ArticleBMC health services research2011
Something is amiss in Denmark: a comparison of preventable hospitalisations and readmissions for chronic medical conditions in the Danish Healthcare system and Kaiser Permanente.
Article in BMC health services research, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.
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Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it, 50 citations in OpenAlex.
- Pooled it
- Comparative health systems research among Kaiser Permanente and other integrated delivery systems: a systematic literature review.The Permanente journal · 2014Pooled it
- Performing up to Nordic principles? Geographic and socioeconomic equity in ambulatory care sensitive conditions among older adults in capital areas of Denmark, Finland and Sweden in 2000-2015.BMC health services research · 2023Article
- First Nations' hospital readmission ending in death: a potential sentinel indicator of inequity?International journal of circumpolar health · 2021Article
- Hospitalization for ambulatory care sensitive conditions: What conditions make inter-country comparisons possible?Health policy OPEN · 2021Article
- Impact of Integrated Care on the Rate of Hospitalization for Ambulatory Care Sensitive Conditions among Older Adults in Stockholm County: An Interrupted Time Series Analysis.International journal of integrated care · 2021Article
- Predicting Individual Risk of Emergency Hospital Admissions - A Retrospective Validation Study.Risk management and healthcare policy · 2021Article
- Efficiency in chronic illness care coordination: public-private collaboration models vs. traditional management.BMC health services research · 2020Article
- Comparison and Impact of Four Different Methodologies for Identification of Ambulatory Care Sensitive Conditions.International journal of environmental research and public health · 2020Article
- Cohort profile: CROSS-TRACKS: a population-based open cohort across healthcare sectors in Denmark.BMJ open · 2020Article
- Profit distribution and managers' behaviour in vertical integrated medical delivery systems - an experimental economics study.BMC health services research · 2020Article
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- Comparative Causal Analysis of the Effects of Long-Acting Muscarinic Antagonist Versus No Long-Acting Bronchodilator Use on Readmission or Mortality After Hospitalization for Chronic Obstructive Pulmonary Disease.Drugs - real world outcomes · 2020Article
- Trajectory modelling of ambulatory care sensitive conditions in Finland in 1996-2013: assessing the development of equity in primary health care through clustering of geographic areas - an observational retrospective study.BMC health services research · 2019Observational
- Impact of Integrated Care on Patient-Related Outcomes Among Older People - A Systematic Review.International journal of integrated care · 2019Article
- Determinants and Differences of Township Hospital Efficiency among Chinese Provinces.International journal of environmental research and public health · 2019Article
- Variation in Point-of-Care Testing of HbA1c in Diabetes Care in General Practice.International journal of environmental research and public health · 2017Article
- Can Vertical Integration Reduce Hospital Readmissions? A Difference-in-Differences Approach.Medical care · 2017Article
- A retrospective analysis to identify predictors of COPD-related rehospitalization.BMC pulmonary medicine · 2016Article
- Article
Corrections and comments
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Authors and funding
9 authors at 7 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAs many other European healthcare systems the Danish healthcare system (DHS) has targeted chronic condition care in its reform efforts. Benchmarking is a valuable tool to identify areas for improvement. Prior work indicates that chronic care coordination is poor in the DHS, especially in comparison with care in Kaiser Permanente (KP), an integrated delivery system based in the United States. We investigated population rates of hospitalisation and readmission rates for ambulatory care sensitive, chronic medical conditions in the two systems.
methodsUsing a historical cohort study design, age and gender adjusted population rates of hospitalisations for angina, heart failure, chronic obstructive pulmonary disease, and hypertension, plus rates of 30-day readmission and mortality were investigated for all individuals aged 65+ in the DHS and KP.
resultsDHS had substantially higher rates of hospitalisations, readmissions, and mean lengths of stay per hospitalisation, than KP had. For example, the adjusted angina hospitalisation rates in 2007 for the DHS and KP respectively were 1.01/100 persons (95%CI: 0.98-1.03) vs. 0.11/100 persons (95%CI: 0.10-0.13/100 persons); 21.6% vs. 9.9% readmission within 30 days (OR = 2.53; 95% CI: 1.84-3.47); and mean length of stay was 2.52 vs. 1.80 hospital days. Mortality up through 30 days post-discharge was not consistently different in the two systems.
conclusionsThere are substantial differences between the DHS and KP in the rates of preventable hospitalisations and subsequent readmissions associated with chronic conditions, which suggest much opportunity for improvement within the Danish healthcare system. Reductions in hospitalisations also could improve patient welfare and free considerable resources for use towards preventing disease exacerbations. These conclusions may also apply for similar public systems such as the US Medicare system, the NHS and other systems striving to improve the integration of care for persons with chronic conditions.
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