Joar Røkke Fystro

• Fystro, Joar Røkke (2023). Fra samstemt altruisme til motstridende feminisme: en analyse av høringen om kompensasjon for eggdonasjon. Etikk i praksis. ISSN 1890-3991. 17(2), s. 7–22. doi: 10.5324/eip.v17i2.5016. Fulltekst i vitenarkiv
• Fystro, Joar Røkke & Feiring, Eli (2023). Policy-makers' conception of patient non-attendance fees in specialist healthcare: a qualitative document analysis. BMJ Open. ISSN 2044-6055. 13(11). doi: 10.1136/bmjopen-2023-077660. Fulltekst i vitenarkiv Vis sammendrag

  Objectives: Patients missing their scheduled appointments in specialist healthcare without giving notice can undermine efficient care delivery. To reduce patient non-attendance and possibly compensate healthcare providers, policy-makers have noted the viability of implementing patient non-attendance fees. However, these fees may be controversial and generate public resistance. Identifying the concepts attributed to non-attendance fees is important to better understand the controversies surrounding the introduction and use of these fees. Patient non-attendance fees in specialist healthcare have been extensively debated in Norway and Denmark, two countries that are fairly similar regarding political culture, population size and healthcare system. However, although Norway has implemented a patient non-attendance fee scheme, Denmark has not. This study aimed to identify and compare how policy-makers in Norway and Denmark have conceptualised patient non-attendance fees over three decades. Design: A qualitative document study with a multiple-case design. Methods: A theory-driven qualitative analysis of policy documents (n=55) was performed. Results: Although patient non-attendance fees were seen as a measure to reduce non-attendance rates in both countries, the specific conceptualisation of the fees differed. The fees were understood as a monetary disincentive in Norwegian policy documents. In the Danish documents, the fees were framed as an educative measure to foster a sense of social responsibility, as well as serving as a monetary disincentive. The data suggest, however, a recent change in the Danish debate emphasising fees as a disincentive. In both countries, fees were partly justified as a means of compensating providers for the loss of income. Conclusions: The results demonstrate how, as a regulative policy tool, patient non-attendance fees have been conceptualised and framed differently, even in apparently similar contexts. This suggests that a more nuanced and complex understanding of why such fees are debated is needed.

• Fystro, Joar Røkke & Thomsen, Simon (2023). Whose motivation? A conceptual and ethical analysis of nudges and incentives in physiotherapy treatment. Fysioterapeuten. ISSN 0016-3384. 90(5), s. 82–86. Fulltekst i vitenarkiv
• Fystro, Joar Røkke & Feiring, Eli (2023). Mapping out the arguments for and against patient non-attendance fees in healthcare: An analysis of public consultation documents. Journal of Medical Ethics. ISSN 0306-6800. 49(12), s. 844–849. doi: 10.1136/jme-2022-108856. Fulltekst i vitenarkiv Vis sammendrag

  Background Patients not attending their appointments without giving notice burden healthcare services. To reduce non-attendance rates, patient non-attendance fees have been introduced in various settings. Although some argue in narrow economic terms that behavioural change as a result of financial incentives is a voluntary transaction, charging patients for non-attendance remains controversial. This paper aims to investigate the controversies of implementing patient non-attendance fees. Objective The aim was to map out the arguments in the Norwegian public debate concerning the introduction and use of patient non-attendance fees at public outpatient clinics. Methods Public consultation documents (2009–2021) were thematically analysed (n=84). We used a preconceived conceptual framework based on the works of Grant to guide the analysis. Results A broad range of arguments for and against patient non-attendance fees were identified, here referring to the acceptability of the fees’ purpose, the voluntariness of the responses, the effects on the individual character and institutional norms and the perceived fairness and comparative effectiveness of patient non-attendance fees. Whereas the aim of motivating patients to keep their appointments to avoid poor utilisation of resources and increased waiting times was widely supported, principled and practical arguments against patient non-attendance fees were raised. Conclusion A narrow economic understanding of incentives cannot capture the breadth of arguments for and against patient non-attendance fees. Policy makers may draw on this insight when implementing similar incentive schemes. The study may also contribute to the general debate on ethics and incentives.

• Fystro, Joar Røkke; Hofmann, Bjørn Morten & Feiring, Eli (2022). On the person in personal health responsibility. BMC Medical Ethics. ISSN 1472-6939. 23(1). doi: 10.1186/s12910-022-00802-y. Fulltekst i vitenarkiv
• Feiring, Eli; Traina, Gloria; Fystro, Joar Røkke & Hofmann, Bjørn (2020). Avoiding hypersensitive reluctance to address parental responsibility in childhood obesity. Journal of Medical Ethics. ISSN 0306-6800. doi: 10.1136/medethics-2020-106120. Fulltekst i vitenarkiv

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• Fystro, Joar Røkke (2024). Tre ankepunkter mot (over)bruk av samfunnsøkonomiske analyser for å promotere fysioterapi. Fysioterapeuten. ISSN 0016-3384.
• Fystro, Joar Røkke & Feiring, Eli (2024). Hvorfor har vi fraværsgebyr? Medisinbloggen.
• Fystro, Joar Røkke (2024). Hvorfor får eggdonorer mindre økonomisk kompensasjon enn sæddonorer? Tidsskrift for Den norske legeforening. ISSN 0029-2001. 144(5), s. 353–354. doi: 10.4045/tidsskr.24.0115.
• Eng-Galåen, Tone Elise & Fystro, Joar Røkke (2023). Pasienters egeninnsats: En vennlig dult er vel greit? [Fagblad]. Fysioterapeuten.
• Bakke, Mathilde Coraline Aarvold & Fystro, Joar Røkke (2023). Gebyr for å utebli fra avtalt legetime har økt til 1.500 kroner. Betyr det at flere møter opp? [Internett]. Forskning.no.
• Fystro, Joar Røkke & Feiring, Eli (2023). Fraværsgebyrer kan lære oss noe om økonomi og etikk. Dagens medisin. ISSN 1501-4290.
• Fystro, Joar Røkke (2023). Pasientfravær til besvær, men er det forkastelig? Gudbrandsdølen Dagningen.
• Fystro, Joar Røkke (2023). Ikke møtt-gebyr versus rettssikkerhet? Tidsskrift for Den norske legeforening. ISSN 0029-2001. 143(2), s. 122–122. doi: 10.4045/tidsskr.22.0783.
• Fystro, Joar Røkke (2022). Evolusjonen forklarer ikke en vanskelig russetid. Gudbrandsdølen Dagningen.
• Fystro, Joar Røkke & Feiring, Eli (2022). 185:poster The ideas behind charging for non-attendance in healthcare: an analysis of key policy documents in Denmark and Norway. BMJ Global Health. ISSN 2059-7908. 7. doi: 10.1136/bmjgh-2022-ISPH.53.
• Fystro, Joar Røkke (2022). Mellom ansvar og skyld: Personlig ansvar i fysioterapi. Fysioterapeuten. ISSN 0016-3384. 89(1), s. 36–38.
• Fystro, Joar Røkke & Moen, Christian (2021). Personlig ansvar med fysioterapeut og stipendiat ved UiO Joar Røkke Fystro. [Radio]. Fysioformidlingen (Podcast).
• Fystro, Joar Røkke & Lossius, Lone Omholt (2021). – Fysioterapeutens kunnskap kan minimere pasientens følelse av skyld. [Fagblad]. Fysioterapeuten.
• Fystro, Joar Røkke (2021). Vaksiner er ingen premie. Tidsskrift for Den norske legeforening. ISSN 0029-2001. 141(6), s. 516–516. doi: 10.4045/tidsskr.21.0206.
• Fystro, Joar Røkke (2021). Oppsøkende genetisk informasjonsvirksomhet – en historisk oversikt. Michael. ISSN 1893-9651. 18(1), s. 74–82.
• Fystro, Joar Røkke (2020). Når jus og moral møtes. Tidsskrift for Den norske legeforening. ISSN 0029-2001. 140(10), s. 993–995. doi: 10.4045/tidsskr.19.0799.
• Fystro, Joar Røkke (2020). Hva er en umotivert pasient? Fysioterapeuten. ISSN 0016-3384. 87(1), s. 32–33.
• Fystro, Joar Røkke (2023). Ekstern rapport om unntaksordninger etter nei-beslutning i utvalgte lands systemer som ligner på systemet for Nye Metoder. Universitetet i Oslo. Fulltekst i vitenarkiv
• Fystro, Joar Røkke (2023). Kartlegging av unntaksordninger i systemer som er ekvivalente til det norske systemet for Nye metoder og Blåreseptordningen: En ekstern rapport til ekspertgruppen om tilgang og prioritering. Universitetet i Oslo. Fulltekst i vitenarkiv

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