Articles de revues : « National health services – Denmark »

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Jørgensen, Torben, Anne Hvenegaard et Finn Børlum Kristensen. « HEALTH TECHNOLOGY ASSESSMENT IN DENMARK ». International Journal of Technology Assessment in Health Care 16, n^o 2 (avril 2000) : 347–81. http://dx.doi.org/10.1017/s0266462300101047.

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The Danish healthcare services are mainly provided by public sector institutions. The system is highly decentralized. The state has little direct influence on the provision of healthcare services. State influence is exercised through legislation and budget allocations. The main task of the state is to initiate, co-ordinate, and advise. Counties, which run the hospitals, also decide on the placement of services. The hospital sector is controlled within the framework of legislation and global budgets. General practitioners occupy a central position in the Danish healthcare sector, acting as gatekeepers to the rest of the system. The system works well, and its structure has resulted in steady costs of health care for a long period. There is no regulatory mechanism in the Danish health services requiring use of health technology assessment (HTA) as a basis for policy decisions, planning, or administrative procedures. However, since the late 1970s a number of comprehensive assessments of health technology have formed the basis for national health policy decisions. In 1997, after years of public criticism of the quality of hospital care and health technologies, and on the basis of a previously developed national HTA strategy, a national institute for HTA (DIHTA) was established. There seems to be a growing awareness of evidence-based healthcare among health professionals and a general acceptance of health economic analyses as a basis for health policy decision making. This progress is coupled with growing regional HTA activity in the health services. HTA seems to have a bright future in Denmark.

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Hansen, Rikke N., Lotte S. Nørgaard, Ulla Hedegaard, Lone Søndergaard, Kerly Servilieri, Susanne Bendixen et Charlotte Rossing. « Integration of and visions for community pharmacy in primary health care in Denmark ». Pharmacy Practice 19, n^o 1 (22 janvier 2021) : 2212. http://dx.doi.org/10.18549/pharmpract.2021.1.2212.

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In 2014, the Danish government launched a plan for health entitled: “Healthier lives for everyone – national goals for the health of Danes within the next 10 years”. The overall objective is to prolong healthy years of life and to reduce inequality in health. In Denmark, the responsibility for health and social care is shared between the central government, the regions and the municipalities. National and local strategies seek to enhance public health through national and local initiatives initiated by different stakeholders. The Danish community pharmacies also contribute to promoting public health through distribution of and counselling on medication in the entire country and through offering several pharmacy services, six of which are fully or partly remunerated on a national level. Because of greater demands from patients, health care professionals and society and a lack of general practitioners, the Danish community pharmacies now have the opportunity to suggest several new functions and services or to extend existing services. The Danish pharmacy law changed in 2015 with the objective to maintain and develop community pharmacies and to achieve increased patient accessibility. The change in the law made it possible for every community pharmacy owner to open a maximum of seven pharmacy branches (apart from the main pharmacy) in a range of 75 km. This change also increased the competition between community pharmacies and consequently the pharmacies are now under financial pressure. On the other hand, each pharmacy may have been given an incentive to develop their specific pharmacy and become the best pharmacy for the patients. Community pharmacies are working to be seen as partners in the health care system. This role is in Denmark increasingly being supported by the government through the remunerated pharmacy services and through contract with municipalities. Concurrent with the extended tasks for the Danish community pharmacies and utilisation of their excellent competencies in medication the community pharmacies need to focus on their main tasks of supplying medicines and implementing services. This requires efficient management, an increased use of technology for distribution and communication and continuing education and training.

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Kastrup, M. « Diagnostic Differences Among Different Ethnic Groups Contacting Mental Health Services ». European Psychiatry 24, S1 (janvier 2009) : 1. http://dx.doi.org/10.1016/s0924-9338(09)70301-3.

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Aim:A nationwide register study was carried out in Denmark comprising 50,877 persons aged 18-66, who were registered in 2003 in the Danish Psychiatric Register or the National Patient Register with a psychiatric ICD-10 diagnosis with the aim to compare diagnostic profiles and use of services.Method:The study is a register survey linking Psychiatric/and National Patient Register with Statistical Bureau data.Results:Of the population 87.1% were ethnic Danes, 7.8% migrants, 4.0% descendants with one Danish born parent, 0.7% descendants with both parents born outside Denmark and 0.3% foreign adoptees. Males comprised 49%, women 51% of the population. The 5 ethnic groups had significant differences in utilization of care, in diagnostic distribution and in the use of coercion. Diagnostically, contacts due to schizophrenia were significantly higher among non-Danish patients and highest among young descendant males. Personality disorders were significantly higher among women than men and highes in adopted and descendant young women. PTSD had a preponderance among migrant men. Substance abuse was higher among men in all ethnic groups, but lower among migrant groups compared to Danes. Self-mutilating behaviour was seen more frequently among female descendants from non-Western countries than among migrant women from non-Western countries as well as among young adopted women.Conclusion:Significant diagnostic differences were observed. Possible explanatory models to these findings will be discussed.

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Fonseca, Ana Sofia, Amalie Kofoed Jørgensen, Bianca Xuan Larsen, Marina Moser-Johansen, Esben Meulengracht Flachs, Niels Erik Ebbehøj, Jakob Hjort Bønløkke et al. « Historical Asbestos Measurements in Denmark—A National Database ». International Journal of Environmental Research and Public Health 19, n^o 2 (6 janvier 2022) : 643. http://dx.doi.org/10.3390/ijerph19020643.

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Objectives: Due to the long lag-time for health outcomes, historical asbestos exposure measurements are valuable to support assessments of associated occupational health effects, and also to assess time trends and effects of preventive measures. Methods: Different sources of stored data were collated, assessed and refined to create a harmonized database on historical asbestos fibre concentrations measured in specific work tasks and different industries. The final database contains 9236 asbestos measurements from Danish workplaces collected from 1971 to 1997. Results: The geometric mean of asbestos concentrations in different occupations and tasks ranged from 0.003 to 35 fibres cm−3. Highest concentrations were registered during handling of asbestos products in the construction services during the period 1981–1997. Although all the measured asbestos exposures without the use of respiratory equipment by the worker in the period of 1971–1997 exceeded the current 8-h time-weighted average exposure limit of 0.1 fibres cm−3, the majority of samples collected in the earlier period of 1971 to 1980 did not exceed the exposure limit of 2 fibres cm−3, which was in place at the time. All exposure data obtained from 1980 and onwards were found to be one seventh of the mean fibre concentrations in the previous measurement period. The impact of time shows a clear exponentially decreasing trend-line. Conclusions: Despite limitations in coverage of different occupations and tasks associated with the inventoried historical asbestos measurements, the data are helpful to identify specific work scenarios within an industry, where relatively high asbestos exposure levels may still occur or have occurred from 1971 to 1997.

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Arat, Arzu, Marie Norredam, Ulrike Baum, Stefán Hrafn Jónsson, Geir Gunlaugsson, Thomas Wallby et Anders Hjern. « Organisation of preventive child health services : Key to socio-economic equity in vaccine uptake ? » Scandinavian Journal of Public Health 48, n^o 5 (17 mai 2019) : 491–94. http://dx.doi.org/10.1177/1403494819850430.

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Background: Measles has made a comeback in Western Europe, with more cases being reported each year. One factor behind this development is low vaccination coverage in socially disadvantaged segments of the population in many countries. This study investigates whether socioeconomic patterns of uptake of the measles, mumps and rubella (MMR) vaccine in the Nordic countries differ by national organisation of preventive health services for children. Methods: MMR vaccine uptake before the age of two years was analysed in register data from Denmark, Finland, Iceland and Sweden, linked to family indicators of socio-economic status (SES) from national registers. Results: Denmark, a country where child vaccinations are administered by general practitioners, presented the lowest overall coverage of MMR at 83%. It also had the greatest difference between subpopulations of low and high SES at 14 percentage points. Finland, Iceland and Sweden, countries where preschool children are vaccinated in ‘well-baby’ clinics, had a higher overall coverage at 91–94%, with a more equal distribution between SES groups at 1–4 percentage points. Conclusions: This study suggests that the organisation of preventive health care in special units, ‘well-baby’ clinics, facilitates vaccine uptake among children with low SES in a Nordic welfare context.

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Mucic, D. « Telemental health in treatment of ethnic minorities in EU ». European Psychiatry 26, S2 (mars 2011) : 2194. http://dx.doi.org/10.1016/s0924-9338(11)73897-4.

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Access to adequate mental health care services is one of the identified problems within EU mental health services. Increased migration into and within EU cause the increased demands for clinicians with selected skills.TeleMental Health applications could improve access to mental health care in rural, remote and under-served as well as in metropolitan areas all around EU. Telepsychiatry is the most common telemental health application. Furthermore, there are various internet based approaches to treatment of mental conditions on distance. Transcultural telepsychiatry model, developed in Denmark during last decade was aimed to treat ethnic minorities via their own mothertongue(s) by use of telepsychiatry. Patient satisfaction rapported within telepsychiatry service in Denmark is very high. The restricted physical contact and non-verbal communication of telepsychiatry compensates by the fact that the doctor and patient spoke the same language and had similar cultural and/or national references.Ongoing international telepsychiatry collaboration established between Sweden and Denmark is a success that may be exported to other european countries. The experiences from this pioneer international transcultural telepsychiatry service may contribute to further development an European Telepsychiatry Network. However, this model may be used as an inspiration for conducting of larger international telepsychiatry service capable to provide mental health care toward diversity of patient populations underserved on their mother tongue within EU.

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Jensen, Anita, Theodore Stickley et Alison Edgley. « The perspectives of people who use mental health services engaging with arts and cultural activities ». Mental Health and Social Inclusion 20, n^o 3 (8 août 2016) : 180–86. http://dx.doi.org/10.1108/mhsi-02-2016-0011.

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Purpose – The purpose of this paper is to present a study of arts engagement for mental health service users in Denmark. Design/methodology/approach – The study was completed at Hans Knudsen Instituttet, Denmark. It involved analysis of emerging themes from semi-structured interviews with six participants who had participated in a structured visit to the National Gallery (Statens Museum for Kunst) in Denmark. Findings – Multiple benefits for people who use mental health services engaging in arts activities are reported. Arts activities are described as a central component of everyday life; a way of life and a significant factor in getting through the day. Barriers are identified in the interdisciplinary working between the museum educator and participants. Social implications – This study identifies that the participants benefited from taking part in the arts/cultural activity. Findings also suggest that if museums are offering activities to people who use mental health services they should equip staff with training designed to support appropriate ways of working with this group. This interdisciplinary activity offers a relatively untapped potential arena of support. Originality/value – The paper will be of relevance and value to those working with mental health and arts. The study demonstrates the importance for mental health service users to engage in creative activity and for museum staff to have appropriate skills for inclusion to be successful.

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Nyhus, Eskil, Søren Holst, Charlotte Munch et Erik Søndenaa. « Forensic intellectual disability services : differences in staff perspectives in the Danish and Norwegian systems ». Journal of Intellectual Disabilities and Offending Behaviour 12, n^o 2 (28 juin 2021) : 75–83. http://dx.doi.org/10.1108/jidob-01-2021-0001.

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Purpose Persons with intellectual disabilities (ID) who offend are treated differently depending on the national jurisdiction. Norway and Denmark are two such examples. The differences in care models may also have an impact on staff perspectives. This paper aims to study the differences between Norwegian and Danish staff members within secure forensic ID services. Design/methodology/approach A cross-sectional study involving Norwegian (n = 145) and Danish staff (n = 279) in secure forensic learning disabilities services was conducted. The response rates were 50% in Denmark (n = 147) and 69% in Norway (n = 98), respectively. An electronic survey covering five sets of topics (demographic characteristics, working conditions, workplace culture, work motivation and work resilience) was used. The findings was statistically analysed using SPSS. Findings This study confirmed that staff in the two neighbouring countries have common conceptions of their employment. Danish staff were more exposed to violent incidents (t = 4.1(237); p < 0.001). There was greater concern with workplace safety in Denmark (t = 5.2(237); p < 0.001) compared to more team-based and rigid working conditions in Norway (t = −2.6(237); p < 0.01). Originality/value These differences are discussed in relation to some important national differences in a professional culture, educational systems, service organisation and legal issues that possibly add realistic explanations to the findings.

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Koster, A. « Mental health services in Denmark. Where are people with schizoprenia treated in the danish national schizophrenia project ? » European Psychiatry 23 (avril 2008) : S49. http://dx.doi.org/10.1016/j.eurpsy.2008.01.178.

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Grinde, Turid. « Nordic child welfare services : variations in norms, attitudes and practice ». Journal of Children's Services 2, n^o 4 (1 décembre 2007) : 44–58. http://dx.doi.org/10.1108/17466660200700035.

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Earlier Nordic comparative studies show variation between countries in child welfare practice, reflecting cultural differences, and that case workers share the norms, values and attitudes of their society. Can cultural factors be concretised for discussion? Child welfare workers in Denmark, Iceland and Norway were presented with five child care stories (vignettes) that focused on the ‘threshold’ between preventive measures and out‐of‐home care (consensual or compulsory). Vignette themes included parental neglect, maternal alcohol misuse and youth problems. Study participants gave written answers to the vignettes and took part in group discussions with colleagues. The results showed significant differences between countries in case workers' responses. Variations in arguments, decisions, use of compulsion and working style reflected national views and priorities. A central dimension was how case workers balanced parental interests with children's needs: in Denmark they were reluctant to intervene with parental rights, whereas the Norwegians were more accepting of compulsory decisions to protect children.

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Aadal, Lena, Hanne Pallesen, Cathrine Arntzen et Siri Moe. « Municipal Cross-Disciplinary Rehabilitation following Stroke in Denmark and Norway : A Qualitative Study ». Rehabilitation Research and Practice 2018 (25 octobre 2018) : 1–12. http://dx.doi.org/10.1155/2018/1972190.

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Aim. To explore and compare the content of rehabilitation practices in, respectively, a Danish and a Norwegian region, focusing on how the citizens’ rehabilitation needs are met during rehabilitation in the municipalities. Method. Six Danish and five Norwegian cases were followed 12 months after the onset of stroke. Field work and focus group interviews with multidisciplinary teams in the municipalities were conducted. The conceptual frame of the International Classification of Functioning was used to outline general patterns and local variation in the rehabilitation services. Findings. Each of the settings faces different challenges and opportunities in the provision of everyday life-supportive rehabilitation services. Rehabilitation after stroke in both settings basically follows the same guidelines, but the organization of rehabilitation programmes is more specialized in Denmark than in Norway. Team organization, multidisciplinarity, and collaboration to assess and target the patients’ needs characterized the Danish rehabilitation services. Decentralized coordination and monodisciplinary contributions with scarce or unsystematic collaboration were common in the Norwegian cases. Seamless holistic rehabilitation was challenged in both countries, but more notably in Norway. The municipal services emphasized physical functioning, which could conflict with the patients’ needs. Cognitive disturbances to and aspects of activity or participation were systematically addressed by the interdisciplinary teams in Denmark, while practitioners in Norway found that these disturbances were scarcely addressed. Discussion. The study showed major differences in municipal stroke rehabilitation services in the Northern Norway and Central Denmark Regions—in their ability to conduct everyday life—supportive rehabilitation services. Despite the fact that biopsychosocial conceptions of disease and illness, as recommended in the ICF, have been generally accepted, they seemed scarcely implemented in the political and health managerial arenas, especially in Norway. These national diversities can partly be explained by the size of the municipalities and the available health profiles in delivering patient and family-centred rehabilitation services.

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Jeppesen, Charlotte, Helle T. Maindal, Jette K. Kristensen, Per G. Ovesen et Daniel R. Witte. « National study of the prevalence of gestational diabetes mellitus among Danish women from 2004 to 2012 ». Scandinavian Journal of Public Health 45, n^o 8 (23 octobre 2017) : 811–17. http://dx.doi.org/10.1177/1403494817736943.

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Aims: The prevalence of gestational diabetes mellitus (GDM) is increasing worldwide. We studied the prevalence of GDM from 2004 to 2012 in Danish women aged 15–49 years using registries with records of the diagnosis of GDM at delivery. Methods: We conducted a national register-based study of 12,538 women with a diagnosis of GDM during a pregnancy leading to a live birth in the period 2004–2012. The diagnosis of GDM was taken from the National Patient Registry and combined with the total number of births at the national level from Statistics Denmark. Prevalence estimates were reported as crude and age-standardized using Danish and international data for women aged 15–49 years. Results: A total of 566,083 live births was registered in Denmark from 2004 to 2012. The age-standardized prevalence of GDM increased from 1.7% (1095/63,465) of the total births in 2004 to 2.9% (1721/56,894) of the total births in 2012. During the period 2004–2012, the age-stratified prevalence increased from 1.1 to 1.8% among women aged 15–24 years, from 1.5 to 2.6% among women aged 25–34 years and from 2.9 to 4.7% among women aged 35–49 years. The prevalence was higher among immigrants and their descendants than in native Danish women (4.06 and 2.09% in 2007 vs. 4.51 and 2.72% in 2012, respectively). Conclusions:The prevalence of GDM in Denmark has increased across all age groups. Although the prevalence is low on a global scale, attention should be paid to this development by preventive health services.

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Jensen, Andreas, Per Kragh Andersen, John Sahl Andersen, Gorm Greisen et Lone Graff Stensballe. « The match between need and use of health services among healthy under-fives in Denmark : A register-based national cohort study ». PLOS ONE 15, n^o 4 (16 avril 2020) : e0231776. http://dx.doi.org/10.1371/journal.pone.0231776.

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Bloomquist, Kira, Lars H. Tang, Sissel Kjelsbak, Linea L. Hansen et Jan Christensen. « National mapping of municipality-based rehabilitation services for patients recovering from COVID-19 in Denmark : a cross-sectional study ». International Journal of Therapy and Rehabilitation 29, n^o 11 (2 novembre 2022) : 1–11. http://dx.doi.org/10.12968/ijtr.2021.0167.

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Background/aims A lack of knowledge exists as to how municipalities are meeting the rehabilitation needs of patients recovering from COVID-19. This poses a potential barrier when referring patients for rehabilitation. The aim of this study was to map and describe municipality-based rehabilitation services for patients recovering from COVID-19 in Denmark. Methods This was a cross-sectional, nation-wide survey. Key staff members from all 98 municipalities in Denmark were invited to participate. Participants had insight into the organisation and professional content of municipal rehabilitation. Structured telephone interviews were conducted by three interviewers between October and November 2020. The interview guide consisted of items that asked about the availability, content and organisation of municipality-based rehabilitation services. Results A total of 91 municipalities (93% response rate) participated in the study. Rehabilitation could be provided within pre-existing services in 98% of municipalities and 93% systematically assessed individual rehabilitation needs using a variety of measurement methods. All municipalities reported that they had services in place to provide functional rehabilitation (eg gait training) and over 90% provided physical, cognitive and lifestyle-related rehabilitation. In contrast, 70% could provide COVID-19 education and 64% psychological therapy. Overall, 32% of municipalities had not received referrals for COVID-19 rehabilitation. Of the 62 municipalities that had COVID-19 rehabilitation experience, 73% rated the degree to which they could deliver coherent and coordinated rehabilitation for patients with complex rehabilitation needs as high or very high. Conclusions Overall, Danish municipalities reported that pre-existing services are in place to provide relevant, individualised rehabilitation for patients recovering from COVID-19. Nonetheless, future efforts should ensure that patient education is established, in step with health care providers accumulating knowledge, as well as integrated referral pathways between sectors, to deliver rehabilitation to patients with complex needs. Further, implementation of a national data collection strategy would strengthen and inform future development of relevant services both nationally and internationally.

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Saltman, Richard B. « The impact of slow economic growth on health sector reform : a cross-national perspective ». Health Economics, Policy and Law 13, n^o 3-4 (24 janvier 2018) : 382–405. http://dx.doi.org/10.1017/s1744133117000445.

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AbstractThis paper assesses recent health sector reform strategies across Europe adopted since the onset of the 2008 financial crisis. It begins with a brief overview of the continued economic pressure on public funding for health care services, particularly in tax-funded Northern European health care systems. While economic growth rates across Europe have risen a bit in the last year, they remain below the level necessary to provide the needed expansion of public health sector revenues. This continued public revenue shortage has become the central challenge that policymakers in these health systems confront, and increasingly constrains their potential range of policy options. The paper then examines the types of targeted reforms that various European governments have introduced in response to this increased fiscal stringency. Particularly in tax-funded health systems, these efforts have been focused on two types of changes on the production side of their health systems: consolidating and/or centralizing administrative authority over public hospitals, and revamping secondary and primary health services as well as social services to reduce the volume, cost and less-than-optimal outcomes of existing public elderly care programs. While revamping elderly care services also was pursued in the social health insurance (SHI) system in the Netherlands, both the Dutch and the German health systems also made important changes on the financing side of their health systems. Both types of targeted reforms are illustrated through short country case studies. Each of these country assessments flags up new mechanisms that have been introduced and which potentially could be reshaped and applied in other national health sector contexts. Reflecting the tax-funded structure of the Canadian health system, the preponderance of cases discussed focus on tax-funded countries (Norway, Denmark, Sweden, Finland, England, Ireland), with additional brief assessments of recent changes in the SHI-funded health systems in the Netherlands and Germany. The paper concludes that post-2008 European reforms have helped stretch existing public funds more effectively, but seem unlikely to resolve the core problem of inadequate overall public funding, particularly in tax-based health systems. This observation suggests that ongoing Canadian efforts to consolidate and better integrate its health care providers, while important, may not eliminate long-term health sector-funding dilemmas.

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Petersen, Poul Erik, Mette Kjøller, Lisa Bøge Christensen et Ulla Krustrup. « Changing Dentate Status of Adults, Use of Dental Health Services, and Achievement of National Dental Health Goals in Denmark by the Year 2000 ». Journal of Public Health Dentistry 64, n^o 3 (septembre 2004) : 127–35. http://dx.doi.org/10.1111/j.1752-7325.2004.tb02742.x.

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Kjaersgaard, Maiken, Peter Vedsted, Erik Parner, Bodil Bech, Mogens Vestergaard, Kaare Flarup et Morten Fenger-Grøn. « Algorithm linking patients and general practices in Denmark using the Danish National Health Service Register ». Clinical Epidemiology Volume 8 (août 2016) : 273–83. http://dx.doi.org/10.2147/clep.s108307.

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Helweg-Larsen, Karin, Lisbeth B. Knudsen, Markil Gregersen et Jørn Simonsen. « Sudden Infant Death Syndrome (SIDS) in Denmark : Evaluation of the Increasing Incidence of Registered SIDS in the Period 1972 to 1983 and Results of a Prospective Study in 1987 through 1988 ». Pediatrics 89, n^o 5 (1 mai 1992) : 855–59. http://dx.doi.org/10.1542/peds.89.5.855.

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To investigate a reported increase, from 0.4 to 1.3 per thousand live births, in the Danish incidence of sudden infant death syndrome (SIDS), a retrospective analysis of SIDS in Denmark from 1972 to 1983 was carried out. Based on data registered with the National Board of Health, a notable regional difference in SIDS rate between the western and eastern parts of Denmark was found. This difference did not correlate with the overall postneonatal mortality by region. Danish law requires medicolegal investigation in all cases of sudden unexpected death. Medicolegal autopsies are performed only in the three forensic institutes which cover all of Denmark. Despite the law and a uniform organization of the forensic medical services, differing application of postmortem examinations and individual interpretation of the history and autopsy in cases of sudden infant death existed. Differences in reporting of respiratory infections, suffocation, and cardiac malformation were found to contribute to the increase and to regional disparities in SIDS incidence. The three Danish forensic institutes examined all cases of sudden infant deaths in Denmark 1987 and 1988. These cases were classified as explained cause of death, pure SIDS, and atypical SIDS; atypical cases were evaluated by consensus. The SIDS incidence (the number of classic SIDS and atypical SIDS per thousand live births) was 1.9 in 1987 and 1.3 in 1988, and it was identical in the eastern and western part of Denmark; however, a higher incidence both of overall postneonatal and SIDS mortality was found in the middle region of Denmark. The analysis stresses the importance of high autopsy rate and expert investigation in all cases of infant death in order to obtain reliable data for epidemiological studies. A prospective joint study of all postneonatal infant deaths in Finland, Iceland, Norway, Sweden, and Denmark will be carried out to analyze the reliability and the possible cause of reported differences in SIDS incidence in the five Nordic countries.

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Jakobsen, Lykke Schrøder, Christina Jacobsen, Niels Lynnerup, Jacob Steinmetz et Jytte Banner. « Clinical forensic medicine in Eastern Denmark : Organisation and assessments ». Medicine, Science and the Law 60, n^o 2 (24 février 2020) : 150–58. http://dx.doi.org/10.1177/0025802419898338.

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Internationally, clinical forensic medicine (CFM) is diverse in content and conduct, and forensic medical methods are not always evidence based. The first step towards evidence-based practice is to achieve a thorough knowledge of international diversity, which necessitates that CFM practitioners provide information about their national practice. This paper’s aim is to describe the organisation of CFM in Denmark, exemplified by the set-up in Eastern Denmark, and the types of assessments performed. In Denmark, forensic medicine is a board-certified specialty under the health authorities, with mandatory qualifications. The Danish Accreditation Fund accredits the Departments of Forensic Medicine as inspection bodies, according to an international European standard that is approved by Danish Standards. Mainly at police request, forensic doctors perform examinations of both victims and suspected perpetrators of perilous crimes. The examinations’ purposes are documentation and assessment of the findings and collection of biological evidence. The clinical forensic examinations do not include any treatment or medical follow-up. Thus, the forensic doctors must be neutral, objective and impartial. The clinical forensic examinations provide documentation of findings and conclusions not otherwise available for the police investigation and legal aftermath. Moreover, the accredited, standardised protocols ensure that the Departments of Forensic Medicine meet their obligations as inspection bodies, thus ensuring public confidence in the departments’ services.

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Hunter, Stewart. « Provision of care for congenital heart disease in the United Kingdom ». Cardiology in the Young 4, n^o 3 (juillet 1994) : 231–34. http://dx.doi.org/10.1017/s1047951100011100.

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The organization of the national health service in the United Kingdom has been under constant review and revision since its inception after the Second World War. Central government spends £35,894 million each year on the Health Service and it is the country's largest employer. Total health expenditure in the United Kingdom accounts for 6.1% of the Gross Domestic Product. This apparently compares unfavorably with 12.4% total health expenditure in the United States.States. However the public health expenditure is identical in the two countries, 5.2%, and this figure is similar in most developed countries including Australia, Denmark, Spain and Switzerland. The overall regional administration of the Health Service in England (Scotland, Wales and Northern Ireland have slightly different organizations) is well established, although the names of the different strata of administration change from time to time. The Secretary of State for Health oversees the Department of Health including the National Health Service Management Executive. Under this Management Executive are 14 Regional Health Authorities covering 100% of the total population.There are within the London area several Special Health Authorities set up in the past because of the particular expertise which they provided. These are under review and will almost certainly lose their special status in the future because of the improvements and increase in services nationwide. The Regional Health Authorities have under their care 177 District Health Authorities and 90 Family Health Service Authorities.They do not manage the National Health Service Trusts—a new development which allows hospitals and other organizations within the Health Service to work autonomously to provide NHS services.

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Lindhardt, A., A. Køster, M. Lajer et B. Rosenbaum. « Danish national schizophrenia project. Psychiatric service development in Denmark during the course of DNS ». European Psychiatry 23 (avril 2008) : S49—S50. http://dx.doi.org/10.1016/j.eurpsy.2008.01.180.

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Qin, Ping, Keith Hawton, Preben Bo Mortensen et Roger Webb. « Combined effects of physical illness and comorbid psychiatric disorder on risk of suicide in a national population study ». British Journal of Psychiatry 204, n^o 6 (juin 2014) : 430–35. http://dx.doi.org/10.1192/bjp.bp.113.128785.

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BackgroundPeople with physical illness often have psychiatric disorder and this comorbidity may have a specific influence on their risk of suicide.AimsTo examine how physical illness and psychiatric comorbidity interact to influence risk of suicide, with particular focus on relative timing of onset of the two types of illness.MethodBased on the national population of Denmark, individual-level data were retrieved from five national registers on 27 262 suicide cases and 468 007 gender- and birth-date matched living controls. Data were analysed using conditional logistic regression.ResultsBoth suicides and controls with physical illness more often had comorbid psychiatric disorder than their physically healthy counterparts. Although both physical and psychiatric illnesses constituted significant risk factors for suicide, their relative timing of onset in individuals with comorbidity significantly differentiated the associated risk of suicide. While suicide risk was highly elevated when onsets of both physical and psychiatric illness occurred close in time to each other, regardless which came first, psychiatric comorbidity developed some time after onset of physical illness exacerbated the risk of suicide substantially.ConclusionsSuicide risk in physically ill people varies substantially by presence of psychiatric comorbidity, particularly the relative timing of onset of the two types of illness. Closer collaboration between general and mental health services should be an essential component of suicide prevention strategies.

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Asmussen, Ida Helene, et Katharina Eva Ó Cathaoir. « Making Access to a Population of Bodies in the Name of Autonomy ». European Journal of Health Law 25, n^o 5 (15 novembre 2018) : 555–72. http://dx.doi.org/10.1163/15718093-12550402.

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AbstractDevelopments within biotechnology are of a pace and complexity that challenge the predictability at the foundation of legislation, i.e. the possibility for politicians to foresee pitfalls and hazards, and design legislation accordingly. The lack of predictability is not only a challenge for the legislature, but also for the citizen, who is to consent to the new biotech services offered by the health authorities. How can one give informed consent to a measure, the consequences of which is hard to predict? Does the uncertainty and lack of predictability mean that paternalism has slipped back in as a ‘self-selected’ responsiveness to the rhetoric of the health regime? Recently, Denmark has taken another step in the direction of voiding autonomy of actual value by rendering genetic analysis contingent on agreeing that the resulting data may be stored in the recently established National Genome Centre, and reused for research unless the patient opts out.

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Prior, Anders, Claus Høstrup Vestergaard, Anette Riisgaard Ribe, Annelli Sandbæk, Flemming Bro, Peter Vedsted, Susan Smith, Mogens Vestergaard et Morten Fenger-Grøn. « Chronic care services and variation between Danish general practices : a nationwide cohort study ». British Journal of General Practice 72, n^o 717 (29 novembre 2021) : e285-e292. http://dx.doi.org/10.3399/bjgp.2021.0419.

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BackgroundLittle is known about variations in the provision of chronic care services in primary care.AimTo describe the frequency of chronic care services provided by GPs and analyse the extent of non-random variation in service provision.Design and settingNationwide cohort study undertaken in Denmark using data from 2016.MethodInformation on chronic care services was obtained from national health registers, including annual chronic care consultations, chronic care procedures, outreach home visits, and talk therapy. The associations between services provided, patient morbidity, and socioeconomic factors were estimated. Service variations were analysed, and excess variation related to practice-specific factors was estimated while accounting for random variation.ResultsChronic care provision was associated with increasing patient age, increasing number of long-term conditions, and indicators of low socioeconomic status. Variation across practices ranged from 1.4 to 128 times more than expected after adjusting for differences in patient population and random variation. Variation related to practice-specific factors was present for all the chronic care services that were investigated. Older patients with lower socioeconomic status and multimorbidity were clustered in practices with low propensity to provide certain chronic care services.ConclusionChronic care was provided to patients typically in need of health care, that is, older adults, those with multimorbidity, and those with low socioeconomic status, but service provision varied more than expected across practices. GPs provided slightly fewer chronic care services than expected in practices where many patients with multimorbidity and low socioeconomic status were clustered, suggesting inverse care law mechanisms.

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Dürr, Dorte Wiwe, et Anita Lunde. « Complementary and alternative medicine (CAM) in Danish residential homes for people with severe mental illness : Use and perceived benefits of CAM in relation to recovery ». International Journal of Social Psychiatry 66, n^o 5 (11 mai 2020) : 489–95. http://dx.doi.org/10.1177/0020764020919485.

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Background and Aim: Mental health services in Denmark offer various rehabilitative treatment interventions to people with severe mental illness. Complementary and Alternative Medicine (CAM) such as National Acupuncture Detoxification Association (NADA) ear acupuncture are used as rehabilitative interventions. We investigated the use of CAM in four psychiatric residential homes, and whether CAM supports residents’ rehabilitation and personal recovery. Methods: Residents in four selected residential homes participated in a questionnaire study, which elicited information on the use of CAM offered in a residential home setting. The study was conducted from February to November 2017. Recovery scores were assessed using the Mental Health Recovery Measure (MHRM). Results: Of 131 eligible respondents, 68 (52%) participated. CAM was used by 84% of the residents. NADA ear acupuncture (38%) and music therapy (37%) were the most commonly used types of CAM. Conclusions: CAM is a commonly used rehabilitative intervention and more than 50% receiving treatment with CAM believed that it has supported their recovery process.

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Pedersen, Lasse, Roland Valori, Inge Bernstein, Karen Lindorff-Larsen, Charlotte Green et Christian Torp-Pedersen. « Risk of post-colonoscopy colorectal cancer in Denmark : time trends and comparison with Sweden and the English National Health Service ». Endoscopy 51, n^o 08 (7 juin 2019) : 733–41. http://dx.doi.org/10.1055/a-0919-4803.

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Abstract Background The post-colonoscopy colorectal cancer (PCCRC) rate is a key quality indicator for colonoscopy. Previously published PCCRC rates have been difficult to compare owing to differences in methodology. The primary aim of this study was to compare Danish PCCRC rates internationally and to calculate Danish PCCRC rates using the World Endoscopy Organization (WEO) consensus method for future comparison. The secondary aim was to identify factors associated with PCCRC. Methods National registries were used to examine the risk of PCCRC. The Danish 3-year rate of PCCRC (PCCRC-3yr) was calculated using previously published methods from England, Sweden, and the WEO. Poisson regression analysis was performed to identify factors associated with PCCRC. Results The Danish PCCRC-3yr was significantly higher than the rate in the English NHS (relative risk [RR] 1.12, 95 % confidence interval [CI] 1.05 – 1.19) and Sweden (RR 1.15, 95 %CI 1.06 – 1.24). The Danish PCCRC-3yr based on the WEO consensus method fell from 22.5 % in 2001 to 7.9 % in 2012. The multivariable Poisson regression model found PCCRC to be significantly associated with diverticulitis (RR 3.25, 95 %CI 2.88 – 3.66), ulcerative colitis (RR 3.44, 95 %CI 2.79 – 4.23), hereditary cancer (age < 60 years: RR 7.39, 95 %CI 5.77 – 9.47; age ≥ 60 years: RR 3.81, 95 %CI 2.74 – 5.31), and location in the transverse (RR 1.57, 95 %CI 1.28 – 1.94) and ascending colon (RR 1.85, 95 %CI 1.64 – 2.08). Conclusions The PCCRC-3yr was higher in Denmark than in comparable countries. Differences in colonoscopist training, background, and certification are possible contributing factors. A review of colonoscopist training and certification in Denmark, and continuous audit and feedback of colonoscopist performance may reduce PCCRC-3yr.

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Marti-Castaner, Maria, Camila Hvidtfeldt, Sarah Fredsted Villadsen, Bjarne Laursen, Trine Pagh Pedersen et Marie Norredam. « Disparities in postpartum depression screening participation between immigrant and Danish-born women ». European Journal of Public Health 32, n^o 1 (2 décembre 2021) : 41–48. http://dx.doi.org/10.1093/eurpub/ckab197.

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Abstract Background Qualitative studies suggest that immigrant women experience barriers for postpartum depression (PPD) screening. This study examines the prevalence of participation in PPD screening in the universal home-visiting programme in Denmark, in relation to migrant status and its association with acculturation factors, such as length of residence and age at migration. Methods The sample consists of 77 694 births from 72 292 mothers (2015–18) that participated in the programme and were registered in the National Child Health Database. Lack of PPD screening using the Edinburgh Postpartum Depression Scale (EPDS) was examined in relation to migrant group and acculturation factors. We used Poisson regression with cluster robust standard errors to estimate crude and adjusted relative risk. Results In total, 27.8% of Danish-born women and 54.7% of immigrant women lacked screening. Compared with Danish-born women, immigrant women in all groups were more likely to lack PPD screening (aRR ranging from 1.81 to 1.90). Women with low acculturation were more likely to lack screening. Women who migrated as adults [aRR = 1.27 (95% CI 1.16, 1.38)] and women who had resided in Demark for <5 years [aRR = 1.37 (95% CI 1.28, 1.46)] were more likely to lack screening. Conclusions Immigrant women in Denmark, particularly recent immigrants, are at increased risk of not being screened for PPD using the EPDS. This can lead to under-recognition of PPD among immigrant women. More work is needed to understand how health visitors recognize the mental health needs of immigrant women who are not screened, and whether this gap results in reduced use of mental health services.

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Scavenius, Christoffer, Anil Chacko, M. R. Lindberg, Megan Granski, M. M. Vardanian, Maiken Pontoppidan, Helle Hansen et Misja Eiberg. « Parent Management Training Oregon Model and Family-Based Services as Usual for Behavioral Problems in Youth : A National Randomized Controlled Trial in Denmark ». Child Psychiatry & ; Human Development 51, n^o 5 (23 juillet 2020) : 839–52. http://dx.doi.org/10.1007/s10578-020-01028-y.

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Lyngsøe, Bente K., Dorte Rytter, Trine Munk-Olsen, Claus H. Vestergaard, Kaj S. Christensen et Bodil H. Bech. « Maternal depression and primary healthcare use for children : a population-based cohort study in Denmark ». British Journal of General Practice 69, n^o 680 (17 décembre 2018) : e182-e189. http://dx.doi.org/10.3399/bjgp18x700733.

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BackgroundDepression is a common mental illness worldwide. The offspring of a mother with depression has higher risk of developing mental and physical illness.AimThis study aimed to investigate the association between the timing of maternal depression and the use of primary health care for the offspring.Design and settingA population-based birth cohort study in Danish primary care using Danish national registers.MethodAll Danish children born between 1 January 2000 and 31 December 2013 (n = 869 140 children) were included in the study. The primary outcome was number and type of annual contacts with the GP. The secondary outcome was specific services used by the GP to assess inflammatory and infectious disease in the children. Exposure was maternal depression of four categories: non-depressed, recent, previous, and past depression. The association was expressed as adjusted incidence rate ratios (IRR) with 95% confidence intervals (CI).ResultsMaternal depression was associated with a higher use of primary health care for all three categories of depression. The strongest association was found for children of a mother with recent depression; they had 16% more contacts than children of a non-depressed mother (adjusted IRR = 1.16, 95% CI = 1.15 to 1.17), and 19–24% more positive infectious-related tests were found in this group.ConclusionExposure to maternal depression was associated with a significantly higher use of primary health care for the offspring for all exposure categories. These findings reveal that healthcare use is higher for the offspring exposed to maternal depression, even several years after expected remission. The higher ratio of positive tests indicates that exposed children are ill with infectious disease more often.

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Golubeva, Elena, et Anastasia Emelyanova. « Local community practices to improve healthy aging in the North ». Magyar Gerontológia 13 (29 décembre 2021) : 25–26. http://dx.doi.org/10.47225/mg/13/kulonszam/10575.

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The governments of Finland, Denmark, Norway and Russia have developed national programs to address population ageing. There are also successful practices in healthy ageing at the local level in different countries, but they remain unknown among the global professional community and governmental authorities. Healthy ageing has become an important policy issue at all levels of the society. The key international document is the World Health Organization’s (WHO) plan for a Decade of Healthy Ageing 2020–2030 which is the second action plan of the WHO ‘s Global strategy on ageing and health. The Plan consists of 10 years of concerted, catalytic, sustained collaboration to improve the lives of older people, their families, and their communities. Older people themselves are in the core of this plan, and it brings together variety of actors, including governments, civil society, international agencies, professionals, academia, the media, and the private sector. The Plan also notes that healthy ageing is not only a healthcare issue but also needs to engage many other sectors. The aim of research was to search and introduce local community practices according the priority areas of WHO Decade of Healthy Aging action plan for gerontological policy in arctic countries. Examples of good practices for the Priority 1 of the Plan: Change how we think, feel and act towards age and ageing Fostering of Healthy Ageing requires fundamental shifts from existing stereotypes, prejudices, and discrimination towards older people. Older people should not be seen only as an economic burden for the welfare society, but as contributors to the state and communities, and as resourceful carriers of traditional values and wisdom. Governments eliminate age discrimination by variety of actions, such as legislative changes, and policies and programs which engage older people in decision-making. Initiatives for Priority 2 of the Plan: Ensure that communities foster the abilities of older people The environments which are built on decisions made not only by policy makers but involve citizens of all ages are better places to grow, play, live, work and retire. Even those people who have lost their capacity, shall be able to continue to enjoy everyday activities, to continue to develop personally and professionally, to participate and contribute to their communities while retaining their autonomy, dignity, health, and well-being. Practices for Priority 3 of the Plan: Deliver person-centered, integrated care and primary health services to older people Good-quality essential health services include prevention of diseases; promotion of healthy lifestyle; curative, rehabilitative, palliative and end-of-life care; safe, effective, good-quality essential medicines and vaccines; dental care; assistive technologies, while ensuring that the use of services does not cause the user financial hardship. Local northern practices are mirrored against the recently released WHO Decade of Healthy Ageing 2020-2030 Action Plan with paying attention to indigenous elders. Based on these practices the national, regional, and municipal level authorities of the Nordic countries and Russia were suggested to consider the policy recommendations based of the research.

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Vadstrup, Kasper, Sarah Alulis, Andras Borsi, Nina Gustafsson, Agnete Nielsen, E. Christina M. Wennerström, Tine Rikke Jørgensen, Niels Qvist et Pia Munkholm. « Cost Burden of Crohn’s Disease and Ulcerative Colitis in the 10-Year Period Before Diagnosis—A Danish Register-Based Study From 2003–2015 ». Inflammatory Bowel Diseases 26, n^o 9 (4 novembre 2019) : 1377–82. http://dx.doi.org/10.1093/ibd/izz265.

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Abstract Background The diagnostic delay in inflammatory bowel disease (IBD) is well known, yet the costs associated with diagnoses before IBD diagnosis have not yet been reported. This study explored societal costs and disease diagnoses 10 years before Crohn’s disease (CD) and ulcerative colitis (UC) diagnosis in Denmark. Methods This national register study included patients diagnosed between 2003 and 2015 identified in the Danish National Patient Registry (NPR) and controls who were individually matched on age and sex from the general population. Societal costs included health care services, prescription medicine, home care services, and labor productivity loss. Prediagnostic hospital contact occurring before CD or UC diagnosis was identified using the NPR. Average annual costs per individual were calculated before the patient’s first CD or UC diagnosis. A 1-sample t test was then applied to determine significance in differences between cases and controls. Results Among CD (n = 9019) and UC patients (n = 20,913) the average societal costs were higher throughout the entire 10-year period before the diagnosis date compared with the general population. The difference increased over time and equaled €404 for CD patients and €516 for UC patients 10 years before diagnosis and €3377 and €2960, respectively, in the year before diagnosis. Crohn’s disease and UC patients had significantly more diagnoses before their CD and UC diagnosis compared with the general population. Conclusions Compared with the general population, the societal costs and number of additional diagnoses among CD and UC patients were substantially higher in the 10-year period before diagnosis.

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ALULIS, S., K. Vadstrup, A. Borsi, S. Elkjær Stallknecht, J. Olsen, T. Rikke Jørgensen, C. Wennerström, N. Qvist et P. Munkholm. « P798 Societal costs attributable to Crohn’s disease and ulcerative colitis within the first 5 years after diagnosis : –a Danish Nationwide Cost-of-Illness Study 2003–2015 ». Journal of Crohn's and Colitis 14, Supplement_1 (janvier 2020) : S627. http://dx.doi.org/10.1093/ecco-jcc/jjz203.926.

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Abstract Background There is little information on cost-of-illness among patients diagnosed with Crohn’s disease (CD) and ulcerative colitis (UC) in Denmark. The objective of this study was to estimate the average 5-year societal costs attributable to CD or UC including costs related to health care, prescription medicine, home care, and production loss. Methods Incident patients with CD or UC were identified in the National Patient Registry and matched with a non-IBD control from the general population on age and sex. Attributable costs were estimated applying a difference-in-difference approach, where the total costs among individuals in the control group were subtracted from the total costs among patients. Information on primary and secondary healthcare services were obtained from the National Health Insurance Service Registry. Results CD and UC incidence was approximately 14 and 31 per 100,000 persons-years, respectively. Average attributable costs were highest the first year after diagnosis, with costs equalling €12,919 per CD patient and €6,501 per UC patient. Hospital admission costs accounted for 36% in the CD population and 31% in the UC population, the first year after diagnosis. Production loss exceeded all other costs the third year after diagnosis. Conclusion We found that the societal costs attributable to incident CD and UC patients are substantial compared with the general population, primarily consisting of hospital admission costs and production loss. Appropriate treatment at the right time may be beneficial from a societal perspective.

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Deidda, Manuela, Laura Coll-Planas, Maria Giné-Garriga, Míriam Guerra-Balic, Marta Roqué i Figuls, Mark A. Tully, Paolo Caserotti et al. « Cost-effectiveness of exercise referral schemes enhanced by self-management strategies to battle sedentary behaviour in older adults : protocol for an economic evaluation alongside the SITLESS three-armed pragmatic randomised controlled trial ». BMJ Open 8, n^o 10 (octobre 2018) : e022266. http://dx.doi.org/10.1136/bmjopen-2018-022266.

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IntroductionPromoting physical activity (PA) and reducing sedentary behaviour (SB) may exert beneficial effects on the older adult population, improving behavioural, functional, health and psychosocial outcomes in addition to reducing health, social care and personal costs. This paper describes the planned economic evaluation of SITLESS, a multicountry three-armed pragmatic randomised controlled trial (RCT) which aims to assess the short-term and long-term effectiveness and cost-effectiveness of a complex intervention on SB and PA in community-dwelling older adults, based on exercise referral schemes enhanced by a group intervention providing self-management strategies to encourage lifestyle change.Methods and analysisA within-trial economic evaluation and long-term model from both a National Health Service/personal social services perspective and a broader societal perspective will be undertaken alongside the SITLESS multinational RCT. Healthcare costs (hospitalisations, accident and emergency visits, appointment with health professionals) and social care costs (eg, community care) will be included in the economic evaluation. For the cost-utility analysis, quality-adjusted life-years will be measured using the EQ-5D-5L and capability well-being measured using the ICEpop CAPability measure for Older people (ICECAP-O) questionnaire. Other effectiveness outcomes (health related, behavioural, functional) will be incorporated into a cost-effectiveness analysis and cost-consequence analysis.The multinational nature of this RCT implies a hierarchical structure of the data and unobserved heterogeneity between clusters that needs to be adequately modelled with appropriate statistical and econometric techniques. In addition, a long-term population health economic model will be developed and will synthesise and extrapolate within-trial data with additional data extracted from the literature linking PA and SB outcomes with longer term health states.Methods guidance for population health economic evaluation will be adopted including the use of a long-time horizon, 1.5% discount rate for costs and benefits, cost consequence analysis framework and a multisector perspective.Ethics and disseminationThe study design was approved by the ethics and research committee of each intervention site: the Ethics and Research Committee of Ramon Llull University (reference number: 1314001P) (Fundació Blanquerna, Spain), the Regional Committees on Health Research Ethics for Southern Denmark (reference number: S-20150186) (University of Southern Denmark, Denmark), Office for Research Ethics Committees in Northern Ireland (ORECNI reference number: 16/NI/0185) (Queen’s University of Belfast) and the Ethical Review Board of Ulm University (reference number: 354/15) (Ulm, Germany). Participation is voluntary and all participants will be asked to sign informed consent before the start of the study.This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement number 634 270. This article reflects only the authors' view and the Commission is not responsible for any use that may be made of the information it contains.The findings of the study will be disseminated to different target groups (academia, policymakers, end users) through different means following the national ethical guidelines and the dissemination regulation of the Horizon 2020 funding agency.Use of the EuroQol was registered with the EuroQol Group in 2016.Use of the ICECAP-O was registered with the University of Birmingham in March 2017.Trial registration numberNCT02629666; Pre-results.

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Skorstad, Mette, Belle H. de Rooij, Mette Moustgaard Jeppesen, Stinne Holm Bergholdt, Nicole Paulina Maria Ezendam, Tonje Bohlin, Pernille Tine Jensen, Kristina Lindemann, Lonneke van de Poll et Ingvild Vistad. « Self-management and adherence to recommended follow-up after gynaecological cancer : results from the international InCHARGE study ». International Journal of Gynecologic Cancer 31, n^o 8 (15 avril 2021) : 1106–15. http://dx.doi.org/10.1136/ijgc-2020-002377.

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ObjectiveTo assess the relationship between self-management skills and adherence to follow-up guidelines among gynecological cancer survivors in the Netherlands, Norway, and Denmark, and to assess the relationship between adherence to follow-up programs and use of additional healthcare services.MethodsFor this international, multicenter, cross-sectional study, we recruited gynecological cancer survivors 1–5 years after completion of treatment. Information on follow-up visits, use of healthcare resources, self-management (measured by the Health Education Impact Questionnaire), clinical characteristics, and demographics were obtained by validated questionnaires. Participants were categorized as adherent if they attended the number of follow-up visits recommended by national guidelines, non-adherent if they had fewer visits than recommended, or over-users if they had more visits than recommended.ResultsOf 4455 invited survivors, 2428 (55%) returned the questionnaires, and 911 survivors were included in the analyses. Survivors with high self-management most frequently adhered to recommended follow-up. Non-adherent survivors showed lower self-management in the health-directed activity domain (OR 1.54, 95% CI 1.03 to 2.32) than adherent survivors. No other associations between self-management and follow-up adherence were revealed. Non-adherent survivors tended to have endometrial cancer, surgical treatment only, be older, and be Danish residents. Over-users reported more follow-up visits and also used additional healthcare services more frequently than adherent survivors.ConclusionLow self-management appears to reduce the likelihood of adherence to national guidelines for gynecological cancer follow-up. Focusing on patient education for survivors at risk of low self-management to ensure adherence to recommended follow-up may improve personalization of follow-up.

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Taggiasco, Nadine, Bernard Sarrut et Christian G. Doreau. « European Survey of Independent Drug Information Centers ». Annals of Pharmacotherapy 26, n^o 3 (mars 1992) : 422–28. http://dx.doi.org/10.1177/106002809202600318.

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OBJECTIVE: The purpose of our survey was to ascertain the activities of the independent drug information centers (DICs) in Europe and to contact the person in charge of these services to establish a European network of DICs in the future. DATA SOURCES: The survey was conducted in 32 European countries. We contacted 2026 people in DICs and official healthcare organizations by mail. On request, we returned our questionnaire including 167 closed questions on the means and activities of a DIC. Data were collected and analyzed on a personal computer using dBASE III PLUS (Ashton-Tate). RESULTS: Of the 110 questionnaires received, 88 answered the question pertaining to the number of queries asked of the DIC per year and were analyzed (1 from West Germany, Denmark, Finland, Sweden, Portugal, Poland; 2 from Italy; 3 from Switzerland; 6 from Spain; 8 from The Netherlands; 16 from France; and 47 from the United Kingdom). We recorded data on their location, their means (e.g., staff, information), their users (e.g., health professionals), and activities. CONCLUSIONS: The DICs were located in healthcare structures, managed by pharmacists or physicians, and open to other health professionals. Only the United Kingdom maintains a national organized network. Most of the participants showed interest in cooperating with each other to establish a list of the centers, guidelines on good information practices, a database, and a European network.

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Blakø, Mitti. « Characteristics of citizens with repeated calls within 48 hours to the Medical helpline 1813 ». Dansk Tidsskrift for Akutmedicin 2, n^o 3 (30 avril 2019) : 42. http://dx.doi.org/10.7146/akut.v2i3.112984.

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Background: In the Capital Region of Denmark, the Medical helpline 1813 is integrated in the Emergency Medical Services, where citizens are triaged to receive face-to-face consultation (e.g. emergency department) or telephone consultation. Approximately 4,0 % of the calls received are repeated calls < 48 hours, representing citizens with progression in symptoms or an unmet need for help during the initial call, witch potentially may lead to delay in triage to face-to-face consultation, examination and treatment. We aimed to identify differences in sociodemographic and health related characteristics between citizens performing single calls compared to citizens performing repeated calls < 48 hours. Methods: The authors used data from the prospective observational Degree-of-worry study, conducted from the Medical Helpline 1813 from 18 January - 9 February 2017, including citizens performing single calls (n=11.131) and citizens performing repeated calls (n=464), defined by < 48 hours between calls. Information on callers were collected from the Medical Helpline electronic records, Statistic Denmark Registers and the National Patient Register. Self-reported characteristics as self-rated health (SRH scale 1-5) and Degree of worry concerning the actual situation (DOW on scale 1-3) were collected at the initial call. The authors performed logistic regression analyses, calculating Odds Ratio (OR) and 95% Confidence Intervals (CI). Results: Seven variables were significantly associated with repeated callers: Age > 65 OR=1.58 (95% CI=1.18-2.10), immigrants OR=1.41 (95% CI=1.03-1.93), annual income in highest quartiles OR=0.69 (95% CI=0.54-0.89), high DOW OR=1.33 (95% CI=1.06-1.66), pore SRH OR=1.64 (95% CI=1.21-2.21) and > 2 comorbidities OR=1.66 (95% CI=1.26-2.19). Gender and time of call were not significantly associated with repeated callers. The significant association remained in analyses adjusted for age and gender. In the mutual adjusted analyzes the disproportions decreases. Conclusion: Results identify disproportions between repeated callers and single callers in characteristics related to age, immigrants, income, comorbidities and the self-rated variables SRH and DOW. This indicates that these characteristics potentially could be determinants for a delay in a face-to-face examination and treatment for citizens performing repeated calls. However, these disproportions are decreased in the mutual adjusted analyzes, indicating that sociodemographic and health related characteristics have a reinforcing effect.

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Solhjell, Randi. « Practices in Multiagency Collaboration against Violent Extremism at the City Level : Nordic Approaches ». Proceedings 77, n^o 1 (27 avril 2021) : 13. http://dx.doi.org/10.3390/proceedings2021077013.

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In the Nordic countries, prevention of radicalization and violent extremism is based on an existing crime prevention collaboration. The core tenet of crime prevention approaches is that early radicalization prevention is best organized as a joint effort, where individual cases are assessed holistically and relevant information shared. This presentation is based on Nordic comparative research that provides a critical analysis of policies, perceptions, and practices regarding multiagency approaches. At the city level, we systematically explore how core components of a Nordic governance model contribute to and might be preconditions for effective multiagency collaboration and secure societies. Variations in these city-level approaches lead to an important question: do these various multiagency approaches to countering violent extremisms and radicalization constitute a unified model? The project provides an informed platform for spreading Nordic experiences and models of governance to other countries in the area of radicalization prevention and countering violent extremism. The multiagency collaboration in Nordic cities tends to be composed of a smaller number of professionals, e.g., three to eight, representing social and health services, a coordinator, and the police. Their positions vary; some represent leadership in the municipality, others are positioned at more mid-level management, and others are frontline professionals handling clients on a daily basis. The origin of these collaborative efforts is based on the School, Social and health services, and Police framework (SSP) in Denmark, Norway, and the Ankkuri group in Finland. We assert that future efforts can also be more need-based, comprising municipal/local initiatives with an element of the guiding national policies, and include the legal frameworks to guide professionals on ethical issues like confidentiality. This presentation is part of a larger project entitled “Nordic Multiagency Approaches to Handling Extremism: Policies, Perceptions, and Practices”, led by professor and center director Tore Bjørgo (University of Oslo) and is funded by NordForsk (Nordic Council of Minister), 2018–2021.

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Al-Sheikh, M., J. Olsen, M. Spangaard, P. Egedesø, C. Peters-Lehm, E. Fjordside, M. Bennedsen, J. Burisch et P. Munkholm. « P140 Costs of home-monitoring by telemedicine versus standard care management of Inflammatory Bowel Disease – a Danish register-based five-year follow-up study ». Journal of Crohn's and Colitis 17, Supplement_1 (30 janvier 2023) : i302—i303. http://dx.doi.org/10.1093/ecco-jcc/jjac190.0270.

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Abstract Background The increasing incidence of Inflammatory bowel diseases (IBD) with subsequent increasing use of costly biological treatments such as well as the need for tight control of IBD places a significant economic direct and indirect cost burden on health care systems. Thus, eCare Constant-Care APP, home-monitoring of Patient Reported Outcome (PROs-SCCAI/HB-I, quality of life QoL, Disability index WEB-DI) and calprotectin (POCT-Point of Care Test) was introduced at North Zealand Hospital (NOH) in Denmark in 2015. The aim of this study was to assess long-term cost effectiveness of remote telemedicine services (eCare) compared to standard care (sCare) for IBD patients during 5 years follow-up. Methods A retrospective register-based study was carried out among patients with ulcerative colitis (UC) or Crohn’s disease (CD) continuously included in the telemedicine service Constant Care (CC) in 2015-2020. Direct and indirect healthcare costs over a 5-year period were obtained from Danish registers and compared to a control group of IBD patients from all five regions in Denmark who were 1:5 matched on year of birth, gender, education, income, disease, use of biologics, duration of disease and Charlson Comorbidity index. The IBD patients (cases and controls) were identified in the National Patient Register (NPR) via registered ICD-10 diagnosis codes. Direct and indirect costs were estimated on a yearly basis from two years before inclusion in CC (i.e., the index year) and five years after using a linear regression model. Results A total of 572 IBD patients were included in the study. Average annual costs of IBD-related outpatient visits were significantly (P<.005) higher among patients enrolled in CC compared to controls before and after index date whereas costs of hospital admissions were non-significant (ns). However, a slight decrease was observed in year 2 and 5 from index year (ns). The total direct costs were higher among CC patients compared to controls in the year prior to enrollment in CC and the five years after (Figure 1) primarily driven by the costs of outpatient visits. Significantly (P<.05) fewer CC patients were on early retirement compared to controls and CC patients received less public transfer payments compared to controls (ns). Conclusion Telemedicine care was associated with higher cost than standard care. One potential confounder is inefficient out-patient registration in NRP which highlights the need for continuous validation of clinical registration approaches in Denmark. A prospective RCT is warranted in future.

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Bath, Philip MW, Jason P. Appleton, Maia Beridze, Hanne Christensen, Robert A. Dineen, Lelia Duley, Timothy J. England et al. « Baseline characteristics of the 3096 patients recruited into the ‘Triple Antiplatelets for Reducing Dependency after Ischemic Stroke’ trial ». International Journal of Stroke 12, n^o 5 (4 novembre 2016) : 524–38. http://dx.doi.org/10.1177/1747493016677988.

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Background The risk of recurrence following ischemic stroke or transient ischemic attack is highest immediately after the event. Antiplatelet agents are effective in reducing the risk of recurrence and two agents are superior to one in the early phase after ictus. Design The triple antiplatelets for reducing dependency after ischemic stroke trial was an international multicenter prospective randomized open-label blinded-endpoint trial that assessed the safety and efficacy of short-term intensive antiplatelet therapy with three agents (combined aspirin, clopidogrel and dipyridamole) as compared with guideline treatment in acute ischemic stroke or transient ischemic attack. The primary outcome was stroke recurrence and its severity, measured using the modified Rankin Scale at 90 days. Secondary outcomes included recurrent vascular events, functional measures (cognition, disability, mood, quality of life), and safety (bleeding, death, serious adverse events). Data are number (%) or mean (standard deviation, SD). Results Recruitment ran from April 2009 to March 2016; 3096 patients were recruited from 106 sites in four countries (Denmark 1.6%, Georgia 2.7%, New Zealand 0.2%, UK 95.4%). Randomization characteristics included: age 69.0 (10.1) years; male 1945 (62.8%); time onset to randomization 29.4 (11.9) h; stroke severity (National Institutes for Health Stroke Scale) 2.8 (3.6); blood pressure 143.5 (18.2)/79.5 (11.4) mmHg; IS 2143 (69.2%), transient ischemic attack 953 (30.8%). Conclusion Triple antiplatelets for reducing dependency after ischemic stroke was a large trial of intensive/triple antiplatelet therapy in acute ischemic stroke and transient ischemic attack, and included participants from four predominantly Caucasian countries who were representative of patients in many western stroke services.

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Dotsenko, Tetiana, et Svitlana Kolomiiets. « Bibliometric analysis of research of the behavioral and social dimension of the public health system of the world ». SocioEconomic Challenges 6, n^o 3 (2022) : 97–106. http://dx.doi.org/10.21272/sec.6(3).97-106.2022.

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The paper emphasizes the importance of human health as the most valuable, most important resource at the individual and national level, affecting the country’s socio-economic development and competitiveness. It states that it is necessary for the actors ensuring the public health system to form a new concept for the functioning of the health system, taking into account the current state of public health, the functioning of medical institutions, and the resource support of the healthcare industry. The primary purpose is to conduct a bibliometric analysis of scientific publications dealing with the global behavioral and social dimension of the public health system. The systematization of literary achievements and approaches to solving this problem has been carried out, which indicates the need for proper attention and high-quality, conceptual, international research by world scientists on issues related to the state and level of public health, satisfaction with the healthcare system. The relevance of the analysis of research on the behavioral and social dimension of the public health system of the world implies that the further development of the healthcare industry necessitates research, intensive development, and dissemination of available scientific and methodological international experience in solving this issue of the public health system in different countries worldwide. The research consisted of four stages. A map of the interrelationships of key concepts with other scientific categories has been constructed; a content-contextual study of the constructed blocks of bibliometric analysis has been implemented; an inter-cluster analysis has been carried out. A map of the interrelationships of the key concepts under study with other scientific categories has been constructed, reflecting the dynamics in the form of a contextual-time block; the evolutionary-time prospects of the study have been determined. A geographically extensive map of the scientific bibliography of the categories under study has been constructed; the spatial component of the study has been analyzed. A territorially branched map of the spatio-temporal dimension of the category under the study in dynamics has been constructed. The methodological tools of the research are theoretical (grouping, abstraction, synthesis) and empirical methods (observation, description), research methods, services of the Scopus information platform, and VOSViewers tools.1.6.15. The study was conducted based on the publications indexed by the Scopus database for 2000-2020. The objects of research were the following scientific categories: “health care system, medical services, behavioral aspect, social aspect,” the countries United States, Germany, Norway, Greece, United Kingdom, Australia, Canada, India, Netherlands, China, Brazil, Switzerland, Denmark, Belgium, Iran, Japan, Italy, Spain, because these two groups of objects allowed to conduct two-directional analysis of the problem under study. The results of the bibliometric analysis presented in the paper showed that the aspect of the behavioral and social dimension of the public health system was relatively young and insufficiently developed; the attention of the scientific community for a long time on this issue was mainly concentrated in the United States and the United Kingdom. China, Iran, and Japan were less involved in this process at an earlier time interval, but this research became relevant for them in recent years. The study results can be used to identify the most potential priority areas for forming the policy and strategy of the state health system, based on determining the main significant, modern, relevant characteristics of the healthcare industry.

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Cvancarova, Milada, Olafur G. Jonsson, Henrik Schroder, Mikko Perkkio, Goran Gustafsson et Finn Wesenberg. « Trends in survival of childhood solid tumors diagnosed 1985-2008 in the Nordic countries. » Journal of Clinical Oncology 30, n^o 15_suppl (20 mai 2012) : 9590. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.9590.

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9590 Background: Classification of childhood solid tumors differs greatly from tumors diagnosed in adults. Thus establishment of childhood cancer registries is essential to monitor changes and progress in cancer care. Methods: All individuals born in the Nordic countries are allocated a unique ID number and have access to comprehensive health care services. Further, it is required by law that all new cases of cancer are reported to cancer registries. This makes it possible to achieve almost complete registration of all cancer cases and their status together with information regarding the cancer tumour and its treatment. Status registrations were made partly from national population registries and partly from death registries only, as conditions differ between countries. Crude survival was modelled using the Kaplan-Meier method stratified by selected diagnostic groups, age groups and diagnostic period. The crude estimates were compared with log-rank tests. Results: In total, 12,343 children <15 yrs of age were diagnosed with cancer during 1986-2010 in the Nordic regions (Denmark, Finland, Iceland, Norway, Sweden) and classified according to Birch & Marsden classification. Data were collected at the NOPHO solid tumour registry located at the Cancer Registry of Norway. The overall incidence for the whole period was 11.2 per 100,000 children per year. The overall 5-year survival for all solid tumours reached 80.0 %, 95% CI [79.3 to 80.7] %. There was a significant increase in survival for those diagnosed after 1991, p < 0.001. Children diagnosed when older than 10 years reached higher 5-yrs survival than those diagnosed <5 yrs, 82.4% and 78.3%, respectively. The highest 5-yrs survival was seen for retinoblastoma (97.0%), germ.cell neoplasm (90.8%), renal tumours (88.3%) and lymphomas (88.2%). The lowest 5-yrs survival was observed for sympathetic nervous system (65.4%). The highest increase in survival was seen for non-Hodgkin lymphoma pts, 77.2% diagnosed 1986-1990 vs. 85.9% diagnosed 2001-05. Conclusions: There has been some improvement in survival in recent time periods, especially for some diagnoses. However, there were no changes in overall survival wrt sex and only very limited changes in overall survival by age groups.

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Oluyase, Adejoke O., Irene J. Higginson, Deokhee Yi, Wei Gao, Catherine J. Evans, Gunn Grande, Chris Todd, Massimo Costantini, Fliss EM Murtagh et Sabrina Bajwah. « Hospital-based specialist palliative care compared with usual care for adults with advanced illness and their caregivers : a systematic review ». Health Services and Delivery Research 9, n^o 12 (mai 2021) : 1–218. http://dx.doi.org/10.3310/hsdr09120.

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Background Most deaths still take place in hospital; cost-effective commissioning of end-of-life resources is a priority. This review provides clarity on the effectiveness of hospital-based specialist palliative care. Objectives The objectives were to assess the effectiveness and cost-effectiveness of hospital-based specialist palliative care. Population Adult patients with advanced illnesses and their unpaid caregivers. Intervention Hospital-based specialist palliative care. Comparators Inpatient or outpatient hospital care without specialist palliative care input at the point of entry to the study, or community care or hospice care provided outside the hospital setting (usual care). Primary outcomes Patient health-related quality of life and symptom burden. Data sources Six databases (The Cochrane Library, MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature, PsycINFO and CareSearch), clinical trial registers, reference lists and systematic reviews were searched to August 2019. Review methods Two independent reviewers screened, data extracted and assessed methodological quality. Meta-analysis was carried out using RevMan (The Cochrane Collaboration, The Nordic Cochrane Centre, Copenhagen, Denmark), with separate synthesis of qualitative data. Results Forty-two randomised controlled trials involving 7779 participants (6678 patients and 1101 unpaid caregivers) were included. Diagnoses of participants were as follows: cancer, 21 studies; non-cancer, 14 studies; and mixed cancer and non-cancer, seven studies. Hospital-based specialist palliative care was offered in the following models: ward based (one study), inpatient consult (10 studies), outpatient (six studies), hospital at home or hospital outreach (five studies) and multiple settings that included hospital (20 studies). Meta-analyses demonstrated significant improvement favouring hospital-based specialist palliative care over usual care in patient health-related quality of life (10 studies, standardised mean difference 0.26, 95% confidence interval 0.15 to 0.37; I 2 = 3%) and patient satisfaction with care (two studies, standardised mean difference 0.36, 95% confidence interval 0.14 to 0.57; I 2 = 0%), a significant reduction in patient symptom burden (six studies, standardised mean difference –0.26, 95% confidence interval –0.41 to –0.12; I 2 = 0%) and patient depression (eight studies, standardised mean difference –0.22, 95% confidence interval –0.34 to –0.10; I 2 = 0%), and a significant increase in the chances of patients dying in their preferred place (measured by number of patients with home death) (seven studies, odds ratio 1.63, 95% confidence interval 1.23 to 2.16; I 2 = 0%). There were non-significant improvements in pain (four studies, standardised mean difference –0.16, 95% confidence interval –0.33 to 0.01; I 2 = 0%) and patient anxiety (five studies, mean difference –0.63, 95% confidence interval –2.22 to 0.96; I 2 = 76%). Hospital-based specialist palliative care showed no evidence of causing serious harm. The evidence on mortality/survival and cost-effectiveness was inconclusive. Qualitative studies (10 studies, 322 participants) suggested that hospital-based specialist palliative care was beneficial as it ensured personalised and holistic care for patients and their families, while also fostering open communication, shared decision-making and respectful and compassionate care. Limitation In almost half of the included randomised controlled trials, there was palliative care involvement in the control group. Conclusions Hospital-based specialist palliative care may offer benefits for person-centred outcomes including health-related quality of life, symptom burden, patient depression and satisfaction with care, while also increasing the chances of patients dying in their preferred place (measured by home death) with little evidence of harm. Future work More studies are needed of populations with non-malignant diseases, different models of hospital-based specialist palliative care, and cost-effectiveness. Study registration This study is registered as PROSPERO CRD42017083205. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 9, No. 12. See the NIHR Journals Library website for further project information.

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Sprigg, Nikola, Katie Flaherty, Jason P. Appleton, Rustam Al-Shahi Salman, Daniel Bereczki, Maia Beridze, Alfonso Ciccone et al. « Tranexamic acid to improve functional status in adults with spontaneous intracerebral haemorrhage : the TICH-2 RCT ». Health Technology Assessment 23, n^o 35 (juillet 2019) : 1–48. http://dx.doi.org/10.3310/hta23350.

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Background Tranexamic acid reduces death due to bleeding after trauma and postpartum haemorrhage. Objective The aim of the study was to assess if tranexamic acid is safe, reduces haematoma expansion and improves outcomes in adults with spontaneous intracerebral haemorrhage (ICH). Design The TICH-2 (Tranexamic acid for hyperacute primary IntraCerebral Haemorrhage) study was a pragmatic, Phase III, prospective, double-blind, randomised placebo-controlled trial. Setting Acute stroke services at 124 hospitals in 12 countries (Denmark, Georgia, Hungary, Ireland, Italy, Malaysia, Poland, Spain, Sweden, Switzerland, Turkey and the UK). Participants Adult patients (aged ≥ 18 years) with ICH within 8 hours of onset. Exclusion criteria Exclusion criteria were ICH secondary to anticoagulation, thrombolysis, trauma or a known underlying structural abnormality; patients for whom tranexamic acid was thought to be contraindicated; prestroke dependence (i.e. patients with a modified Rankin Scale [mRS] score > 4); life expectancy < 3 months; and a Glasgow Coma Scale score of < 5. Interventions Participants, allocated by randomisation, received 1 g of an intravenous tranexamic acid bolus followed by an 8-hour 1-g infusion or matching placebo (i.e. 0.9% saline). Main outcome measure The primary outcome was functional status (death or dependency) at day 90, which was measured by the shift in the mRS score, using ordinal logistic regression, with adjustment for stratification and minimisation criteria. Results A total of 2325 participants (tranexamic acid, n = 1161; placebo, n = 1164) were recruited from 124 hospitals in 12 countries between 2013 and 2017. Treatment groups were well balanced at baseline. The primary outcome was determined for 2307 participants (tranexamic acid, n = 1152; placebo, n = 1155). There was no statistically significant difference between the treatment groups for the primary outcome of functional status at day 90 [adjusted odds ratio (aOR) 0.88, 95% confidence interval (CI) 0.76 to 1.03; p = 0.11]. Although there were fewer deaths by day 7 in the tranexamic acid group (aOR 0.73, 95% CI 0.53 to 0.99; p = 0.041), there was no difference in case fatality at 90 days (adjusted hazard ratio 0.92, 95% CI 0.77 to 1.10; p = 0.37). Fewer patients experienced serious adverse events (SAEs) after treatment with tranexamic acid than with placebo by days 2 (p = 0.027), 7 (p = 0.020) and 90 (p = 0.039). There was no increase in thromboembolic events or seizures. Limitations Despite attempts to enrol patients rapidly, the majority of participants were enrolled and treated > 4.5 hours after stroke onset. Pragmatic inclusion criteria led to a heterogeneous population of participants, some of whom had very large strokes. Although 12 countries enrolled participants, the majority (82.1%) were from the UK. Conclusions Tranexamic acid did not affect a patient’s functional status at 90 days after ICH, despite there being significant modest reductions in early death (by 7 days), haematoma expansion and SAEs, which is consistent with an antifibrinolytic effect. Tranexamic acid was safe, with no increase in thromboembolic events. Future work Future work should focus on enrolling and treating patients early after stroke and identify which participants are most likely to benefit from haemostatic therapy. Large randomised trials are needed. Trial registration Current Controlled Trials ISRCTN93732214. Funding This project was funded by the National Institute for Health Research Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 35. See the NIHR Journals Library website for further project information. The project was also funded by the Pragmatic Trials, UK, funding call and the Swiss Heart Foundation in Switzerland.

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Safi, Mariam, Maja L. Bertram et Gabriel Gulis. « Assessing Delivery of Selected Public Health Operations via Essential Public Health Operation Framework ». International Journal of Environmental Research and Public Health 17, n^o 17 (3 septembre 2020) : 6435. http://dx.doi.org/10.3390/ijerph17176435.

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Background: To assess the conduct of delivery of public health services at the municipal level in Denmark by applying services enlisted in the Essential Public Health Operation framework (EPHO) of WHO. Methods: We conducted individual qualitative interviews with key informants working with public health using a self-assessment survey tool in order to obtain an in-depth understanding of the interrelation or multidisciplinary work in Kolding Municipality. The developed self-assessment survey tool entailed questions about essential public health activities performed in a municipality. Results: The Municipality organizes and contributes to core service delivery EPHOs, namely health protection, health promotion, and disease prevention. It collaborates with the general practitioners and the Region of Southern Denmark, responsible for hospital care, to fulfill the selected EPHOs. Conclusions: To obtain a comprehensive picture of the organizations that deliver public health services within a municipality, it is necessary to conduct interviews with representatives from those organizations as well. Additionally, the results from this study can be used to improve the survey tool further and hereafter conduct a nationwide survey in Denmark, as well as other European countries.

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Zwisler, Ann-Dorthe O., Ulla I. Træden, Jørgen Videbæk et Mette Madsen. « Cardiac rehabilitation services in Denmark : Still room for expansion ». Scandinavian Journal of Public Health 33, n^o 5 (octobre 2005) : 376–83. http://dx.doi.org/10.1080/14034940510005824.

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Choi, Joo Hee, Jung Sik Gong et Mun Jung Hyun. « A Comparative Study on the Rehabilitation System in Denmark ». Forum of Public Safety and Culture 17 (30 juillet 2022) : 137–53. http://dx.doi.org/10.52902/kjsc.2022.17.137.

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Recently, the number of criminal offenses has been gradually increasing, and among the arrested offenders, the proportion of ex-convicts accounted for 43.1% in 2020, so social problems caused by recidivism has been continued. This indicates that the after-care for released prisoners and prevention of recidivism, including the operation of the Korea Rehabilitation Agency(‘a.k.a Gongdan’), are not being operated efficiently in society. This seems to have been affected by the lack of national and social interest in rehabilitation services, and also institutional loopholes, lack of manpower and budget, and lack of cooperation between related institutions those arose from lack of interest. Therefore, the purpose of this study is to analyze the case of Denmark to identify the problems of Korea’s rehabilitation system and derive improvement proposals. The study was conducted focusing on foreign literature and data. First of all, analyzing the laws related to the rehabilitation system in Denmark was conducted in order to study the rehabilitation system of Denmark and its current status. Second, current rehabilitation services in Denmark were investigated. And, comparing the case of Denmark with Korea was conducted, to present measures to be improved and supplemented in Korea’s rehabilitation system. As a result of the study, Denmark was enacting related laws that guaranteed the cooperation obligation of local governments to care for released prisoners, although there were no independent laws on the rehabilitation system. And, a reform plan for inmates is established to quickly identify the characteristics and needs of inmates so that related treatment was provided quickly and long-term after the subject was released from prison. Rehabilitation services in Denmark were specialized in family support services, and there are charity institution-centered services such as family activities(family camp, peer camp) and psychological support(online chat counseling). Through the case of Denmark, the following improvement plans were proposed. First, it is to establish a legal basis for smooth information sharing and linkage between the Gongdan, correctional institutions, and local government. Second, it is to supplement manpower and institutions so that advance consultation of Gongdan is carried out quickly and continuously. Third, in relation to the family support services, it is to introduce an online chat counseling system for released prisoners’ children and to hold regular family camps and peer camps. Fourth, it is to provide specialized services to those subject to protection who are highly likely to recidivism in the advance consultation system.

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Mori, Anna. « The impact of public services outsourcing on work and employment conditions in different national regimes ». European Journal of Industrial Relations 23, n^o 4 (1 février 2017) : 347–64. http://dx.doi.org/10.1177/0959680117694272.

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This article examines the impact of outsourcing of public services on employment relations and working conditions in three countries: Italy, the United Kingdom and Denmark. It presents six matched case studies and investigates whether contracting out by public administrations causes a market-driven convergence across national boundaries or whether cross-country differences endure. Although outsourcing blurs the organizational boundaries between public and private sectors everywhere, making terms and conditions of employment fragmented and less protected, distinct structures and legacies of national employment relations institutions result in differences between national trajectories.

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Maynard, Alan. « Financing the U.K. national health services ». Health Policy 6, n^o 4 (janvier 1986) : 329–40. http://dx.doi.org/10.1016/0168-8510(86)90048-5.

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Ensio, A., M. Laine, P. Nykänen, P. Itkonen et N. Saranummi. « National Health IT Services in Finland ». Methods of Information in Medicine 46, n^o 04 (2007) : 463–69. http://dx.doi.org/10.1160/me9054.

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Summary Objectives: In 2002 a decision was reached to set up a nation-wide electronic health record system in Finland. The legal framework of actors with the necessary mandate was approved in the parliament in December 2006. A set of standards and norms have been selected that all health care actors need to follow. Functional specifications of the services were completed in 2006. Setting up the centralized health IT services begins in 2007.Centralization of patient record data allows the reorganization of health service providers to take place at local and regional levels according to need. The services allow users to access patient records securely from anywhere with the provision that they have the right to access private patient data. Methods: The functionality of the services and the necessary infrastructure has been agreed to in projects and working groups involving users, experts, key stakeholders and vendors. Results: The legal framework was approved in the parliament in December 2006. The functional specifications of thecentralized health IT services were finalized in 2006. Conclusions: The implementation of the services will start in 2007.

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Nøerregaard, Susan, Susan Bermark, Tonny Karlsmark, Peter J. Franks, Susie Murray et Christine J. Moffatt. « LIMPRINT : Prevalence of Chronic Edema in Health Services in Copenhagen, Denmark ». Lymphatic Research and Biology 17, n^o 2 (avril 2019) : 187–94. http://dx.doi.org/10.1089/lrb.2019.0019.

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