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1.  Health service use in adults 20–64 years with traumatic brain injury, spinal cord injury or pelvic fracture. A cohort study with 9-year follow-up 
BMJ Open  2012;2(5):e001521.
Objectives
To estimate the health service use over 9 years after the injury year for patients with traumatic brain injury (TBI), spinal cord injury (SCI) and pelvic fracture (PF), and compare with non-injured.
Design
A register-based cohort design with a 9-year follow-up period.
Setting
The Danish population.
Participants
The study included 434, 100 and 278 hospital-treated incident patients with TBI, SCI and PF, respectively, among 20-year-olds to 64-year-olds identified using the National Patient Register. Controls for each patient group were drawn from the population register, matched by age, sex and health service use during 1995. All were followed during 1996–2005 by linkage to national health registers. The observations were excluded when the patients left Denmark or died.
Outcome measures
The use of hospital treatments, contacts with general practitioners and the use of physiotherapy.
Results
Compared to the controls, more patients with TBI and SCI were hospital admitted all 9 years after the injury year, on average 0.36 and 0.50 times annually, respectively. For patients with PF hospital admissions returned to baseline year 2 after the injury year. For patients with SCI the use of general practitioner services remained at an increased level year 9 after the injury year, while it returned to baseline level year 4 after the injury year for patients with TBI and year 2 for patients with PF. For patients with SCI physiotherapy use remained increased over 9 years after the injury year, while it returned to baseline the fifth year for patients with TBI and the third year after for patients with PF.
Conclusions
TBI and SCI increase the use of health services over 9 years after the injury year, while most health service use after PF returned to baseline 2 years after the injury year.
doi:10.1136/bmjopen-2012-001521
PMCID: PMC3488711  PMID: 23103605
Accident & Emergency Medicine; Epidemiology; Public Health
2.  Physical violence and health-related quality of life: Danish cross-sectional analyses 
Background
The aim of this study was to evaluate the association between experienced physical violence and health-related quality of life (HRQoL) by comparing self-reported health status for individuals with and without experience of physical violence. Our hypothesis was that individuals exposed to violence would experience worse HRQoL than non-exposed individuals. We tested whether men and women and different age groups experience similar reductions in HRQoL, and the extent to which such differences might be associated with social circumstances and lifestyle conditions. Finally, we explored the HRQoL consequences of exposure to violence in a longer time perspective.
Methods
We used data from self-completed questionnaires in two Danish nationally representative, cross-sectional health interview surveys. Exposure to violence was indicated through specific survey questions (Straus’ conflict tactics scale) enquiring about different types of violence during the last 12 months. Health status of respondents was elicited by the EQ-5D and SF-36 questionnaires. The health status profiles were converted to health score indexes using the Danish algorithm for EQ-5D and the revised Brazier algorithm for SF-6D. Differences in score indexes between the exposed and non-exposed individuals were explored separately for men and women using ordinary least square regression with four age categories as explanatory variables.
Results
In the 2000 and 2005 surveys, respectively, 4.9% and 5.7% of respondents indicated that they had been exposed to physical violence within the last 12 months. Exposure to violence was more prevalent in the younger age groups and more prevalent for men than women. Respondents exposed to violence had lower score indexes on both the EQ-5D and the SF-6D compared with the non-exposed. Respondents who reported exposure to violence in both 2000 and 2005 reported lower HRQoL than individuals who only reported exposure in one of the surveys.
Conclusions
The results of this study provide evidence for an association between exposure to physical violence and reduction in health-related quality of life.
doi:10.1186/1477-7525-10-113
PMCID: PMC3493347  PMID: 22985063
Violence; Health-related quality of life; EQ-5D; SF-6D; General population, Denmark
3.  Effects of armed conflict on access to emergency health care in Palestinian West Bank: systematic collection of data in emergency departments 
BMJ : British Medical Journal  2006;332(7550):1122-1124.
Objective To assess the impact of restrictions in access to hospital services imposed on the civilian population during the armed conflict in the Palestinian territories occupied by Israel.
Design Consecutive registration of demographic and medical data, with information about transportation time, delay in access to hospital, and course of hospital contact.
Setting Three hospital emergency departments in Bethlehem and Nablus, in the occupied Palestinian West Bank, during one week in each hospital.
Participants All patients seeking health care in the three hospitals during the study period.
Results A total of 394 of the 2228 emergency department contacts reported being delayed at checkpoints or by detours on their way to the emergency department. Hospital admission was significantly more common for these patients: 32% (n = 125) compared with 13% (n = 205) among those who were not delayed.
Conclusion 18% of the emergency department contacts were delayed because of the occupation. The higher hospital admission rate in this group suggests that restrictions in access to hospital services influence the severity of the medical conditions presented.
doi:10.1136/bmj.38793.695081.AE
PMCID: PMC1459547  PMID: 16585049

Results 1-3 (3)