines with age and could theoretically limit peak oxygen uptake in elderly. We examined the association between peak oxygen uptake and lung function indices in an elderly population with the hypothesis that lung function indices would be associated with VO2peak up to a threshold value situated above the lower limits of normal lung function for our population.MethodsSpirometry, gas diffusion tests and incremental work tests were performed in 1443 subjects (714 women) aged 69–77 years. Association between lung function indices and peak oxygen uptake was studied with hockey-stick regression.ResultsForced expiratory volume in 1 s (FEV1) had a positive association with peak oxygen uptake up to, but not above, a threshold value of 2.86 l for men, and 2.13 l for women (lower limit of normal 2.73 and 1.77 l respectively). A corresponding threshold was found for diffusing capacity of the lung for carbon monoxide (DLCO) for men at 9.18 mmol/min/kPa (lower limit of normal 6.84 mmol/min/kPa). DLCO for women and DLCO divided by alveolar volume (DLCO/VA) for both sexes had a significant linear relationship to VO2peak (p < 0.05), but no significant threshold value was found in these associations.ConclusionsThreshold values for FEV1 for both sexes and DLCO for men were identified. These lung function indices had a positive association with VO2peak up to these threshold values, but not above. The identified threshold values were above lower limits of normal for FEV1 and DLCO.Electronic supplementary materialThe online version of this article (doi:10.1186/s12931-015-0317-0) contains supplementary material, which is available to authorized users.

Background Familial hypercholesterolaemia increases the risk for cardiovascular disease. The primary aim of the present study was to describe sex differences in incidence and prevalence of cardiovascular disease leading to hospitalisation in a complete cohort of genotyped familial hypercholesterolaemia patients. Design and methods In this registry study data on 5538 patients with verified genotyped familial hypercholesterolaemia were linked to data on all Norwegian cardiovascular disease hospitalisations, and hospitalisations due to pre-eclampsia/eclampsia, congenital heart defects and diabetes. Results During 1994-2009 a total of 1411 of familial hypercholesterolaemia patients were hospitalised, and ischaemic heart disease was reported in 90% of them. Mean (SD) age at first hospitalisation and first re-hospitalisation was 45.1 (16.5) and 47.6 (16.3) years, respectively, with no sex differences ( P = 0.66 and P = 0.93, respectively). More men (26.9%) than women (24.1%) with familial hypercholesterolaemia were hospitalised ( P = 0.02). The median (25th-75th percentile) number of hospital admissions was four (two to seven) per familial hypercholesterolaemia patient, with no sex differences ( P = 0.87). Despite having familial hypercholesterolaemia at the time of hospitalisation, the diagnosis of familial hypercholesterolaemia was registered in only 45.7% of the patients at discharge. Conclusion Most cardiovascular disease hospitalisations were due to ischaemic heart disease. Familial hypercholesterolaemia patients were first time hospitalised at age 45.1 years, with no significant sex differences in age, which are important novel findings. The awareness and registration of the familial hypercholesterolaemia diagnosis during the hospital stays were disturbingly low.

Whether or not a city or a country should bid to host the Olympics or one of the big international football tournaments is often the source of heated debates. One question that is always raised is whether hosting such an event yields positive economic benefits. Using data from the period 1970-2009 we investigate whether there is a link between hosting a major sport event and the amount of foreign direct investment (FDI) a country receives. We employ time-series cross-section data for countries that have hosted either the Summer Olympics, the Winter Olympics, the FIFA World Cup or the UEFA European Championship in that period. While our overall results, on balance, offer support to the 'pessimistic' side of the debate about the economic effects of hosting mega events, our findings also indicate that some FDI benefits might still accrue to the host. Results are not unambiguous, however. More detailed analysis suggests that staging the Olympics has virtually no effect on FDI inflows, whereas hosting a major, nationwide football tournament might have a small positive impact on foreign investment, particularly in the years leading up to the event. These latter results seem to be driven by smaller nations.

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