Inequities in Mental Health Care Quality and Clinical Outcomes Among Inpatients with Depression Within a Tax-Financed Universal Health Care System

Figures & data

Table 1 Performance Measures of Quality of Care in the Danish Depression Database for Inpatients

Performance Measures		Definition
1	Examination by psychiatrist	Indication of whether the patient’s psychopathological assessment was performed by a specialist in psychiatry within seven days after admittance to the hospital ward.
2	Somatically examined	Neurological examination, relevant laboratory tests and other examinations within two days of admittance.
3	Assessment by social worker	Assessment of need for acute or longer-term support, such as help with changing housing, financial help to purchase medicine, educational guidance, rehabilitation, and application for disability benefits.
4	HAM-D17^a assessment (In)	Initial assessment using HAM-D17 within seven days of admittance.
5	HAM-D17 assessment (Out)	Assessment using HAM-D17 at discharge from hospital.
6	Suicide risk assessment (In)	Using structured interview at admittance for suicide risk assessment.
7	Suicide risk assessment (Out)	Clinician’s assessment of the patient’s risk of suicide when discharge from hospital is planned.
8	Contact with relatives	Staff have established or tried to establish contact with the patient’s relatives during hospitalization.
9	Psychiatric aftercare	Before discharge, an agreement has been made on a specific time and place for follow-up care after discharge in an outpatient clinic or at the general practitioner.

Abbreviation: ^aHAM-D17, Hamilton depression scale (17-item version).

Table 2 Patient Characteristics According to Each Stratum of Education, Income, and Employment Status

	Total		Education						Income
			Low (N = 3762)^a		Middle (N = 4433)^a		High (N = 2528)^a		Low (N = 3639)^a		Middle (N = 3639)^a		High (N = 3638)^a
	N	%	N	%	N	%	N	%	N	%	N	%	N	%
Sex
Woman	6082	55.6	2148	57.1	2288	51.6	1531	60.6	2084	57.3	2008	55.2	1981	54.5
Age group
< 31 years	1394	12.7	959	25.5	890	20.1	234	9.3	721	19.8	737	20.3	644	17.7
21–60 years	4198	38.4	1396	37.1	2276	51.3	1539	60.9	1227	33.7	1689	46.4	2399	65.9
61–100 years	4139	37.8	1407	37.4	1267	28.6	755	29.9	1691	46.5	1213	33.3	595	16.4
Immigrant status
Native Danes	9957	91.8	3505	93.2	4090	92.3	2297	90.1	3302	90.8	3309	90.9	3402	93.5
Western migrants	576	5.3	59	1.6	115	2.6	118	4.7	105	2.9	112	3.1	98	2.7
Other migrants	310	2.9	198	5.3	228	5.1	113	4.5	232	6.4	218	6.0	138	3.8
Substance/alcohol abuse
Yes	1304	11.9	540	14.4	528	11.9	209	8.3	570	15.7	429	11.8	297	8.2

Note: ^aPatients with missing values not included.

Figure 1 Proportions and relative risk for high quality of care, 1-year all-cause mortality, 1-year suicidal behavior (suicide attempts and suicide completions), 1-year readmission with depression and 1-year all-cause readmission according to educational- and income level. Variables used for adjustment included sex, age, migration status, and substance/alcohol abuse.

Abbreviation: MDD, major depressive disorder.

Figure 2 Proportions and relative risk for the nine individual quality performance measures according to educational- and income level. Variables used for adjustment included sex, age, migration status, and substance/alcohol abuse.

Abbreviations: MDD, major depressive disorder; HAM-D17, Hamilton depression scale (17-item version).