Healthcare use before and after changing disability pension policy: a regional Danish cohort study.

Abstract

The social security policy for disability pension (DP) was changed in Denmark in 2013 and eligibility requirements were tightened. We describe and compare the use of healthcare among individuals with incident DP before and after the policy change. This was a follow-up study based on data from nationwide databases. The study included individuals with incident DP aged 18-64 years and living in The North Denmark Region. We included individuals with incident DP before (2010-12, n = 6286) and after (2014-15, n = 1042) the 2013 policy change. Poisson regression was used to examine group differences in (i) contact to healthcare and (ii) hospitalization. For this purpose, we used incidence rate ratios stratified on type of contact before being awarded DP. We found a change of diagnoses for healthcare use towards higher proportions of cardiovascular, pulmonary, neurological and cancer diseases and lower proportion with musculoskeletal disorder in the populations being granted DP after policy changes. For individuals with psychiatric contact before being granted DP, we found no significant differences between periods in psychiatric healthcare after DP was awarded. For individuals with somatic contact before being granted DP, we found an increased risk of contact to somatic healthcare and hospitalization after DP requirements were tightened. The study demonstrated that individuals who were granted DP after the eligibility requirements had been tightened suffered from more medical conditions and had an ongoing need for healthcare. In contrast, no significant difference in risk of psychiatric contact or hospitalization after DP was demonstrated.