Statistical processing

Source data

The actual published indicators are based on following sources: In general, information from the municipalities’ care systems (in Danish, EOJ) is used to calculate the indicators. Statistics Denmark receives the data on either monthly or yearly basis.

Acute readmissions are based on Register for Patients from the Agency of Health.

To calculate a total for the country regarding referral hours at nursing homes, rehabilitation and preventative home visits, the population register from Statistics Denmark is used. The register includes and describes people who live in Denmark, in detail, on the basis of the available information from the register of personal identity numbers.

To calculate the quality of service, a sample based on telephone interviews and personal interviews is used. The Ministry of Health has been responsible for the investigation which in the future will be performed by The Danish Health Data Authority.

The agreement of documentation at the elderly area includes a number of impact indicators and background indicators. The majority of the effect indicators will be collected every second year via a national sample-based user survey, while the majority of the background indicators will be based on individual-based data obtained directly from the municipalities' care systems rather than manually aggregated information. It is agreed that the documentation regarding the elderly area must be anchored and compiled in Statistics Denmark.

Frequency of data collection

For referral home care, provided home care, nursing homes, home nursing as well as training services, data is collected automatically every month. This frequency is not the same as the frequency of publishing, which is yearly. For preventative home visits, waiting time for nursing homes and readmissions data is collected yearly. According to the analysis of quality of service, data is collected every second year.

Data collection

Data is collected through the municipalities' EOJ systems (electronic care journal), where data is sent directly from the municipalities' systems to Statistics Denmark through the municipality's IT-supplier. In cases where municipalities have problems sending through EOJ, Excel spreadsheets received encrypted by Statistics Denmark is used. Data concerning readmissions is received on Excel spreadsheets. Average waiting time is summarized data for each municipality and is received by mail. Numbers on clinical pathways and readmissions are received from The Danish Health Data Authority on spreadsheets. Quality of service is received as a SAS dataset from the The Danish Health Data Authority.

Data validation

The reported data is collected in tables in a report for the individual deliveries, which is sent to each municipality. The municipality must review the tables and is responsible for validating the data. Any error must be corrected by the system supplier or by the municipality, after which data can be forwarded to Statistics Denmark. The municipality must approve that data is used for statistics and publication. Some municipalities can only approve data for some months and/or some deliveries. Unapproved months and non-approved deliveries for the individual municipality thus do not become one part of the published figures. If the data has a development beyond what is expected, then Statistics Denmark asks the municipality to explain the development. If this cannot be done, then the municipality corrects the data before they can be included in the publication. See attachment Kommentarer til 2023 - korte udgaver.xlsx for the municipalities' brief notes to data for the relevant year.

Before publishing data from the municipalities' EOJ (electronic care record), a comprehensive error search in Statistics Denmark takes place. All municipalities are asked to confirm their data. Only data, which is approved by the municipality, is included. Debugging is done for invalid data formats, outdated person and company numbers, and dead citizens s.

Data compilation

Calculation of annual total: If a municipality has only approved a few months during the year, an annual total is calculated either by obtaining information from the corresponding months, which have been approved in the previous year of publication, or by calculating an average based on data for the approved months. If a municipality has approved data for 10 months, the average is thus calculated based on the 10 months.

Calculation of the national total: If a municipality has not approved data for the year in question at all, data from previous years are used when a national total is made.

Calculation of age: The age of the citizen is changed to the age of the citizen at the end of the year in question.

Provided home care in own home: The information that Statistics Denmark receives is a weekly average of provided home care in number of minutes per month. If a person both receives private and municipal assistance, the citizen is counted under private home assistance. If a recipient, for example, is provided 1 hour of personal care every two weeks, is the average number minutes per week set to 30 minutes. In 2019, practical help is reported with 0 minutes changed to 1 minute with the system suppliers. This means that 0-time services such as food service is included.

Referred home care in own home: Every month, Statistics Denmark receives a delivery with registrations of visits and referred visits that have been in the municipality's electronic care record (EOJ). There are 3 system providers of EOJ. This has implications for the use of data, as the deliveries are used differently depending on which system supplier the municipality uses.

3 data deliveries from the EOJ are used to calculate referred home care: · L1.1 Start and stop hours · L1.4 Referral home care · L1.3 Provided home care.

Report L1.1 includes information about the visit for the planned home care visits, where the care worker has registered a start and stop time for the visit.

Report L1.4 is a registration on all citizens in the municipalities, who are referred to permanent home care after the rules about free choice. The referral home care is divided into personal help and practical care.

Report L1.3 includes information about the duration of the provided (actual) visit of the care worker. The report counts the actual minutes spent by the care worker.

Originally, report L1.3 should cover all provided home care. Yet, the quality and the coverage appear to be defective for many municipalities. Therefore, the following method to work out provided home care has been decided: All persons who have received a visit according to report L1.3 are part of the population of home care receivers if the municipality or Statistics Denmark has approved the report.

Not all private suppliers have access to report data about provided home care in the municipalities care systems. Therefore, visits of the private suppliers of home care are for some municipalities not part of the reporting of L1.3. Therefore, persons from L1.4 who are referred to home care are included instead. The referred services are corrected with a factor to calculate the provided help, as the provided help typically is lower than the referred help. The ratio between these two ‘types of help’ is found at a national level and on supplier type against a background of municipalities. For these municipalities both data about referred and provided help is found valid and approved by either the municipalities or Statistics Denmark.

Data from the Municipality of Copenhagen has until 2020 been supplied from two different sources (Health Services and Social Services). Copenhagen has therefore been included in micro-data the municipal codes 102 and 103 for the two administrations in the municipality. From 2020, data will be collected from the administrations in a delivery and is therefore referred to as municipality code 101 going forward.

For some municipalities there can be only partly information about the private provided help. These services are included in the statistics and the municipalities’ other referred services are adjusted with the national ratio and are included in the total provided home care.

Rehabilitation: From 2019, a new register table has been made for Rehabilitation courses, which contains the number of rehabilitation courses per month, where for the period 2017-2018 it was rehabilitation courses for the entire year.

Home nursing: Some municipalities report both home nursing in the residents own homes, nursing homes and psychiatric housing, and other municipalities only report home nursing in the residents homes. In order to have comparable data between municipalities, we have removed residents in nursing homes from the data, and the register is called 'Home Care in own home'. There may still be residents of psychiatric housing in the data, but this problem is considered to be minor

Free choice of housing: There is not a total for free choice of housing.

Preventative home visits: When a total for the country is calculated, data from previous years are used for lacking municipalities. In such cases, the age of the citizen is changed to the citizen’s age at the end of the year in question. If there are not data from previous years, the register of population is used. Regarding the municipalities which report data and municipalities with data from the year before, a share is found for the part of the population who has received a preventative home visit. This share is multiplied to the population in the municipalities which have not reported data, in order to find the number of receivers. This is summed up with the known municipalities to a total for the country.

Training: When a total for the country is calculated, data from previous years are used for the lacking municipalities. In such cases, the age of the citizen is changed to the citizen’s age at the end of the year in question. If there are not data from previous years, the register of population is used. Regarding the municipalities which report data and municipalities with data from the year before, a share is found for the part of the population who receives training. This share is multiplied to the population in the municipalities which have not reported data, in order to find the number of recipients. These are summed up with the known municipalities to a total for the country.

Readmissions: In the spring of 2018 it was decided by the National Board of Health to implement a new definition of readmissions and in spring 2021 the indicator is rearranged to include data from the 3. version of the register of patients (LPR3). The new definition is used in table AED20A on data back to 2012, so the numbers are comparable over time. The new definition uses non-specific readmissions, since no specific relationship between primary admission and readmissions has been established beyond time, for example. disease relationships in the form of the same / corresponding diagnosis. All acute readmissions within 30 days after discharge are included in the definition. The readmissions are related to the municipality where the patient's address is registered at the end of the primary admission (last contact in the admission).

Length of stay: In spring 2018, the National Board of Health data decided to implement a new definition of length of stay and in spring 2021, the indicator is rearranged to include data from the 3. version of the Register of Patients (LPR3). The definition is based on the new definition of residence, where time-related contacts are considered a coherent stay. The length of stay is only calculated for stays with a duration of more than 12 hours, for instance hospitalization. LPR is based on contact registration. This means that if a patient is moved from one department to another at the same hospital, an administrative discharge will be made from the first department and immediately afterwards an admission at the next department. In LPR this process is registered as two separate contacts. Similarly, when moving between different hospitals. Thus, a patient can be administratively admitted and discharged many times in the period from the patient enters the door of the hospital and until the patient is home again without the patient at any time is out of the hospital. In order to clarify when the patient is no longer in the hospital's care, it is necessary to determine the actual date of discharge. For this purpose, it is necessary to clarify whether the different contacts are temporally coherent. Continuous contacts are considered a coherent stay. A hospitalization is defined as a periodically close stay at one or more hospitals (consisting of one or more contacts) and for a total duration ≥ 12 hours. A number of connection rules are used that define when the contacts can be seen as a coherent stay and when the hospital's care ceases. Currently, two contacts are connected if they occur with ≤4 hours distance between the start and end.

Adjustment

No corrections of data are made in addition to those already described under data validation and data processing.