The match between need and use of health services among healthy under-fives in Denmark: A register-based national cohort study

Abstract

To study a potential positive association (referred to as 'a match') between the need for health service (expressed by a mortality risk score) and observed health service utilisation among healthy Danish under-fives. Further, municipal differences in the match were examined to motivate focused comparisons between the organisation of regional health services. Design Register-based national cohort study. Participants The population of 1,246,599 Danish children born 1997-2016 who survived until date of first discharge to the home after birth without a diagnosis of severe chronic disease. Main outcome measures Hazard ratios (HR) for a doubling of the mortality rate were calculated for the following health services: total contacts, inpatient contacts (admission > 1 day), outpatient contacts, general practitioner contacts, specialist contacts, medication use, and vaccinations. Results The use of total contacts, inpatient contacts (> 1 day) and general practitioner contacts as well as medication matched with the mortality risk score, HRs between 1.027 (1.026 to 1.028) and 1.111 (1.108 to 1.113), whereas outpatient and specialist contacts as well as vaccinations did not, HRs between 0.913 (0.912 to 0.915) and 0.991 (0.991 to 0.991). There were some remarkable differences among the 98 Danish municipalities.

Surgical procedures in Danish children 1999–2018

“…In a previous series of papers we described the use of health service utilisation in Danish children under five years of age [ 1 – 3 ]. The papers highlighted the fact that during the period 1999–2016, the total number of contacts with the health system for children under 5 years of age remained stable, but the services became increasingly specialised.…”