The effects of a cancer diagnosis on the health of a patient's partner: a population-based registry study of cancer in Sweden.

The aim of this population-based registry study was to explore how cancer influences the health of partners, by examining the onset of new diagnoses for partners, health care use and health care costs among partners living with patients with cancer. The sample consisted of partners of patients with cancer (N = 10 353) and partners of age- and sex-matched controls who did not have cancer (N = 74 592). Diagnoses, health care use and health care costs were studied for a continuous period starting 1 year before the date of cancer diagnosis and continued for 3 years.

Cancer among patients with diabetes, obesity and abnormal blood lipids: a population-based register study in Sweden.

Objective: To study how the incidence of cancer is related to diabetes, obesity or abnormal blood lipids.

Methods: Diagnosis of diabetes, obesity or abnormal blood lipids was studied 0-10 years prior to the diagnosis of cancer in 19,756 cases of cancer and in 147,324 controls matched regarding age, sex and domicile.

Results: Diabetes was significantly more common prior to diagnosis in patients with liver, pancreatic, colon and urinary tract/bladder cancer and in patients with breast cancer diagnosed with diabetes 0-4 years prior to the cancer diagnosis.

Sickness absence among cancer patients in the pre-diagnostic and the post-diagnostic phases of five common forms of cancer.

Purpose: The purpose of this study was to observe sickness absence before and after the cancer diagnosis among cancer patients with five common forms of cancer.

Methods: Using cohort data, we observed sick leave in the pre- and post-diagnostic phase among patients with colon, rectal, breast, prostate, or lung cancer (n = 2,738). We also identified reference subjects without cancer (total n = 12,246) who were individually matched for age and gender for each specific cancer cohort in order to compare sickness absence between patients with a specific form of cancer and the background population without cancer.

Low cancer rates among patients with dementia in a population-based register study in Sweden.

Background: Some studies have suggested a lower incidence of cancer in patients with dementia. We studied this further for 18 cancer types in population-based registers.

Methods: In 19,756 cases and in 147,324 age- and sex-matched controls a diagnosis of dementia was studied 9-45 months prior to the diagnosis of cancer.

Sick leave of spouses to cancer patients before and after diagnosis.

Background: The impact of cancer on spouses of cancer patients may be considerable in many aspects. Our objective was to evaluate sick leave in spouses of cancer patients before and after the diagnosis.

Material And Methods: Using Swedish population-based registries, we studied sick leave of spouses to patients with newly diagnosed colon, rectal, lung, prostate, or breast cancer.

Health care utilisation and attitudes towards health care in subjects reporting environmental annoyance from electricity and chemicals.

Environmentally intolerant persons report decreased self-rated health and daily functioning. However, it remains unclear whether this condition also results in increased health care costs. The aim of this study was to describe the health care consumption and attitudes towards health care in subjects presenting subjective environmental annoyance in relation to the general population, as well as to a group with a well-known disorder as treated hypertension (HT).

Influence on the health of the partner affected by tumor disease in the wife or husband based on a population-based register study of cancer in Sweden.

Purpose: To examine health care use and health care costs among partners of persons with cancer.

Patients And Methods: Partners of patients with colon, rectal, lung, breast, and prostate cancer (N = 11,076) were identified via linked data from the Tumor Registry of Southern Sweden and Census Registry of Sweden. Health care use, total costs of health care, and diagnosis of the partner were studied before and after diagnosis of the cancer patient.

Social capital, the miniaturisation of community, traditionalism and first time acute myocardial infarction: a prospective cohort study in southern Sweden.

This longitudinal study investigates the impact of social participation, trust and the combinations of social participation and trust on the incidence of first time acute myocardial infarction (AMI) in the population of Scania, southern Sweden. It is based on the cross-sectional 2000 public-health survey in Scania with a 59% participation rate and 13,604 participants, and prospective morbidity/mortality data collected for three years (January 2000-December 2002). The study cohort was followed prospectively to examine first ever AMI.

Representativity of a postal public health questionnaire survey in Sweden, with special reference to ethnic differences in participation.

Aim: Non-participation in health surveys is a common phenomenon. When differences between participants and non-participants are considerable, the external validity of the sample survey may decrease and false conclusions might be drawn about the health status of the population. For this reason, the authors aimed to investigate the representativity of a postal questionnaire survey performed in the county of Scania, Sweden, in 1999-2000.

The role country of birth plays in receiving disability pensions in relation to patterns of health care utilisation and socioeconomic differences: a multilevel analysis of Malmo, Sweden.

Background: People of low socioeconomic status have worse health and a higher probability of being granted a disability pension than people of high socioeconomic status. It is also known that public and private general physicians and public and private specialists have varying practices for issuing sick leave certificates (which, if longstanding, may become the basis of disability pensions). However, few studies have investigated the influence of a patient's country of birth in this context.

Children's exposure to nitrogen dioxide in Sweden: investigating environmental injustice in an egalitarian country.

Study Objective: Prior studies have shown that children are particularly sensitive to air pollution. This study examined whether children of low socioeconomic status suffered greater exposure to outdoor nitrogen dioxide than more affluent ones, both at their place of residence and at school, in a country with widespread state intervention for social equity.

Design: Local scale data on outdoor nitrogen dioxide obtained from a validated air pollution model were analysed, along with all school children accurately geocoded to their building of residence and school.

The Danish effect on Swedish alcohol costs. An analysis based on hospitalization data from southern Sweden.

This study investigated: (a) the cost and change in hospitalizations related to alcohol misuse for the healthcare sector and (b) the effect of distance to the border on alcohol-related hospitalization costs. The first objective was analyzed using descriptive statistics and the second using ordinary least squares regression on aggregated municipality data. The total cost decreased marginally during the study period while the number of patient-cases decreased substantially, presenting evidence of a substitution towards outpatient care.

Understanding adherence to official guidelines on statin prescribing in primary health care--a multi-level methodological approach.

Objective: The aim was to investigate the role that municipalities and out-patient health care centres (HCCs) have in understanding adherence to official guidelines on statin prescribing. Our hypothesis was that after guideline publication, adherence to recommended statin prescription would increase and variance among HCCs and municipalities would decrease. Since multi-level regression analysis (MLRA) is a relatively new methodology in pharmacoepidemiology, we also aimed to explore the application of MLRA in our investigation.

Low adherence with antihypertensives in actual practice: the association with social participation--a multilevel analysis.

Background: Low adherence is a key factor in explaining impaired effectiveness and efficiency in the pharmacological treatment of hypertension. However, little is known about which factors determine low adherence in actual practice. The purpose of this study is to examine whether low social participation is associated with low adherence with antihypertensive medication, and if this association is modified by the municipality of residence.

Country of birth, socioeconomic position, and healthcare expenditure: a multilevel analysis of Malmö, Sweden.

Study Objective: The principle of equity aims to guarantee allocation of healthcare resources on the basis of need. Therefore, people with a low income and persons living alone are expected to have higher healthcare expenditures. Besides these individual characteristics healthcare expenditure may be influenced by country of birth.

Prostate cancer--prevalence-based healthcare costs.

Objective: To calculate the total costs of in- and outpatient healthcare for patients with prostate cancer based on an episode-of-care approach. The cost analysis includes costs incurred during the first year of diagnosis, a longitudinal 3-year analysis and the incremental cost of prostate cancer during the first year of diagnosis.

Material And Methods: Patients registered with prostate cancer between 1998 and 2000, according to the data files of the Southern Swedish Regional Tumour Registry, were given encrypted identifiers that could also be used in the Patient Administrative System of the Region Skåne County Council, making it possible to identify consumption of healthcare on an episode-of-care basis.

Utilisation of antibiotics in young children: opposite relationships to adult educational levels in Danish and Swedish counties.

Background: Antibiotic utilisation varies profoundly among and within countries, and the extent of antibiotic utilisation correlates with the frequency of bacterial resistance, particularly among children. Hence, it is important to assess which factors may influence prescribing. In addition to variations in morbidity, health-care organisation, drug regulatory and supply systems, prescriber's attitudes, parents' behaviour, attitudes and socio-economic positions seem important.

Social inequalities in health- do they diminish with age? Revisiting the question in Sweden 1999.

BACKGROUND: Individuals with low income have poorer health and should, therefore, have higher health expenditure than people with high income particularly in countries with a universal health care system. However, it has been discussed if social inequities in health diminish with age and we, hence, aimed to analyse this question. METHODS: We performed an age stratified cross-sectional analysis using averages, logistic and linear regression modelling of health care contacts, health care expenditures and mortality in relation to individual income in five groups by quintiles.

[Multilevel analysis of regional disparities in survival after heart failure: differences between county health services affect little patients' prognosis].

The prognosis for patients suffering from heart failure in Sweden differs from county to county, indicating a need for a comparative study in order to uncover the reasons. Conventional single-level analytical methods, however, underestimate the statistical uncertainty in such studies, leading to an inappropriate ranking of regions. Consequently, public opinion and decision-making may be misled.