Display options
Share it on

Clin Epidemiol. 2019 Jul 12;11:563-591. doi: 10.2147/CLEP.S179083. eCollection 2019.

The Danish health care system and epidemiological research: from health care contacts to database records.

Clinical epidemiology

Morten Schmidt, Sigrun Alba Johannesdottir Schmidt, Kasper Adelborg, Jens Sundbøll, Kristina Laugesen, Vera Ehrenstein, Henrik Toft Sørensen

Affiliations

  1. Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
  2. Department of Cardiology, Regional Hospital West Jutland, Herning, Denmark.
  3. Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark.
  4. Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark.

PMID: 31372058 PMCID: PMC6634267 DOI: 10.2147/CLEP.S179083

Abstract

Denmark has a large network of population-based medical databases, which routinely collect high-quality data as a by-product of health care provision. The Danish medical databases include administrative, health, and clinical quality databases. Understanding the full research potential of these data sources requires insight into the underlying health care system. This review describes key elements of the Danish health care system from planning and delivery to record generation. First, it presents the history of the health care system, its overall organization and financing. Second, it details delivery of primary, hospital, psychiatric, and elderly care. Third, the path from a health care contact to a database record is followed. Finally, an overview of the available data sources is presented. This review discusses the data quality of each type of medical database and describes the relative technical ease and cost-effectiveness of exact individual-level linkage among them. It is shown, from an epidemiological point of view, how Denmark's population represents an open dynamic cohort with complete long-term follow-up, censored only at emigration or death. It is concluded that Denmark's constellation of universal health care, long-standing routine registration of most health and life events, and the possibility of exact individual-level data linkage provides unlimited possibilities for epidemiological research.

Keywords: epidemiology; health care sector; political systems; population health; registries

Conflict of interest statement

VE reports institutional grants (none related to this work) from various pharmaceutical companies. The authors report no conflicts of interest in this work.

References

  1. Mult Scler. 1999 Aug;5(4):293-6 - PubMed
  2. Dan Med Bull. 1999 Sep;46(4):357-60 - PubMed
  3. Science. 2000 Mar 31;287(5462):2398-9 - PubMed
  4. Scand J Public Health. 1999 Mar;27(1):78 - PubMed
  5. Dan Med Bull. 2001 Aug;48(3):161-3 - PubMed
  6. Health Policy. 2002 Feb;59(2):107-18 - PubMed
  7. Scand J Public Health. 2001 Dec;29(4):300-7 - PubMed
  8. Scand J Public Health. 2003;31(1):12-6 - PubMed
  9. Diabetes Care. 2004 Jan;27(1):70-6 - PubMed
  10. Inform Prim Care. 2004;12(1):49-50 - PubMed
  11. Ann Allergy Asthma Immunol. 2004 Oct;93(4):381-9 - PubMed
  12. Eur J Health Econ. 2003;4(1):60-5 - PubMed
  13. Dan Med Bull. 2004 Nov;51(4):415-7 - PubMed
  14. Scand J Public Health. 2005;33(3):197-202 - PubMed
  15. Health Econ. 2005 Sep;14(Suppl 1):S41-57 - PubMed
  16. Pharmacoepidemiol Drug Saf. 2007 Apr;16(4):393-401 - PubMed
  17. Scand J Public Health. 2007;35(4):432-41 - PubMed
  18. Scand J Public Health. 2007;35(5):497-502 - PubMed
  19. Int J Epidemiol. 2009 Aug;38(4):938-43 - PubMed
  20. Int J Epidemiol. 2009 Oct;38(5):1202-6 - PubMed
  21. Int J Qual Health Care. 2009 Jun;21(3):160-8 - PubMed
  22. Pediatrics. 2009 May;123(5):e932-9 - PubMed
  23. Nephrol Dial Transplant. 2010 Mar;25(3):947-51 - PubMed
  24. Gastroenterology. 1991 Mar;100(3):790-4 - PubMed
  25. Scand J Public Health. 2010 Mar;38(2):177-83 - PubMed
  26. Int J Epidemiol. 2011 Jun;40(3):602-10 - PubMed
  27. Clin Epidemiol. 2010 Aug 09;2:51-6 - PubMed
  28. Clin Epidemiol. 2010 Dec 02;2:273-9 - PubMed
  29. Scand J Public Health. 2011 Mar;39(2):203-11 - PubMed
  30. Clin Epidemiol. 2011 Apr 01;3:133-8 - PubMed
  31. Scand J Public Health. 2011 Jul;39(7 Suppl):26-9 - PubMed
  32. Scand J Public Health. 2011 Jul;39(7 Suppl):34-7 - PubMed
  33. Scand J Public Health. 2011 Jul;39(7 Suppl):42-5 - PubMed
  34. Scand J Public Health. 2011 Jul;39(7 Suppl):54-7 - PubMed
  35. Scand J Public Health. 2011 Jul;39(7 Suppl):58-61 - PubMed
  36. Scand J Public Health. 2011 Jul;39(7 Suppl):75-8 - PubMed
  37. Scand J Public Health. 2011 Jul;39(7 Suppl):79-82 - PubMed
  38. Scand J Public Health. 2011 Jul;39(7 Suppl):83-6 - PubMed
  39. Scand J Public Health. 2011 Jul;39(7 Suppl):87-90 - PubMed
  40. Scand J Public Health. 2011 Jul;39(7 Suppl):91-4 - PubMed
  41. Scand J Public Health. 2011 Jul;39(7 Suppl):95-8 - PubMed
  42. Scand J Public Health. 2011 Jul;39(7 Suppl):103-5 - PubMed
  43. Scand J Public Health. 2011 Jul;39(7 Suppl):106-8 - PubMed
  44. Scand J Public Health. 2011 Jul;39(7 Suppl):121-5 - PubMed
  45. Scand J Public Health. 2011 Jul;39(7 Suppl):191-5 - PubMed
  46. Scand J Public Health. 2011 Jul;39(7 Suppl):201-5 - PubMed
  47. Scand J Public Health. 2011 Jul;39(7 Suppl):12-6 - PubMed
  48. Scand J Public Health. 2011 Jul;39(7 Suppl):50-3 - PubMed
  49. Vox Sang. 2012 Apr;102(3):271 - PubMed
  50. Acta Orthop. 2012 Apr;83(2):171-3 - PubMed
  51. J Am Board Fam Med. 2012 Mar;25 Suppl 1:S34-8 - PubMed
  52. Health Policy. 2012 Jul;106(2):114-9 - PubMed
  53. Clin Epidemiol. 2012;4:125-35 - PubMed
  54. BMJ Open. 2012 Jul 02;2(4):null - PubMed
  55. Scand J Public Health. 2012 Jun;40(4):391-7 - PubMed
  56. Ugeskr Laeger. 2012 Oct 15;174(42):2521 - PubMed
  57. Ugeskr Laeger. 2012 Oct 15;174(42):2536 - PubMed
  58. Ugeskr Laeger. 2012 Oct 15;174(42):2541 - PubMed
  59. Ugeskr Laeger. 2012 Oct 15;174(42):2553 - PubMed
  60. Clin Epidemiol. 2012;4:303-13 - PubMed
  61. BMJ Open. 2013 Apr 29;3(4):null - PubMed
  62. Epidemiology. 2013 Sep;24(5):632-6 - PubMed
  63. Blood Press. 2014 Apr;23(2):116-25 - PubMed
  64. Clin Epidemiol. 2013 Aug 08;5:249-62 - PubMed
  65. Dan Med J. 2013 Sep;60(9):A4693 - PubMed
  66. Crit Care. 2013 Sep 09;17(5):R192 - PubMed
  67. Eur J Epidemiol. 2014 Feb;29(2):111-8 - PubMed
  68. Am J Cardiol. 2014 Mar 1;113(5):822-6 - PubMed
  69. Int J Epidemiol. 2013 Dec;42(6):1697-701 - PubMed
  70. Clin Epidemiol. 2014 May 12;6:155-68 - PubMed
  71. Int J Obes (Lond). 2014 Oct;38(10):1305-11 - PubMed
  72. Dan Med J. 2014 Jun;61(6):A4839 - PubMed
  73. Eur J Epidemiol. 2014 Aug;29(8):541-9 - PubMed
  74. Clin Epidemiol. 2014 Jun 12;6:199-211 - PubMed
  75. Clin Epidemiol. 2014 Jul 17;6:237-46 - PubMed
  76. Clin Epidemiol. 2014 Sep 18;6:301-8 - PubMed
  77. Colorectal Dis. 2015 Jan;17(1):O27-33 - PubMed
  78. Clin Epidemiol. 2014 Dec 31;7:53-64 - PubMed
  79. Paediatr Perinat Epidemiol. 2015 May;29(3):250-8 - PubMed
  80. Circulation. 2015 May 12;131(19):1682-90 - PubMed
  81. Scand J Soc Med. 1989;17(4):277-80 - PubMed
  82. Int J Epidemiol. 2015 Jun;44(3):827-36 - PubMed
  83. Clin Epidemiol. 2015 Jul 17;7:347-53 - PubMed
  84. Clin Epidemiol. 2015 Aug 13;7:369-80 - PubMed
  85. Clin Epidemiol. 2015 Nov 17;7:449-90 - PubMed
  86. Clin Epidemiol. 2015 Nov 26;7:509-15 - PubMed
  87. Glob Cardiol Sci Pract. 2015 Oct 09;2015(3):33 - PubMed
  88. Clin Epidemiol. 2016 Aug 09;8:273-83 - PubMed
  89. Int J Epidemiol. 2017 Jun 1;46(3):798-798f - PubMed
  90. Clin Epidemiol. 2016 Oct 25;8:439-443 - PubMed
  91. Clin Epidemiol. 2016 Oct 25;8:445-449 - PubMed
  92. Clin Epidemiol. 2016 Oct 25;8:451-456 - PubMed
  93. Clin Epidemiol. 2016 Oct 25;8:457-460 - PubMed
  94. Clin Epidemiol. 2016 Oct 25;8:461-464 - PubMed
  95. Clin Epidemiol. 2016 Oct 25;8:465-468 - PubMed
  96. Clin Epidemiol. 2016 Oct 25;8:469-474 - PubMed
  97. Clin Epidemiol. 2016 Oct 25;8:479-483 - PubMed
  98. Clin Epidemiol. 2016 Oct 25;8:485-490 - PubMed
  99. Clin Epidemiol. 2016 Oct 25;8:497-502 - PubMed
  100. Clin Epidemiol. 2016 Oct 25;8:503-508 - PubMed
  101. Clin Epidemiol. 2016 Oct 25;8:509-514 - PubMed
  102. Clin Epidemiol. 2016 Oct 25;8:515-520 - PubMed
  103. Clin Epidemiol. 2016 Oct 25;8:521-524 - PubMed
  104. Clin Epidemiol. 2016 Oct 25;8:525-530 - PubMed
  105. Clin Epidemiol. 2016 Oct 25;8:537-541 - PubMed
  106. Clin Epidemiol. 2016 Oct 25;8:543-548 - PubMed
  107. Clin Epidemiol. 2016 Oct 25;8:549-552 - PubMed
  108. Clin Epidemiol. 2016 Oct 25;8:553-560 - PubMed
  109. Clin Epidemiol. 2016 Oct 25;8:561-565 - PubMed
  110. Clin Epidemiol. 2016 Oct 25;8:567-572 - PubMed
  111. Clin Epidemiol. 2016 Oct 25;8:577-581 - PubMed
  112. Clin Epidemiol. 2016 Oct 25;8:583-587 - PubMed
  113. Clin Epidemiol. 2016 Oct 25;8:589-594 - PubMed
  114. Clin Epidemiol. 2016 Oct 25;8:595-599 - PubMed
  115. Clin Epidemiol. 2016 Oct 25;8:601-606 - PubMed
  116. Clin Epidemiol. 2016 Oct 25;8:607-612 - PubMed
  117. Clin Epidemiol. 2016 Oct 25;8:613-619 - PubMed
  118. Clin Epidemiol. 2016 Oct 25;8:629-632 - PubMed
  119. Clin Epidemiol. 2016 Oct 25;8:633-636 - PubMed
  120. Clin Epidemiol. 2016 Oct 25;8:637-643 - PubMed
  121. Clin Epidemiol. 2016 Oct 25;8:645-648 - PubMed
  122. Clin Epidemiol. 2016 Oct 25;8:661-666 - PubMed
  123. Clin Epidemiol. 2016 Oct 25;8:673-678 - PubMed
  124. Clin Epidemiol. 2016 Oct 25;8:679-683 - PubMed
  125. Clin Epidemiol. 2016 Oct 25;8:685-690 - PubMed
  126. Clin Epidemiol. 2016 Oct 25;8:703-707 - PubMed
  127. Clin Epidemiol. 2016 Oct 25;8:713-718 - PubMed
  128. Clin Epidemiol. 2016 Oct 25;8:731-735 - PubMed
  129. Clin Epidemiol. 2016 Oct 25;8:737-742 - PubMed
  130. Clin Epidemiol. 2016 Oct 25;8:655-660 - PubMed
  131. Clin Epidemiol. 2016 Oct 25;8:709-712 - PubMed
  132. Clin Epidemiol. 2016 Oct 25;8:425-427 - PubMed
  133. Clin Epidemiol. 2016 Oct 25;8:429-434 - PubMed
  134. Clin Epidemiol. 2016 Oct 25;8:435-438 - PubMed
  135. Clin Epidemiol. 2016 Oct 25;8:475-478 - PubMed
  136. Clin Epidemiol. 2016 Oct 25;8:491-496 - PubMed
  137. Clin Epidemiol. 2016 Oct 25;8:531-535 - PubMed
  138. Clin Epidemiol. 2016 Oct 25;8:573-576 - PubMed
  139. Clin Epidemiol. 2016 Oct 25;8:621-627 - PubMed
  140. Clin Epidemiol. 2016 Oct 25;8:649-653 - PubMed
  141. Clin Epidemiol. 2016 Oct 25;8:667-671 - PubMed
  142. Clin Epidemiol. 2016 Oct 25;8:691-695 - PubMed
  143. Clin Epidemiol. 2016 Oct 25;8:697-702 - PubMed
  144. Clin Epidemiol. 2016 Oct 25;8:725-729 - PubMed
  145. BMJ Open. 2016 Nov 18;6(11):e012832 - PubMed
  146. Int J Epidemiol. 2016 Oct;45(5):1401-1402g - PubMed
  147. BMJ Open. 2016 Dec 9;6(12):e012817 - PubMed
  148. Clin Genet. 2017 Sep;92(3):338-341 - PubMed
  149. Basic Clin Pharmacol Toxicol. 2017 May;120(5):419-425 - PubMed
  150. Br J Psychiatry. 2017 May;210(5):356-361 - PubMed
  151. Clin Epidemiol. 2017 Feb 17;9:105-111 - PubMed
  152. Clin Epidemiol. 2017 Feb 23;9:127-139 - PubMed
  153. Vaccine. 2017 Oct 9;35(42):5589-5596 - PubMed
  154. Int J Epidemiol. 2017 Oct 1;46(5):1368-1369g - PubMed
  155. Eur J Epidemiol. 2018 Jan;33(1):27-36 - PubMed
  156. J Am Coll Cardiol. 2018 Mar 20;71(11):1259-1272 - PubMed
  157. BMJ Open. 2018 Apr 7;8(4):e017273 - PubMed
  158. Int J Epidemiol. 2018 Aug 1;47(4):1023-1024e - PubMed
  159. BMJ. 2018 Sep 4;362:k3426 - PubMed
  160. Scand J Public Health. 2018 Sep 17;:1403494818799613 - PubMed
  161. Eur J Epidemiol. 2019 Jan;34(1):79-90 - PubMed
  162. Clin Epidemiol. 2019 May 13;11:397-402 - PubMed
  163. Methods Inf Med. 1986 Jul;25(3):158-64 - PubMed
  164. Dis Colon Rectum. 1984 Jun;27(6):351-5 - PubMed
  165. Dan Med Bull. 1998 Apr;45(2):221-5 - PubMed
  166. Dan Med Bull. 1998 Jun;45(3):320-3 - PubMed

Publication Types