Patterns in contacts with primary health care centres in Greenland

Botvid, Sofia H C; Hove, Lone Storgaard; Mikkelsen, Carsten Sauer; Skovgaard, Nils; Pedersen, Michael Lynge; Backe, Marie Balslev

doi:10.1080/22423982.2023.2217007

Cited by 3 publications

(4 citation statements)

References 17 publications

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“…Moreover, the risk of compliance issues was reduced due to the de facto elimination of financial reasons for treatment non-compliance. Finally, there is a risk for underestimating the prevalence of autoimmune liver diseases as the EMR registration is not complete [ 17 ]. However, as national recommendations dictate patients with rare liver diseases being followed at the specialised hospital department in Nuuk, the likelihood for correct disease coding and registration in the EMR reaches the highest level for the country [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…The electronic medical record (EMR) system in Greenland includes comprehensive healthcare data on patients with a permanent address in Greenland. Correct registration in the EMR system requires a diagnosis code assignment which is achieved by 74% of patients in Nuuk but less for patients outside Nuuk [ 16 , 17 ]. Patients with rare liver diseases are predominantly followed at the largest hospital in Nuuk although very long travel distances across the country can limit the number of clinical and biochemistry control visits at a specialist department.…”

Section: Methodsmentioning

confidence: 99%

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The prevalence and disease course of autoimmune liver diseases in Greenland

Gantzel,

Bagge,

Villadsen

et al. 2024

International Journal of Circumpolar Health

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Autoimmune liver diseases are rare serious diseases causing chronic inflammation and fibrosis in the liver parenchyma and bile ducts. Yet, the prevalence and burden of autoimmune liver diseases are largely unexplored in Arctic native populations. We investigated the prevalence and management of autoimmune liver diseases in Greenland using nationwide cross-sectional register data and subsequent medical chart reviews validating diagnoses and extracting liver histology examinations and medical treatments. The overall prevalence of autoimmune liver diseases in Greenland was 24.6 per 100,000 (95% CI: 14.7–41.3). This was based on 7 patients with autoimmune hepatitis (AIH) (12.3 per 100,000), 3 patients with primary biliary cholangitis (PBC) (5.3 per 100,000), 4 patients with AIH/PBC overlap disease (7.0 per 100,000), and no patients with primary sclerosing cholangitis. All diagnoses were confirmed by liver histology examinations. Medical treatments adhered to internal recommendations and induced complete remission in most patients with AIH, and complete or partial remission in 1 patient with PBC and 3 patients with AIH/PBC overlap disease. One patient had established cirrhosis at the time of diagnosis, while 2 patients progressed to cirrhosis. In conclusion, the prevalence of autoimmune liver diseases was lower in Greenland than in Scandinavia and among Alaska Inuit.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

The prevalence and disease course of autoimmune liver diseases in Greenland

Gantzel,

Bagge,

Villadsen

et al. 2024

International Journal of Circumpolar Health

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“…Greenland is divided into five healthcare regions, each with a regional hospital. Healthcare centres and units are placed in smaller towns and settlements and 83.7% of the population is in contact with the primary health care system each year [ 24 ]. Hospitals and larger health care centres are staffed with physicians whenever possible; however, recruitment is a challenge in Greenland.…”

Section: Methodsmentioning

confidence: 99%

“…In the health care centre in Nuuk, diagnosis codes are registered by nurses or doctors following phone consultations and visits. Approximately 74% of the patients in Nuuk and 26% of the patients outside of Nuuk are assigned a diagnosis code [ 24 ].…”

Section: Methodsmentioning

confidence: 99%

Quality of care among patients diagnosed with atrial fibrillation in Greenland

Nielsen,

Hykkelbjerg Nielsen,

Andersen

et al. 2024

International Journal of Circumpolar Health

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This cross-sectional study sought to assess the prevalence of atrial fibrillation (AF) diagnosis in Greenland among various age groups and examine the corresponding quality of care. We collected data from Greenland’s electronic medical records and evaluated the quality of care using six internationally recommended indicators, which are: percentage of AF patients with an assessment of smoking status within the previous year, an assessment of body mass index within the previous year, assessment of blood pressure within the previous year, measurement of thyroid stimulating hormone (TSH), treatment with an anticoagulant and percentage of patients with a measurement of serum-creatinine. We found the prevalence of AF among patients aged 20 years or older in Greenland to be 1.75% (95% CI 1.62–1.88). We found an increasing prevalence of AF with age and a greater proportion of men than women until the age of 74 years. Our study suggests that the associated quality of care could be higher as the requirement of only one of the six quality indicators was met. A lack of registration may partly explain this, and initiatives to improve the quality of care are recommended.

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Burden of selected chronic non-communicable diseases in a primary healthcare setting in Nuuk, Greenland, compared to a Danish suburb

Backe,

Kallestrup,

Rasmussen

et al. 2024

Scandinavian Journal of Primary Health Care

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Introduction Noncommunicable diseases (NCDs) constitute a massive global burden and are the leading cause of death and disability worldwide. In Greenland, the prevalence of NCDs has historically been low. However, during the past approximately 70 years, life circumstances have changed dramatically resulting in increased life expectancy. Today, the proportion of inhabitants in Greenland ≥65 years has nearly tripled since the 1980s, and the prevalence of obesity and diabetes has increased rapidly within the past decades. The aim of this study was to describe the burden of selected NCDs in a primary care setting in Nuuk and compare it to a modern westernized suburban general practice in Denmark. Methods The study was performed as a cross sectional register-based study using data extracted from the electronic medical records (EMR) based on diagnosis codes from inhabitants living in Nuuk, Greenland, and a suburb in Denmark. Estimates of prevalence were age-standardized to the WHO world standard population. Results In both Nuuk and the Danish suburb, the highest prevalence was observed for hypertension (13.2% for both populations), followed by asthma (4.4 and 9.5%, respectively) and diabetes (4.3 and 2.9%, respectively). The age-standardized prevalences of diabetes, COPD, atrial fibrillation, and heart failure, were significantly higher in Nuuk, while seven NCDs including asthma, ischemic heart disease, arthritis urica, psoriasis, hyperthyreosis, hypothyreosis and osteoporosis were significantly higher in the Danish suburb. Conclusion In contrast to the disease pattern observed in Greenland in the last century, the prevalence of diagnosed NCDs in Nuuk is no longer rare. Thus, the overall prevalence of NCDs in the population of Nuuk is now comparable to or even higher than in the suburb in Denmark. This calls for increased focus on all NCDs in the primary healthcare system in Greenland and adaption of the primary healthcare services to a changed disease spectrum.

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Patterns in contacts with primary health care centres in Greenland

Cited by 3 publications

References 17 publications

The prevalence and disease course of autoimmune liver diseases in Greenland

The prevalence and disease course of autoimmune liver diseases in Greenland

Quality of care among patients diagnosed with atrial fibrillation in Greenland

Burden of selected chronic non-communicable diseases in a primary healthcare setting in Nuuk, Greenland, compared to a Danish suburb

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