Abstracts fra Bibliotek for Læger 3/2014

Originalartikel: Sundhedsklinikken Røde Kors

Et sundhedstilbud for udokumenterede migranter
Rune Aabenhus, Niels Michelsen & Vibeke Lenskjold

 

The Red Cross Health Clinic for Undocumented Migrants

Bibl Læger 2014;206:220-241

 

This article describes the history right from the beginning of Health Clinic for Undocumented Migrants in Denmark based on voluntary work by health professionals. An estimated 1,000 to 10,000 people are unofficial inhabitants in Denmark. Legally they have only limited access to health care in the form of acute care. This is ethically questionable and not in line with internationally agreed conventions on human rights. Previously undocumented migrants’ access to health care has been random and based on the willingness of individual doc tors, often channeled through non-governmental organizations working with asylum seekers and irregular migrants. In 2010 the Red Cross in Denmark, the Danish Medical Association and The Danish Refugee Council decided to make a joint effort to address these needs and established the first health clinic for undocumented migrants in Denmark. The clinic which was officially opened in August 2011 is run by voluntary work by almost 300 health professionals, including 100 doctors from different specialties, but primarily general practitioners. From the start the recruitment of doctors has been smooth without need for advertising to fill positions in the clinic. Many doctors refer to the Hippocratic Oath or religious beliefs as motives to engage in this kind of voluntary work. In two years and four months a total of 1,652 unique visits were recorded. Patients were predominantly aged 19-40 years, males slightly more frequent than females. The biggest group of undocumented migrants is from Africa, followed by Eastern Europe and Asia. Main health problems have been infections, musculoskeletal problems and dental problems. The Health Clinic for Undocumented Migrants has been successfully implemented and seems to fill a previously unmet need.

 
Originalartikel: Diagnostisk praksis og lægesøgningsadfærd

Samtidens patientudfordring
Rikke Sand Andersen, Flemming Bro & Svend Brinkmann

 

Diagnostic practice and health-care seeking behaviour. The contemporary patient challenge

Bibl Læger 2014;206:242-259

 

Diagnostics are more than simply identification of disease. Diagnostic practices are embedded withinsocial processes of knowledge production and significantly influence the prevailing definitions of appropriate and legitimate forms of illness categories and behaviour. The aim of this article is to discuss diagnostic practices from a social science perspective: how these practices have changed over time and, in particular, their interrelatedness with changes in health-care seeking behaviours. Overall, we illustrate how changes in diagnostics and medical thinking have introduced a change in the semantics of medicine; or in other words a change in what we consider as signs of illness. Above all, we intend to address what we have labeled the contemporary patient challenge: the fact that current biomedical knowledge of bodily pathologies concurrently with widespread pathologization of life transitions and common human challenges increasingly add to the pool of potential signs of illness, on both a sensory and an emotional level. We focus on the challenges that such an increase of illness signs may establish for individuals who must determine when to seek professional medical advice. In line with this, regulation of access to frontline health-care services is also addressed.

 
Kvartalets genstand
Morten A. Skydsgaard

 
Interview: Medicinhistorie er også drama

Klaus Larsens tanker om »Smitstof« - Klaus Larsens nye bog om medicinens historie i Danmark fra 1840’erne og frem til 1900.
Redaktionen

 
Boguddrag: En lille »dryppert« med store konsekvenser
Klaus Larsen

 
Originalartikel: Hjemløshed i en dansk kontekst

Fokus på registerbaserede undersøgelser
Sandra Feodor Nilsson, Carsten Rygaard Hjorthøj, Annette Erlangsen & Merete Nordentoft

 

Homelessness in a Danish context – focus on register-based studies

Bibl Læger 2014;206:276-299

 

Results from two articles published in international journals on homeless people in Denmark are presented and discussed. The studies are based on Danish register data covering contacts with homeless shelters in Denmark since 1999. Around 60% of the homeless people were recorded with a psychiatric diagnosis; substance use disorder being the most frequent diagnosis. Homeless people also had high mortality compared with the Danish general population, especially for suicide and unintentional injury. The remaining life-expectancy of homeless individuals at age 15-24 years was 17-22 years lower than in the general population. Substance use disorders were associated with a particularly high risk of dying compared with no psychiatric contact. For the outcome of death by suicide, the strongest risk estimates were found for schizophrenia spectrum disorders and among women. For death by unintentional injury as an outcome, particularly substance use disorders were predictive of elevated risk. Danish registers allowed us to study an unselected nationwide homeless population in detail and document the severity of the health problems in this vulnerable population. Identification of high risk groups can be used to direct future research and interventions among homeless people in Denmark.