The value of the Skåne Health-care Register: Prospectively collected individual-level data for population-based studies

Abstract

Aims: This study aimed to examine the population-based Skåne Health-care Register (SHR) regarding feasibility for scientific research and also strengths and weaknesses. Methods: To analyse the feasibility of the SHR, we performed a bibliographic search for peer-reviewed articles based on SHR data from 2000 to 2018. To analyse strengths and weaknesses, we used original SHR data about coverage and validity. Results: We identified 58 articles based on SHR data, covering different study designs and disorders. Most studies focused on musculoskeletal disorders with a cohort design. The majority of all consultations recorded in the SHR have an assigned diagnosis. However, this differs between the levels of care and between types of consultation. For inpatient care, the proportion of consultations with an assigned diagnosis was close to 100% between 1998 and 2017. The proportion of consultations with an assigned diagnosis was lowest within primary care, although the proportion markedly increased in 2004 when the prerequisite for consultation reimbursement was linked to the requirement for an assigned diagnosis. Limitations are that the SHR does not cover health-care provided within nursing homes and equivalent facilities or treatments received by the population of Skåne outside the region. Conclusions: The SHR may be used as a reliable data source for analyses of clinical changes and improvements. Extended use of the SHR in a research context may highlight important shortcomings within the register and thus serve as a way of indirect quality control. To enhance the use of the SHR further, better harmonisation between registers, within and outside of the region and internationally, is of crucial importance.

Trajectory of excess healthcare consultations, medication use, and work disability in newly diagnosed knee osteoarthritis: a matched longitudinal register-based study

“…The SPR is administered by the Swedish Tax Agency and contains the statistics of vital events (e.g., births, deaths, marriages, change of residential address) for the entire population in Skåne, the southernmost region of Sweden (population in 2016 ¼ 1,324,565, 13.3% of Sweden's population). The SHR is a regional legislative administrative health-care database covering all health-care consultations (public and private) in the Skåne region from 1998 onwards 15 . The data in SHR relevant to our study included the healthcare contact date (for outpatient consultations), the date of admission and discharge (for hospital admissions), healthcare centre, healthcare sector (public vs private), health-care level (primary care, secondary outpatient care, and tertiary inpatient care), type of consultation (physical vs nonphysical visit), type of caregiver (e.g., physician, nurse, physiotherapists), and publicly practicing physicians' diagnostic codes according to the International Classification of Diseases 10 (ICD-10) system.…”

“…As diagnosis codes within private care are not transferred to the SHR, those patients with knee OA who have solely visited private caregivers were not captured in our study. Albeit it should be noted that since May 2009 many former private caregivers has been treated as public, and thus the diagnostic codes originating from these caregivers have gradually been transferred to the SHR 15 . The lack of data on over-the-counter medications, medications given during hospitalization, sick leave shorter than 14 days, presenteeism (reduced productivity at work due to health problems), and informal care implies that our estimates are an underestimation of the burden of knee OA.…”

Fertility outcomes in women with pre-existing type 2 diabetes—a prospective cohort study

“…The data for this study were retrieved from the Swedish regional Sk ane Healthcare Register. This is an administrative register containing individual-level data on medical diagnoses and procedures from all healthcare consultations in the region of Sk ane since 1998 (15). All healthcare consultations, in both public and private sectors, at all care levels (primary and specialized outpatient or inpatient) with all types of healthcare professionals (physicians, nurses, physiotherapists, midwives, etc.)…”

Variability in end-of-life healthcare use in patients with osteoarthritis: a population-based matched cohort study

“…Moreover, diagnosis codes within private care are not transferred to the SHR, which increase the possibility of misclassification of OA and comorbidity burden for those individuals who have solely visited private caregivers. Albeit from 2009 many former private caregivers have been treated as public and the diagnostic codes originating from these caregivers have gradually been transferred to the SHR 32 . This study was conducted in Skåne region which limit the generalizability of our findings to other regions in Sweden as well as other countries.…”