Antenatal care in Denmark is shared between general practitioners, midwives, and hospital departments. A minimum of 9 visits is officially recommended for all pregnant women. In 1987, 80% made 10 or more visits. An inadequate number of visits in relation to recommendations was most frequent in the lowest social group. Risk of stillbirth and neonatal death varied substantially between social groups even after taking account of number of visits made.
Computer-based longitudinal recording of episodes of care in general practice using the International Classification of Primary Care (ICPC). Experience from one practice. Perspectives for audit and quality assessment.
The Danish healthcare services are mainly provided by public sector institutions. The system is highly decentralized. The state has little direct influence on the provision of healthcare services. State influence is exercised through legislation and budget allocations. The main task of the state is to initiate, coordinate, and advise. Counties, which run the hospitals, also decide on the placement of services. The hospital sector is controlled within the framework of legislation and global budgets. General practitioners occupy a central position in the Danish healthcare sector, acting as gatekeepers to the rest of the system. The system works well, and its structure has resulted in steady costs of health care for a long period. There is no regulatory mechanism in the Danish health services requiring use of health technology assessment (HTA) as a basis for policy decisions, planning, or administrative procedures. However, since the late 1970s a number of comprehensive assessments of health technology have formed the basis for national health policy decisions. In 1997, after years of public criticism of the quality of hospital care and health technologies, and on the basis of a previously developed national HTA strategy, a national institute for HTA (DIHTA) was established. There seems to be a growing awareness of evidence-based healthcare among health professionals and a general acceptance of health economic analyses as a basis for health policy decision making. This progress is coupled with growing regional HTA activity in the health services. HTA seems to have a bright future in Denmark.
The objective of the study was to characterize and quantify various demographic factors in idiopathic preterm delivery. All women with a permanent address in Denmark with singleton pregnancies who gave birth to an infant in 1982 (n = 51,851) are included. The material was obtained by a linkage of the Medical Birth Register and the National Register of Hospital Discharges, using the personal identification number. The incidence of singleton preterm delivery was 4.5% (n = 2330) of which 67% (n = 1557) were idiopathic. Neonatal mortality rates were significantly lower in idiopathic compared to indicated preterm birth. Following stepwise logistic regression analysis, maternal age below 20 (adjusted odds ratio 1.63, 95% confidence interval (CI) 1.07-2.47; p
OBJECTIVE: To characterize and quantify various demographic factors in idiopathic preterm delivery. METHODS: All women with a permanent address in Denmark and a singleton pregnancy who gave birth to a preterm infant in 1982 (N = 51,851) were included. The material was obtained by a linkage of the Medical Birth Register and the National Register of Hospital Discharges, using personal identification numbers. RESULTS: The incidence of singleton preterm delivery was 4.5% (N = 2330), of which 67% (N = 1557) were idiopathic. The neonatal mortality rate was significantly lower with idiopathic than with indicated preterm birth. Following stepwise logistic regression analysis, age under 20 (adjusted odds ratio [OR] 1.63, 95% confidence interval [CI] 1.07-2.47; P
OBJECTIVE: To describe the relationship between pregnancy complications and fetal outcome in first and second pregnancies, focusing on idiopathic and indicated preterm birth of singleton infants in either pregnancy. METHODS: Included in the study were 13,967 women in Denmark who gave birth to their first singleton infant in 1982 and a second infant in 1982-1987. Information on pregnancy and birth was obtained by linking the National Medical Birth Register and the National Register of Hospital Discharges, based on personal identification numbers. RESULTS: The risk of a preterm second birth in women with idiopathic and indicated preterm first birth did not differ significantly (15.2 and 12.8%, respectively). However, women with idiopathic preterm birth in the first pregnancy tended to repeat idiopathic preterm birth twice as often as women with indicated preterm birth repeated indicated preterm birth (11.3 versus 6.4%). Adjustment by logistic regression analysis for other risk factors for preterm birth did not influence the relative risk (6.0 before 32 weeks and 4.8 for 32-36 weeks) of a second preterm birth after a first preterm birth. Women with idiopathic preterm delivery in their first and second pregnancies gave birth to infants with lower birth weight than in previous or subsequent pregnancies. Emergency cesarean delivery in a first term pregnancy was a risk factor for subsequent idiopathic preterm birth. CONCLUSION: Idiopathic preterm birth is associated with emergency cesarean delivery at term in previous pregnancies and infants with lower birth weight in previous and subsequent pregnancies.