Conditions In Denmark Research Articles

Impacts of the COVID-19 pandemic on deprivation-level differences in cardiovascular hospitalisations: a comparison of England and Denmark using the OpenSAFELY platform and National Registry Data

ObjectivesTo examine the impact of the COVID-19 pandemic on deprivation-related inequalities in hospitalisations for cardiovascular disease (CVD) conditions in Denmark and England between March 2018 and December 2021.DesignTime-series studies in...

Concentration of disability in families: Intergenerational transmission or assortative mating?

Although studies have established that health and socioeconomic disadvantages often accumulate within families, little is known about the extent to which disability is concentrated within certain families and transmitted across generations. We use retrospective information about growing up with parent(s) or sibling(s) with a disability from the 2020 wave of the representative Survey of Health, Impairment and Living Conditions in Denmark (N = 7709). Building on this data and applying a family life course perspective, we examine if growing up with parent(s) and/or sibling(s) with a disability is associated with 1) having a disability oneself, 2) the probability of having a partner with a disability and 3) the occurrence of disability in the next generation. Our findings demonstrate that the odds of having a disability are higher among individuals who grew up with parent(s) and/or sibling(s) with a disability. While the odds of being partnered are not associated with family members’ disabilities, we find a positive association between having grown up with parents with a disability and having a partner with a disability. Moreover, having a child with a disability is positively associated with one’s own, parents’, siblings’ and partner’s disabilities. We thus conclude that disability is concentrated within certain families and that both intergenerational transmission and assortative mating contribute to this concentration.

Modeling groundwater redox conditions at national scale through integration of sediment color and water chemistry in a machine learning framework

Redox conditions play a crucial role in determining the fate of many contaminants in groundwater, impacting ecosystem services vital for both the aquatic environment and human water supply. Geospatial machine learning has previously successfully modelled large-scale redox conditions. This study is the first to consolidate the complementary information provided by sediment color and water chemistry to enhance our understanding of redox conditions in Denmark. In the first step, the depth to the first redox interface is modelled using sediment color from 27,042 boreholes. In the second step, the depth of the first redox interface is compared against water chemistry data at 22,198 wells to classify redox complexity. The absence of nitrate containing water below the first redox interface is referred to as continuous redox conditions. In contrast, discontinuous redox conditions are identified by the presence of nitrate below the first redox interface. Both models are built using 20 covariate maps, encompassing diverse hydrologically relevant information. The first redox interface is modelled with a mean error of 0.0 m and a root-mean-squared error of 8.0 m. The redox complexity model attains an accuracy of 69.8 %. Results indicate a mean depth to the first redox interface of 8.6 m and a standard deviation of 6.5 m. 60 % of Denmark is classified as discontinuous, indicating complex redox conditions, predominantly collocated in clay rich glacial landscapes. Both maps, i.e., first redox interface and redox complexity are largely driven by the water table and hydrogeology. The developed maps contribute to our understanding of subsurface redox processes, supporting national-scale land-use and water management.

Further evaluation of a new method to investigate antimicrobial, colour retainment and slice healing properties of cucumber (Cucumis sativus L.) shows differences between conventional and organic production systems in inter-laboratory comparison trials

ABSTRACT Food quality is influenced by different cultivation methods and the type and amount of fertiliser used. The resulting vitality of the food and the ability to resist degradation processes were investigated using a vitality test method, assessing antimicrobial (AMP), colour retainment (CRP) and slice healing properties (SHP) of cucumber fruit (Cucumis sativus L.). Five hundred and sixty-four cucumber samples, grown in greenhouse conditions in Denmark and fertilised with different nitrogen (N) levels, were examined, testing cucumbers from conventional (Conv: 145 g N m−2), organic (OrgN-: 70 g N m−2) and biodynamic (BdN+: 122 g N m−2) cultivation regimes. The experimental design resulted in 54 comparisons consisting of six trial repetitions with three measured parameters examined in three laboratories. Every sample was sliced by a slicing tool, producing alternating slice thickness of 15 and 20 mm. The samples were reassembled, wrapped in transparent plastic foil and stored vertically in a heating cabinet for 14 days in the dark. Subsequently, AMP and CRP were scored visually based on a photo reference series. SHP were examined on the horizontally fixed cucumber sample by attaching weights to two specific slices one after the other until the slices detached. The evaluation of the cucumbers analysed by the vitality test method in inter-laboratory comparison trials led to consistent results. Cucumbers of the OrgN- and BdN+ variants scored higher in the test than Conv. It was not possible to differentiate OrgN- vs. BdN+ cucumbers. The vitality test is an attractive method for evaluating post-harvest resilience in cucumbers.

Ukrainian refugees’ wellbeing and adaptation in Denmark

Abstract In Denmark - 28 765 individuals from Ukraine have been granted residency under the Danish Special Act. While Ukrainians share the war exposure with other groups of refugees in Denmark, they differ in many aspects. For example, the special act has allowed Ukrainians access to the welfare state benefits (including healthcare) relatively fast and they have been accommodated outside of asylum centers. In addition, the political climate in the reception of Ukrainians has been rather favorable compared to the last refugee crisis. Yet, we know very little about their health needs and access to care. The aim of our project is to identify and understand the health needs of Ukrainian refugees and how they access healthcare in Denmark in order to inform the development of strategies that help them cope with postmigration stress and improve their quality of life. We have developed a survey, in collaboration with a group of experts by experience (Ukrainian refugees). The survey combines validated tools and self-developed questions and includes several themes: i) factors influencing adaptation of Ukrainian refugees; ii) individual sociodemographic characteristics; iii) trauma/war exposure; iv) living and housing conditions in Denmark; v) experiences in access to Danish healthcare system; and vi) health needs and well-being including symptoms of trauma. The target population is Ukrainian refugees in Copenhagen aged 18 and above. Currently, there are 2916 refugees living across the city. The aim is to recruit at least half of them, located in three municipalities: Copenhagen Municipality, Frederiksberg Municipality and Gentofte Municipality. The survey has been launched May 2023, and by November 2023, we expect to have collected and analyzed all data, which we are going to present at workshop. Our participatory research methods involving Ukrainian refugees throughout the process include their engagement in intervention and policy suggestions based on the survey.

A comparative study of the whole life carbon of a radiant system and an all-air system in a non-residential building

There is an urgent need to reduce carbon emissions from the building sector. This study focused on the whole life carbon of a building’s heating, ventilation, and air conditioning system. A methodology to compare the whole life carbon of different HVAC systems was proposed and used in a case study with boundary conditions in Denmark. All-air system and radiant systems were compared, as they have different working principles and the potential for differences in both their embodied and operational carbon. The radiant system was a Thermally Active Building System (TABS), and the all-air system was a packaged variable-air-volume system with reheat. The building model was based on the medium-sized office of prototype buildings developed by the U.S. Department of Energy. Life cycle stages of the building were classified based on EN15978:2011. Two models, one for dynamic building simulation and the other for measuring the mass of materials (e.g., concrete), were adopted in a novel approach. The operational carbon of the HVAC systems was calculated under very similar indoor thermal comfort conditions. The whole life carbon was 10.1 kgCO2-eq/m2/year and 9.0 kgCO2-eq/m2/year for the all-air system and TABS, respectively. Compared to the all-air system, TABS reduced annual total primary energy use by 34% and whole life carbon by 11%. If dynamic carbon intensity of the grid were to be implemented, further reduction of carbon emission is expected with TABS, owing to its flexibility in operation with the activated thermal mass.

Optimized number of suction cups required to predict annual nitrate leaching under varying conditions in Denmark

Nitrate concentrations in soil water leaving the root zone measured by suction cups combined with water transport modeling is a commonly used practice in Denmark for calculating nitrate leaching. Two suction cups installed in one plot giving one water sample and replicated four times, (eight total suction cups) to reduce variability between samples. For practical reasons, it would be beneficial to minimize the number of suction cups used yet maintain reliable predictions. To assess the variability in reducing suction replicates, this study analyzed data from five research sites across Denmark representing annual field nitrate leaching predictions for different combinations of soil, weather conditions, crops, N-fertilizer rates, and winter soil cover, covering a total of 173 annual nitrate leaching experiments. The analysis was conducted having different nitrate leaching predictions using different numbers of replicates of suction cup measurements. Linear regression was used to identify the different influences of leaching year (hydrological year), N rate applied, soil characteristics, and crop sequence on nitrate leaching. The analyses were set up on three 2-yr and two 3-yr field experiments in five different sites. Crop effects showed that cereals and winter cover sown in autumn 2017 had significantly more nitrate leaching than in 2015 and 2016 leaching years due to high precipitation rates in the autumn. Furthermore, decreasing the number of suction cup replicates from four (eight total) to three replicates (six total) did not have a significant effect on nitrate leaching prediction. In contrast, decreasing replicates from four to two (four total) and one (two total) replicates did show a significant difference. Therefore, using three replicates is a viable solution for future sampling strategies and a good trade-off between costs and accuracy.

Prevalence of parental mental health conditions among children aged 0-16 years in Denmark: A nationwide register-based cross-sectional study.

Aim: Parental mental health conditions adversely affect the children. Information on the prevalence of parental mental health conditions is needed to help policymakers allocate resources appropriately. Therefore, the aim of this study was to estimate the prevalence of children with parental mental health conditions in Denmark and further estimate the age-specific prevalence and geographical variation. Methods: In this nationwide register-based cross-sectional study, we included all children born between 2000 and 2016 if they resided in Denmark on 31 December 2016. Information on both maternal and paternal mental health conditions was retrieved from primary and secondary healthcare registers. Parental mental health conditions were categorised in three severity groups: minor, moderate, and severe. We estimated the proportion of children with parental mental health conditions on 31 December 2016. Results: Of the 1,106,459 children aged 0-16 years, 39.1% had at least one parent with a mental health condition. The prevalence increased with age of the children until the age of six years. Geographical variation in the prevalence ranged from 29.0% to 48.3% in the 98 municipalities. Minor parental mental health conditions (23.5%) were more common than moderate (13.5%) and severe parental mental health conditions (2.2%). Hospital-diagnosed parental mental health conditions were prevalent in 12.8% of the children. Conclusions: Two in five children aged 0-16 years in Denmark have parents with a mental health condition and geographical variation exists. The high prevalence of children with parental mental health conditions is an important public health challenge, which calls for attention.

Estimating disability prevalence and disability-related inequalities: Does the choice of measure matter?

Different measures for quantifying the percentage of people with a disability in surveys result in diverging estimates of prevalence and disability-related inequalities. Thus understanding the implications of using different disability measures is of vital policy importance. This study is the first to investigate the within-survey variation in disability prevalence based on two internationally recognized measures: the Washington Group Short Set (WGSS) and the Global Activity Limitation Indicator (GALI). It is also the first to examine the disability-related inequality in voter turnout, based on official validated voter records. We use data on 11,308 25-54-year-old respondents from the 2016 wave of the Survey of Health, Impairment and Living Conditions in Denmark (SHILD) to estimate the disability prevalence based on the WGSS and the GALI. Moreover, we investigate health characteristics of individuals with a disability according to the two measures and inequalities in two central social policy success parameters: voter turnout and employment. The WGSS estimates higher disability prevalence (10.6%) than the GALI (5.5%). Only 2.5% of the sample are in both groups, implying that largely, different individuals are defined as having a disability depending on which measure is used. The health profiles of the two groups also differ, as people with a GALI-defined disability are significantly more likely to report a severe mental illness or a major physical health problem. The GALI estimates indicate larger inequalities between people with and without a disability than the WGSS for the probability of being employed, whereas there are no significant differences for voter turnout. The choice of disability measure strongly influences within-survey estimates of disability prevalence, the health profile of the defined groups, and inequalities in outcomes. The WGSS underrepresents the number of people suffering from severe mental illness. Estimated inequalities in employment are larger for the GALI than for the WGSS.

Modelling phosphorus removal efficiency of a reactive filter treating agricultural tile drainage water

Phosphorus (P) leaching from agricultural to tile drainage land contributes to nonpoint pollution of surface waters. Drainage filter technologies are potentially cost-effective technologies at the field scale for mitigating P losses.The objective of this study was to evaluate the removal efficiency for dissolved P (PRE) in a porous reactive filter constructed from crushed seashells, which was part of a full-scale filter system. The hydraulic properties (hydrodynamic and hydrodispersive) were estimated by performing salt (NaCl) tracer tests at two different flow rates representative for in situ discharge conditions in Denmark. The reactive properties of the filter material were determined in the laboratory by measuring P sorption in batch experiments. The hydraulic and reactive parameters were subsequently used as input parameters in a numerical model, which was calibrated based on flow data and dissolved P concentrations collected between May 2015 and 2017. Results show a homogeneous distribution of the tracer in drainage water outside the reactive P-filter and a uniform dissolved P load into the seashell material. The in situ saturated hydraulic conductivity was one order of magnitude lower than the estimation from previous column experiments. The model described accurately dissolved P concentrations at the filter outlet (Nash-Sutcliffe index = 0.79) and the P removal efficiency (PRE) of the reactive filter was equal to 62% during the monitored period. The model presented in this work can be integrated in a larger model addressing the complexity of P sorption processes for the evaluation of the removal efficiency in full-scale filter systems.

A Nationwide Study of Prevalence Rates and Characteristics of 199 Chronic Conditions in Denmark.

BackgroundReal-world data of disease prevalence represents an important but underutilised source of evidence for health economic modelling.AimsThe aim of this study was to estimate nationwide prevalence rates and summarise the characteristics of 199 chronic conditions using Danish population-based health registers, to provide an off-the-shelf tool for decision makers and researchers.MethodsThe study population comprised all Danish residents aged 16 years or above on 1 January 2013 (n = 4,555,439). The study was based on the linkage of national registers covering hospital contacts, contacts with primary care (including general practitioners) and filled-in out-of-hospital prescriptions.ResultsA total of 65.6% had one or more chronic condition. The ten conditions with the highest degree of prevalence were hypertension (23.3%), respiratory allergy (18.5%), disorders of lipoprotein metabolism (14.3%), depression (10.0%), bronchitis (9.2%), asthma (7.9%), type 2 diabetes (5.3%), chronic obstructive lung disease (4.7%), osteoarthritis of the knee (3.9%) and finally osteoporosis (3.5%) and ulcers (3.5%) in joint tenth place. Characteristics by gender, age and national geographical differences were also presented.ConclusionsA nationwide catalogue of the prevalence rates and characteristics of patients with chronic conditions based on a nationwide population is provided. The prevalence rates of the 199 conditions provide important information on the burden of disease for use in healthcare planning, as well as for economic, aetiological and other research.Electronic supplementary materialThe online version of this article (10.1007/s41669-019-0167-7) contains supplementary material, which is available to authorized users.

Career histories as determinants of gendered retirement timing in the Danish and Swedish pension systems

After reforms in pension systems had taken place in most European countries within the last two decades, the concern was raised that women may be disadvantaged by these reforms. It is suggested that they are faced with a higher financial need to work longer. Retrospective data from SHARELIFE are used to run an event history analysis on the timing of the final employment exit, separately for gender, country and exit cohort. This study aims to disentangle the influence of gendered labour markets and pension regulations on retirement timing by investigating conditions in Denmark and Sweden. Some evidence was found that women compensate for lower labour market attachment due to long part-time periods by working longer, especially in younger cohorts. This seems to depend on the pension system. In countries with broad basic pensions, high replacement rates for low-income groups and fewer penalties for early retirement, the compensation is suggested to be less frequent. This study indicates the growing importance of the “compensation hypothesis” compared to the “status maintenance hypothesis” of previous careers in relation with retirement timing.

Partial Pit Exhaust Improves Indoor Air Quality and Effectiveness of Air Cleaning in Livestock Housing: A Review

Abstract. Ammonia and odor emissions from livestock production systems cause negative impact on atmospheric environment and local society. It is, therefore, important to develop cost-effective methods to reduce these emissions. Air cleaning technologies, including chemical and biological filters, have been proposed to clean the exhaust ventilation air from confined livestock buildings. However, it requires large capacity of the air cleaning unit for the total exhaust air and, consequently, results in high investment and operational costs of the livestock production system. Aiming at emission reduction and optimal indoor air quality of confined farm animal buildings, a concept of partial pit ventilation has been investigated in varied conditions in Denmark. Partial pit ventilation is based on the hypothesis that the most polluted air can be removed by a separate air exhaust near the pollution sources in pit head space, while the room air exhaust is kept as a major ventilation exhaust and controlled according to indoor thermal conditions. The airflow rate of the partial pit air exhaust is designed and controlled as only a small portion of the designed ventilation capacity of the building. By cleaning the pit exhaust air only, the required capacity for a cleaning unit will be significantly reduced. The investigations in Denmark, mostly in growing-finishing pig housing, have shown that partial pit air exhaust can remove a large share of the ammonia, hydrogen sulfide, and odor from the room using a pit air exhaust rate of 10% of the designed ventilation capacity, which is equivalent to 10 m3 h-1 pig-1 for growing-finishing pig housing. This article provides an overview of the investigation results currently available on a partial pit air exhaust (PPAE) system, including both numerical simulations and experimental investigations, to identify important factors that may affect the system performances for removal of ammonia and other pollutants from the animal housing and to address the extension work that may be needed to apply the method in actual production scales. It is shown that PPAE is an effective approach to reduce emissions by combining an effective exhaust cleaner. The system can significantly improve the indoor air quality, because a considerable amount of the concentrated pollutants in the air are removed directly via PPAE. The pollutant removal via PPAE is influenced by airflow patterns, airflow rates, and locations of PPAE openings in pit headspace. Therefore, configuration and control of ventilation systems are crucial for system efficiency. Besides, slatted floor openings, as well as animal lying behavior and location, can also influence the pollutant removal ratio by a PPAE. To achieve an optimal design and control of the system, further systematic investigations, both experimental and numerical, are still needed.

Refugee Policy As ‘Negative Nation Branding’: The Case of Denmark and the Nordic

Once a liberal frontrunner, Denmark today maintains a self-declared hard-line approach to refugees. In contrast to other deterrence measures blocking access to asylum per se, the bulk of Denmark’s restrictions on asylum-seeking aim to make asylum and protection conditions in Denmark as unattractive as possible, thereby indirectly pushing asylum-seekers towards other countries. This article conceptualizes such indirect deterrence policies in Europe as a form of “negative nation branding”. In order to achieve the deterrent effect of these policies, states are, on the one hand, prompted to advertise new restrictions actively both in public discourse and through targeted campaigns towards migrants and refugees. On the other hand, this kind of branding is likely to prompt critical responses among wider audiences both internationally and domestically. Contrary to the majority of existing scholarship, the Danish case suggests that, at least under some circumstances, indirect deterrence may be an effective strategy in reducing the numbers of asylum-seekers arriving in a country. At the same time, however, indirect deterrence is likely to create a number of negative externalities, and the beggar-thy-neighbour dynamics upon which these policies are premised make individual countries vulnerable to similar policy developments in neighbouring states, thus reducing, or even reversing, the deterrent effect over time.

Barriers for district heating as a source of flexibility for the electricity system

The Scandinavian countries Denmark, Norway and Sweden currently deploy large amounts of variable renewable energy (VRE) sources, especially wind power. This calls for additional flexibility in the power market. The right coupling to the underlying national and local district heating (DH) markets can generate large amounts of flexibility. However, regulatory barriers and different energy market designs may hinder the potential benefits from system integration, and lower the potential that can be realized. The Scandinavian countries have a large extension of DH with a good potential for providing flexibility services to the electricity market. We survey and discuss regulatory barriers and drivers for exploiting this potential for flexibility. Combined heat and power (CHP) is widely integrated in the power market, but it is threatened by low electricity prices due to the increasing amounts of wind power. Power-to-heat technologies, electric boilers and heat pumps are blocked by high tariffs and taxes. A calculation of the heat costs of different DH technologies demonstrates that, under the present price and tax conditions in Denmark and Sweden, CHP and power-to-heat are unable to compete with heat-only boilers that use tax-free biomass.

Comparison of regression techniques to predict response of oilseed rape yield to variation in climatic conditions in Denmark

Abstract Statistical regression models represent alternatives to process-based dynamic models for predicting the response of crop yields to variation in climatic conditions. Regression models can be used to quantify the effect of change in temperature and precipitation on yields. However, it is difficult to identify the most relevant input variables that should be included in regression models due to the high number of candidate variables and to their correlations. This paper compares several regression techniques for modeling response of winter oilseed rape yield to a high number of correlated input variables. Several statistical regression methods were fitted to a dataset including 689 observations of winter oilseed rape yield from replicated field experiments conducted in 239 sites in Denmark, covering nearly all regions of the country from 1992 to 2013. Regression methods were compared by cross-validation. The regression methods leading to the most accurate yield predictions were Lasso and Elastic Net, and the least accurate methods were ordinary least squares and stepwise regression. Partial least squares and ridge regression methods gave intermediate results. The estimated relative yield change for a +1°C temperature increase during flowering was estimated to range between 0 and +6 %, depending on choice of regression method. Precipitation was found to have an adverse effect on yield during autumn and winter. It was estimated that an increase in precipitation of +1 mm/day would result in a relative yield change ranging from 0 to −4 %. Soil type was also important for crop yields with lower yields on sandy soils compared to loamy soils. Later sowing was found to result in increased crop yield. The estimated effect of climate on yield was highly sensitive to the chosen regression method. Regression models showing similar performance led in some cases to different conclusions with respect to effect of temperature and precipitation. Hence, it is recommended to apply an ensemble of regression models, in order to account for the sensitivity of the data driven models for projecting crop yield under climate change.

Global warming potential of material fractions occurring in source-separated organic household waste treated by anaerobic digestion or incineration under different framework conditions

This study compared the environmental profiles of anaerobic digestion (AD) and incineration, in relation to global warming potential (GWP), for treating individual material fractions that may occur in source-separated organic household waste (SSOHW). Different framework conditions representative for the European Union member countries were considered. For AD, biogas utilisation with a biogas engine was considered and two potential situations investigated – biogas combustion with (1) combined heat and power production (CHP) and (2) electricity production only. For incineration, four technology options currently available in Europe were covered: (1) an average incinerator with CHP production, (2) an average incinerator with mainly electricity production, (3) an average incinerator with mainly heat production and (4) a state-of-the art incinerator with CHP working at high energy recovery efficiencies. The study was performed using a life cycle assessment in its consequential approach. Furthermore, the role of waste-sorting guidelines (defined by the material fractions allowed for SSOHW) in relation to GWP of treating overall SSOHW with AD was investigated. A case-study of treating 1tonne of SSOHW under framework conditions in Denmark was conducted. Under the given assumptions, vegetable food waste was the only material fraction which was always better for AD compared to incineration. For animal food waste, kitchen tissue, vegetation waste and dirty paper, AD utilisation was better unless it was compared to a highly efficient incinerator. Material fractions such as moulded fibres and dirty cardboard were attractive for AD, albeit only when AD with CHP and incineration with mainly heat production were compared. Animal straw, in contrast, was always better to incinerate. Considering the total amounts of individual material fractions in waste generated within households in Denmark, food waste (both animal and vegetable derived) and kitchen tissue are the main material fractions allowing GWP mitigation with AD when it is compared to incineration. The inclusion of other material fractions in SSOHW sorting guidelines may be considered of less importance.

High-EPA Biomass from Nannochloropsis salina Cultivated in a Flat-Panel Photo-Bioreactor on a Process Water-Enriched Growth Medium.

Nannochloropsis salina was grown on a mixture of standard growth media and pre-gasified industrial process water representing effluent from a local biogas plant. The study aimed to investigate the effects of enriched growth media and cultivation time on nutritional composition of Nannochloropsis salina biomass, with a focus on eicosapentaenoic acid (EPA). Variations in fatty acid composition, lipids, protein, amino acids, tocopherols and pigments were studied and results compared to algae cultivated on F/2 media as reference. Mixed growth media and process water enhanced the nutritional quality of Nannochloropsis salina in laboratory scale when compared to algae cultivated in standard F/2 medium. Data from laboratory scale translated to the large scale using a 4000 L flat panel photo-bioreactor system. The algae growth rate in winter conditions in Denmark was slow, but results revealed that large-scale cultivation of Nannochloropsis salina at these conditions could improve the nutritional properties such as EPA, tocopherol, protein and carotenoids compared to laboratory-scale cultivated microalgae. EPA reached 44.2% ± 2.30% of total fatty acids, and α-tocopherol reached 431 ± 28 µg/g of biomass dry weight after 21 days of cultivation. Variations in chemical compositions of Nannochloropsis salina were studied during the course of cultivation. Nannochloropsis salina can be presented as a good candidate for winter time cultivation in Denmark. The resulting biomass is a rich source of EPA and also a good source of protein (amino acids), tocopherols and carotenoids for potential use in aquaculture feed industry.

Serious Mental Illness and Risk for Hospitalizations and Rehospitalizations for Ambulatory Care-sensitive Conditions in Denmark: A Nationwide Population-based Cohort Study.

Hospitalizations for ambulatory care-sensitive conditions (ACSCs) and early rehospitalizations increase health care costs. To determine if individuals with serious mental illnesses (SMIs) (eg, schizophrenia or bipolar disorder) are at increased risk for hospitalizations for ACSCs, and rehospitalization for the same or another ACSC, within 30 days. Population-based cohort study. A total of 5.9 million Danish persons aged 18 years and older between January 1, 1999 and December 31, 2013. The Danish Psychiatric Central Register provided information on SMI diagnoses and the Danish National Patient Register on hospitalizations for ACSCs and 30-day rehospitalizations. SMI was associated with increased risk for having any ACSC-related hospitalization after adjusting for demographics, socioeconomic factors, comorbidities, and prior primary care utilization [incidence rate ratio (IRR): 1.41; 95% confidence interval (95% CI), 1.37-1.45]. Among individual ACSCs, SMI was associated with increased risk for hospitalizations for angina (IRR: 1.14, 95% CI, 1.04-1.25), chronic obstructive pulmonary disease/asthma exacerbation (IRR: 1.87; 95% CI, 1.74-2.00), congestive heart failure exacerbation (IRR: 1.25; 95% CI, 1.16-1.35), and diabetes (IRR: 1.43; 95% CI, 1.31-1.57), appendiceal perforation (IRR: 1.49; 95% CI, 1.30-1.71), pneumonia (IRR: 1.72; 95% CI, 1.66-1.79), and urinary tract infection (IRR: 1.70; 95% CI, 1.62-1.78). SMI was also associated with increased risk for rehospitalization within 30 days for the same (IRR: 1.28; 95% CI, 1.18-1.40) or for another ACSC (IRR: 1.62; 95% CI, 1.49-1.76). Persons with SMI are at increased risk for hospitalizations for ACSCs, and after discharge, are at increased risk for rehospitalizations for ACSCs within 30 days.

Depression and risk of hospitalisations and rehospitalisations for ambulatory care-sensitive conditions in Denmark: a population-based cohort study

ObjectiveHospitalisations for ambulatory care-sensitive conditions (ACSCs), a group of chronic and acute illnesses considered not to require inpatient treatment if timely and appropriate ambulatory care is received, and early rehospitalisations...