Too much? Mortality and health service utilisation among Danish children 1999-2016: A register-based study


Autoři: Andreas Jensen aff001;  Per Kragh Andersen aff002;  John Sahl Andersen aff003;  Gorm Greisen aff004;  Lone Graff Stensballe aff001
Působiště autorů: Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark aff001;  Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark aff002;  Section of General Practice, Department of Public Health and Research Unit for General Practice, University of Copenhagen, Copenhagen, Denmark aff003;  Department of Neonatology, Rigshospitalet, Copenhagen University Hospital and the University of Copenhagen, Copenhagen, Denmark aff004
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224544

Souhrn

Objectives

To describe the temporal development of mortality and health service utilisation defined as in- and outpatient hospital contacts, contacts with general practitioner and specialists, and prescribed dispensed medication among Danish children 0–5 years of age from 1999 to 2016.

Design

Register-based descriptive study.

Participants

All children born in Denmark in the period 1994–2016 followed until 5 years of age.

Main outcome measures

Annual incidence rates of mortality and health service utilisation outcomes, and incidence rate ratios compared to the reference calendar year 1999. The new measure of post-discharge mortality is presented.

Results

Post-discharge mortality decreased from 1999 to 2016, IRR2016 = 0.49 (95% CI: 0.36 to 0.66). Total contacts did not change much over time, IRR2016 = 1.02 (1.02 to 1.03), but increased among neonates, IRR2016 = 3.69 (3.63 to 3.75), and decreased among children with chronic disease IRR2016 = 0.94 (0.93 to 0.94). In- and out-patient hospitalisations increased, IRR2016 = 1.26 (1.24–1.27) resp. IRR2016 = 1.62 (1.60–1.63), contacts with medical specialists increased, IRR2016 = 1.43 (1.42 to 1.43), whilst contacts with general practitioner decreased, IRR2016 = 0.91 (0.91 to 0.91). Medication use decreased, IRR2016 = 0.82 (0.82 to 0.82).

Conclusions

Our measure of post-discharge mortality was halved during the study period indicating improved health. Overall health service utilisation did not change much, but the type of utilisation changed, and the development over time differed between subgroups defined by age and chronic disease status. Our findings call for considerations about the benefit of increased specialisation and increased use of health services among ‘healthy’ children not suffering from chronic disease.

Klíčová slova:

Age groups – Death rates – General practitioners – Child health – Inpatients – Neonates – Outpatients – Danish people


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Článek vyšel v časopise

PLOS One


2019 Číslo 10