Clinical Epidemiology (Jul 2019)

The Danish health care system and epidemiological research: from health care contacts to database records

  • Schmidt M,
  • Schmidt SAJ,
  • Adelborg K,
  • Sundbøll J,
  • Laugesen K,
  • Ehrenstein V,
  • Sørensen HT

Journal volume & issue
Vol. Volume 11
pp. 563 – 591

Abstract

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Morten Schmidt1,2, Sigrun Alba Johannesdottir Schmidt1,3, Kasper Adelborg1,4, Jens Sundbøll,1 Kristina Laugesen,1 Vera Ehrenstein,1 Henrik Toft Sørensen11Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; 2Department of Cardiology, Regional Hospital West Jutland, Herning, Denmark; 3Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark; 4Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, DenmarkAbstract: Denmark has a large network of population-based medical databases, which routinely collect high-quality data as a by-product of health care provision. The Danish medical databases include administrative, health, and clinical quality databases. Understanding the full research potential of these data sources requires insight into the underlying health care system. This review describes key elements of the Danish health care system from planning and delivery to record generation. First, it presents the history of the health care system, its overall organization and financing. Second, it details delivery of primary, hospital, psychiatric, and elderly care. Third, the path from a health care contact to a database record is followed. Finally, an overview of the available data sources is presented. This review discusses the data quality of each type of medical database and describes the relative technical ease and cost-effectiveness of exact individual-level linkage among them. It is shown, from an epidemiological point of view, how Denmark’s population represents an open dynamic cohort with complete long-term follow-up, censored only at emigration or death. It is concluded that Denmark’s constellation of universal health care, long-standing routine registration of most health and life events, and the possibility of exact individual-level data linkage provides unlimited possibilities for epidemiological research.Keywords: health care sector, political systems, population health, registries, epidemiology

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