[Selective screening for hepatitis B in pregnant women in Denmark]. / Selektiv hepatitis B-screening af gravide i Danmark.

INTRODUCTION: The objective of this study was to evaluate the implementation of the present Danish selective screening strategy for possible hepatitis B infection in pregnant women who themselves or whose partners originate from medium- or high-endemic hepatitis B areas of the world. We also investigated whether children of hepatitis B carriers were treated with immunoglobulin and vaccination. MATERIALS AND METHODS: We did a retrospective study of 1,924 birth notification forms of women who had delivered between 1 January and 30 June 2000 in Frederiksborg County, Denmark. Women were selected who had foreign-sounding names. The hospital case notes were examined to determine the women's countries of origin and their hepatitis B screening status. We then contacted the Department of Clinical Immunology of each hospital and the Danish State Serum Institute to double-check the women's screening status. RESULTS: The study included 210 women, who made up nearly 11% of this cohort. Sixty-eight (32%) of the women had been tested according to the guidelines. One woman was a hepatitis B carrier. Her child had received immunoglobulin and vaccination within 24 hours of birth. CONCLUSION: This study indicates that a selective antenatal screening program for hepatitis B is difficult to implement in daily clinical practice. The fact that only one third of this well-defined risk group had been tested for hepatitis B emphasizes the need for a universal antenatal screening program.

[The Danish Hysterectomy Database seen from a public health-economic perspective]. / Dansk Hysterektomi Database set i et sundhedsøkonomisk perspektiv.

INTRODUCTION: National clinical databases are a tool for quality improvement in clinical divisions. Furthermore, they can be used to make the quality of health care contributions visible to the population, as part of the free choice of hospital. Using data from one of the Danish nationwide databases, this article is the first to illustrate the potential economic resource gains from the use of these databases. MATERIALS AND METHODS: The calculations performed are based on the Danish Hysterectomy Database. This database has selected quality indicators and measures for quality improvements for a three years period and include reduction of complications to one in three (from 18% to 6%), reduction of admission to one in two (from 4 to 2 days) and reduction of rehospitalisation and reoperation to one in two (from 6% to 3%). RESULTS: Provided the proposed improvements are achieved, the expected resource gain will be approximately Dkr. 22 million (depending on the method of calculation). In-bed per day charges and "hotel charges" may vary considerably among hospitals. DISCUSSION: Every year, Dkr. 15 million are allocated to the national clinical databases, and in 2003, 34 different databases received financial support. The maximum amount that each database can receive is Dkr. 500,000. The amount currently allocated to quality monitoring is small compared to the potential resource gains from these databases and the annual expenditures by the Danish health care sector, which amount to a total of Dkr. 48 billion.

[Who are the users of emergency contraception?]. / Hvem anvender nødpraevention?

INTRODUCTION: A user profile is necessary in order to direct future campaigns for emergency contraception (EC). MATERIAL AND METHODS: Over a three-month period, 423 women with prescriptions for EC were consecutively entered in the study, which was carried out in four inner-city pharmacies in Copenhagen, Denmark. RESULTS: The median age was 24 years (range 13-50 years). Most women (73%) were first-time users of EC. The reason for the current need for EC was most often condom failure (54%) or non-use of any contraceptive method (41%). Only six women (1.4%) reported non-use of contraception because of their knowledge of EC and only four women (0.9%) reported EC as the usual method of contraception. Knowledge about EC more often came from family or friends (51%) and advertising (47%), than from general practitioners (26%) or through sex education in schools (3%). Altogether 282 women (69%) received EC from a doctor in the medical emergency service or a casualty ward. DISCUSSION: Overall, EC is used as recommended. Its availability does not seem to reduce the use of safer contraceptive methods. The mandatory sex education in school should include information on EC.