• Mike Sæderup Astorp
5. Term (Master thesis), Medicine, Master (Master Programme)
Background
A geographic variation of prevalence and mortality from heart disease exists. The aim of this study was to examine a potential unequal geographical variation in the treatment with heart medicine within the coun-ties of northern of Jutland. It has been proven that heart patients have a weaker connection to the labour market. This study further wanted to investigate if the social consequence of having a heart disease (in the form of a weak connection to the labour market) could be proven in the region of northern Jutland and whether this consequence was geographically unequal in within the region.

Method
This study was a cross sectional study by design. Data used were from June 2009 withdrawn from The Danish National Prescription Registry and the DREAM database. 24.131 residents took part in the study. The Danish National Prescription Registry provided information about prescribed medicines in the form of ATC-codes. This study used ATC-codes starting with “C” to define residents who had received medical treatment for a heart condition. The DREAM database provided information about the participants’ place of residency as well as their occupational status. A weak connection to the labour market was defined either by a participant receiving public services more than 80% of the time over the course of a year or by receiving a lasting public service. Frequency tables were constructed and logistics regression analyzes was performed to analyze the data. All analyzes were adjusted for age and sex. Counties of Region Nordjyl-land were divided into 3 categories: “Aalborg”, “surrounding counties” and “outlying counties”.

Results
The proportion of residents who had received a prescription for heart medicine was observed for the 3 categories of counties: Aalborg 18%, surrounding counties 19% and outlaying counties 20%. The Adjusted Odds ratio (A-OR) for prescribed heart medicine was 1,03 (95% confidence interval (95% CI): 0,94 - 1,13) for surrounding counties and 1,06 (95% CI: 0,98 - 1,14) for outlaying counties, both compared to Aalborg. The study found an association between a resident having received heart medicine and them having a weak connection to the labour market. For both definitions of “having a weak connection to the labour market” used in this paper this association was found. For the residents who had received public services over 80% over the course of an year an A-OR was found to be 2,10 (95% CI: 1,93 - 2,27) and for those re-ceiving a lasting public service the A-OR was found to be 2,31 (95% CI: 2,11 - 2,53). A geographical variation in the association between a resident having had prescribed heart medicine and having a weak connec-tion to the labour market could not be positively established though a tendency was found.

Conclusion
This study did not find a geographical variation the treatment with heart medicine across the counties in the region of northern Jutland. The study found an association between a resident having had prescribed heart medicine and having a week connection to the labour market. This association did not show to vary according to geography in the 3 chosen categories of residency used in this study.
LanguageDanish
Publication date4 Jan 2017
Number of pages19
ID: 246746648