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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.
Acknowledgments
We thank the Danish National Archives, the Danish Clinical Registries (RKKP), and many senior researchers from the Universities of Aarhus, Copenhagen, and Odense, for review and comments on . The study was supported by the Department of Clinical Epidemiology’s Research Foundation, by the Program for Clinical Research Infrastructure (PROCRIN) established by Lundbeckfonden and the Novo Nordisk Foundation, and by the Danish Research Council (grants 11-108354 and 11-115818). The funding sources had no role in the design, conduct, analysis, or reporting of the study.
Data permission
No data permission was needed.
Ethics committee approval
No ethics committee approval was needed.
Transparency declaration
The lead author affirms that the manuscript is an honest, accurate, and transparent account of the study being reported, that no important aspects of the study have been omitted, and that any discrepancies from the study as planned have been explained.
Author contributions
HTS and MS conceived the study idea. All authors contributed to the study design. MS organized the writing and wrote the initial draft. All authors contributed toward drafting and critically revising the paper, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.
Disclosure
VE reports institutional grants (none related to this work) from various pharmaceutical companies. The authors report no conflicts of interest in this work.
Supplementary materials
Table S1 Danish administrative, health, and clinical quality databases