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A Krasnik

Publications and source records attributed to A Krasnik.

At least 19 recordsLinked to original sources

["Sound, unsound around the Sound". A congress report on health differences between Denmark and Sweden].

During the past 10 years, researchers on both sides of The Sound in the so-called Oresund region have worked together to analyze the causes of the observed differences in life expectancy between Denmark and Sweden. The region includes Copenhagen and North Zealand and the county of Scania in southern Sweden, with Malmö as its largest city. Both Denmark and Sweden held top rankings among OECD-countries in 1970 regarding life expectancy at birth. In 1990 Denmark had fallen to a bottom ranking, while Sweden was still at the top. At a scientific meeting in Malmö on January 26-27, 2000, some 60 presentations were made concerning differences and similarities in health measures on the two sides of the sound which divides the two countries. On the Swedish side, life expectancy is 3-4 years longer than on the Danish side. Paramount among explanations are higher mortality figures due to smoking and alcohol-related diseases on the Danish side, both in men and women (most pronounced). Minor contributions to the differences are suicides and traffic accidents. Historically, Denmark and Sweden have much in common. Until 1658, Scania, the Swedish county to the east of The Sound was part of Denmark. During the past 150 years rather impressive cultural differences have developed. Smoking prevalence and alcohol consumption are more than twice as high on the Danish side of the sound. In coming years, researchers, representatives for the health service systems and others will work together in order to prevent disease and promote health in the Oresund region. The conference was arranged by the Medicon Valley Academy, an EU-supported enterprise seeking to stimulate research and development within the health sector in the Oresund region (also known as Medicon Valley).

Alcohol Drinking↗

[Sound and unsound around the Sound. A congress report on health differences between Denmark and Sweden].

During the past 10 years, researchers on both sides of The Sound in the so-called Oresund region have worked together to analyze the causes of the observed differences in life expectancy between Denmark and Sweden. The region includes Copenhagen and North Zealand and the county of Scania in southern Sweden, with Malmö as its largest city. Both Denmark and Sweden held top rankings among OECD-countries in 1970 regarding life expectancy at birth. In 1990 Denmark had fallen to a bottom ranking, while Sweden was still at the top. At a scientific meeting in Malmö on January 26-27, 2000, some 60 presentations were made concerning differences and similarities in health measures on the two sides of the sound which divides the two countries. On the Swedish side, life expectancy is 3-4 years longer than on the Danish side. Paramount among explanations are higher mortality figures due to smoking and alcohol-related diseases on the Danish side, both in men and women (most pronounced). Minor contributions to the differences are suicides and traffic accidents. Historically, Denmark and Sweden have much in common. Until 1658, Scania, the Swedish county to the east of The Sound was part of Denmark. During the past 150 years rather impressive cultural differences have developed. Smoking prevalence and alcohol consumption are more than twice as high on the Danish side of the sound. In coming years, researchers, representatives for the health service systems and others will work together in order to prevent disease and promote health in the Oresund region. The conference was arranged by the Medicon Valley Academy, an EU-supported enterprise seeking to stimulate research and development within the health sector in the Oresund region (also known as Medicon Valley).

Alcohol Drinking↗

["Sound and unsound around the Sound". A congress report on health differences between Denmark and Sweden].

During the past 10 years, researchers on both sides of The Sound in the so-called Oresund region have worked together to analyze the causes of the observed differences in life expectancy between Denmark and Sweden. The region includes Copenhagen and North Zealand and the county of Scania in southern Sweden, with Malmö as its largest city. Both Denmark and Sweden held top rankings among OECD-countries in 1970 regarding life expectancy at birth. In 1990 Denmark had fallen to a bottom ranking, while Sweden was still at the top. At a scientific meeting in Malmö on January 26-27, 2000, some 60 presentations were made concerning differences and similarities in health measures on the two sides of the sound which divides the two countries. On the Swedish side, life expectancy is 3-4 years longer than on the Danish side. Paramount among explanations are higher mortality figures due to smoking and alcohol-related diseases on the Danish side, both in men and women (most pronounced). Minor contributions to the differences are suicides and traffic accidents. Historically, Denmark and Sweden have much in common. Until 1658, Scania, the Swedish county to the east of The Sound was part of Denmark. During the past 150 years rather impressive cultural differences have developed. Smoking prevalence and alcohol consumption are more than twice as high on the Danish side of the sound. In coming years, researchers, representatives for the health service systems and others will work together in order to prevent disease and promote health in the Oresund region. The conference was arranged by the Medicon Valley Academy, an EU-supported enterprise seeking to stimulate research and development within the health sector in the Oresund region (also known as Medicon Valley).

Alcohol Drinking↗

[Access to Danish health care by immigrant women. Access to hospital care among immigrant women with breast cancer compared with Danish women].

The study aim is to measure possible differences in access to health care among immigrant women with breast cancer compared with Danish women. We used tumour size at diagnosis as a proxy measure of access. The Danish Central Personal Register provided information from 1977-1996 on women between 20-75 years born in countries in which Islam is the dominating faith. These data were linked to the Danish Breast Cancer Cooperative Group, which registers data concerning tumour size. Sixty-five immigrant women with breast cancer were identified and matched with a control population of Danish women. The study showed larger tumours at diagnosis among women from ethnic minority groups compared to Danes. However, this tendency was not significant. Furthermore, mammographic screening had a significant effect on the tumour sizes of Danish women, but not on those of immigrants. The study indicates ethnic inequalities related to access to health services as measured by tumour size.

Adult↗

Effect of social class on tumour size at diagnosis and surgical treatment in Danish women with breast cancer.

This study examines the effect of socio-economic inequalities on the tumour size at diagnosis and the choice of surgical treatment in Danish women with breast cancer. The Danish Breast Cancer Cooperative Group (DBCG) registers all women with breast cancer in Denmark and provides clinical register data on tumour size and surgical treatment for 1594 women <75 yr diagnosed with breast cancer between 1991 and 1996. A questionnaire including questions on social class was sent to the women. The tumour size at diagnosis (an indicator of access to treatment) and the surgical procedure (lumpectomy or mastectomy) for patients who were potential candidates for lumpectomy were the main outcome measures examined. Social class was not associated with tumour size at diagnosis. The tumour size was associated with age and the existence of a mammographic screening program in the county. However, treatment was strongly related to social class. Among women considered candidates for lumpectomy 77% underwent lumpectomy in the highest social class, compared to 50% in the lowest social class. Treatment was associated with age, tumour size and hospital status. It was concluded that the study showed no socio-economic inequalities related to access to health services as measured by tumour size, though significant social differences were found regarding treatment.

Breast Neoplasms↗

[Changing life expectancy in the 1980's. Why was Denmark different from Sweden?].

The aim of the present study was to identify the contribution from specific causes of death to the changes in life expectancy at birth in Denmark relative to Sweden in different age groups during the 1980s and to compare the difference in life expectancy between the two countries in 1990. Mortality data from WHO mortality tapes grouped in smaller series of clinically meaningful categories were used to calculate the contribution of each of these categories at each ten year age group to the difference in life expectancy at birth in each country between 1979 and 1990 and between the two countries. During the period from 1979 to 1990 life expectancy increased in both Denmark and Sweden. However, Sweden experienced the greatest increase in life expectancy (more than two years) while it increased less than one year in Denmark. In both countries a decrease in cardiovascular disease mortality contributed most to the increase in life expectancy among males as well as females. Both among males and females the less favourable development in Denmark was mainly caused by differences in mortality trends related to cardio-vascular diseases, respiratory and non-respiratory cancer. Over a short period of time two Nordic countries experienced remarkable, but different changes in mortality. These findings suggest that mortality rates are sensitive to even minor differences in social and cultural factors across countries and over short time periods.

Adolescent↗

Copenhagen Community Psychiatric Project (CCPP): characteristics and treatment of homeless patients in the psychiatric services after introduction of community mental health centres.

The main purpose of the study was to describe the characteristics of homeless psychiatric patients, and to compare the treatment they are offered to that offered to domiciled patients by the psychiatric services. Another purpose was to analyse the prevalence of homelessness among psychiatric patients before and after the introduction of community mental health centres in Copenhagen. Cross-sectional studies were conducted in two intervention and two control districts before and after introduction of the new treatment modalities. In 1991, 80 of 1008 patients (8%) were homeless. Male sex, young age, living on general welfare, schizophrenia and alcohol or substance abuse were the factors that most markedly differentiated homeless from domiciled patients. Compared with the treatment of domiciled patients, the homeless were more likely to be offered no further treatment after consultation in a psychiatric emergency and, if admitted, they were more likely to be placed in locked wards, given compulsory medication, and medicated with depot neuroleptics. The homeless were also less likely to be offered psychotherapy and consultation with a social worker. Schizophrenia and alcohol or substance abuse characterised the majority of the patients discharged homeless. In the intervention districts, the number of homeless patients in contact with the psychiatric services was found to increase at the same rate as the number of all patients in contact with the psychiatric services. In the control districts, no changes in prevalence of homeless patients or other patients in contact with the psychiatric services occurred. It is concluded that homeless psychiatric patients comprise a difficult patient group, with problems of schizophrenia, substance abuse and lack of motivation for treatment. It is recommended that special efforts be made to create housing facilities that fit the needs of different types of homeless patients, and that the homeless mentally ill are assisted in obtaining and maintaining an acceptable housing situation.

Adolescent↗

The Danish National Health Service Register. A tool for primary health care research.

The purpose of the article is to describe the Danish National Health Service Register and its value in primary health care research, using mainly general practice as an example. The Danish National Health Service Register is a data system available for counties and municipalities to manage the National Health Insurance covering primary health care providers. The counties use the register for administrative purposes, especially for the settling of accounts with providers. The register contains data on all citizens, providers, and health care services reimbursed by the health authorities, but holds no data regarding health status. The accuracy and degree of completeness of persons and variables in the National Health Service Register rests on the fact that most primary health care services in Denmark are reimbursed and, therefore, included in the data base. This tie to the economy of both health care authorities and providers is supposed to confer the final register with a high degree of completeness. It is a clear advantage that almost all citizens in Denmark are assigned to only one general practice, and that the attitude towards research is positive among Danish patients and doctors. The register has so far only been used occasionally for research purposes. To take advantage of the register for research purposes within clinical and health services research, however, one must possess not only a detailed knowledge of the Danish society, including the structure of the Danish health care system, but also an intimate acquaintance with rather complex agreement system and the actual interpretation of this.

Denmark↗

Determinants of general practice utilization in Denmark.

The study was undertaken to identify determinants of health services' utilization related to organizational characteristics of the health services, social characteristics of the community, and health and socio-demographic characteristics of the population. We used a follow-up design involving a time dimension of 12 months. A cohort of 3000 50-year old males and females were randomly selected from an urban county near Copenhagen and a rural county in Western Jutland and 65% agreed to participate. Data were collected through: 1) mailed questionnaires to the participants every three months, 2) a mailed questionnaire to all general practitioners in the counties, and 3) the Health Insurance Register. Data were analyzed by multivariate logistic regression analysis. Utilization of health services was found to be strongly associated with gender and health characteristics, especially with respect to functional status and chronic diseases. Health service characteristics, demographic and psycho-social factors had very little impact on utilization patterns. The utilization of publicly financed health services was found to be determined by health needs rather than by social, psychological and organizational factors, indicating geographical and social equity in the access to the Danish health services.

Catchment Area, Health↗

CCPP-Copenhagen Community Psychiatric Project. Implementation of community mental health centres in Copenhagen: effects of service utilization, social integration, quality of life and positive and negative symptoms.

Deinstitutionalization of psychiatry in Denmark has been extensive and the number of psychiatric beds per 1,000 inhabitants is among the lowest in Europe. The effect of supplementing hospital treatment with treatment in community mental health centres was evaluated in a quasi-experimental design. The patient group examined consisted of patients with long-term contact with psychiatric services. When development in intervention and control districts was compared, the only significant difference was that the total patient group in the intervention district had an increased number of day attendances per year. Comparison of patients from intervention districts who attended day-centres regularly with patients from control districts before and after implementation of community mental health centres indicated that patients from intervention districts had a reduction in the use of inpatient services, a significant increase in quality of life and a significant decrease in the presence of the negative symptom, alogia. We concluded that implementation of community mental health centres can increase the quality of life for the patients and decrease the frequency of the negative symptom, alogia.

Adult↗

Changing life expectancy in the 1980s: why was Denmark different from Sweden?

OBJECTIVE: To identify the contribution from specific causes of death to the changes in life expectancy at birth in Denmark relative to Sweden in different age groups during the 1980s and to compare the difference in life expectancy between the two countries in 1990. DESIGN: Mortality data from WHO mortality tapes grouped in smaller series of clinically meaningful categories were used to calculate the contribution of each of these categories at each 10 year age group to the difference in life expectancy at birth in each country between 1979 and 1990 and between the two countries. SETTING: Denmark and Sweden. RESULTS: Between 1979 and 1990 life expectancy increased in both Denmark and Sweden. However, the increase in Sweden was more than two years while that in Denmark was less than one year. In both countries a decrease in cardiovascular disease mortality contributed most to the increase in life expectancy in males as well as females. In both sexes the smaller increase in life expectancy in Denmark was a result of differences in mortality trends in cardiovascular diseases and respiratory and non-respiratory cancers. CONCLUSION: Over a short time two Nordic countries experienced remarkable but different changes in mortality. These findings suggest that mortality rates are sensitive to even minor differences in social and cultural factors across countries and over short time periods.

Adolescent↗

The concept of equity in health services research.

A population approach and the general right to health and medical care have been important issues in the development of health policy over many centuries. However, equity is still a crucial issue in the planning and evaluation of health care. Many definitions and criteria related to equity have been formulated on the basis of conflicting theories and models. Three dimensions of fair and just resource allocation are essential when needs-based models are used: equity in access, utilization, and quality of care relative to needs. Health services research should concentrate on such outcome measures regarding equity and the effect of organizational and processual characteristics of health care systems. Prominent examples of such research efforts are presented, but, unfortunately, there are few reliable and systematic data from this kind of study. Health care researchers have a special responsibility towards the population at large to undertake qualified research on equity and to communicate the results to the general public.

Community Health Services↗