IDEAS home Printed from
   My bibliography  Save this paper

Decomposing Inequality in Diabetes Patients' Morbidity Patterns, Survival and Health Care Usage in Denmark


  • Sortsø, Camilla

    () (COHERE)

  • Lauridsen, Jørgen

    () (COHERE)

  • Emneus, Martha

    () (Institute of Applied Economics and Health Research (ApEHR))

  • Green, Anders

    () (Odense Patient Data Explorative Network (OPEN))

  • Jensen, Peter Bjødstrup

    () (Odense Patient Data Explorative Network (OPEN))


Measurement of socioeconomic inequalities in health and health care, and understanding the determinants of such inequalities, are critical for achieving higher equity in health care through targeted health intervention strategies. The aim of the paper is to quantify inequality in diabetes morbidity patterns, survival and health care service usage and understand determinants of these inequalities in relation to socio-demographic and clinical morbidity factors. Further, to compare income level and educational level as proxies for Socio Economic Status (SES). Data on the entire Danish diabetes population in 2011 were applied. Patients’ unique personal identification number enabled individual patient data from several national registers to be linked. Cox survival method and a concentration index decomposition approach are applied. Results indicate that lower socioeconomic status is associated with higher morbidity, mortality and lower survival. Differences in diabetes patients’ morbidity patterns, time of diagnosis and health state at diagnosis as well as health care utilization patterns suggest that despite the Danish universal health care system use of services differ among patients of lower and higher SES. Especially outpatient services, rehabilitation and specialists in primary care show different usage patterns according to SES. Comparison of educational level and income level as proxy for patients’ SES indicate important differences in inequality estimates. This is a result of reversed causality between diabetes morbidity and income as well as income related inequality to a higher extent being explained by morbidity.

Suggested Citation

  • Sortsø, Camilla & Lauridsen, Jørgen & Emneus, Martha & Green, Anders & Jensen, Peter Bjødstrup, 2016. "Decomposing Inequality in Diabetes Patients' Morbidity Patterns, Survival and Health Care Usage in Denmark," DaCHE discussion papers 2016:2, University of Southern Denmark, Dache - Danish Centre for Health Economics.
  • Handle: RePEc:hhs:sduhec:2016_002

    Download full text from publisher

    File URL:
    Download Restriction: no

    References listed on IDEAS

    1. Eddy van Doorslaer & Xander Koolman, 2004. "Explaining the differences in income‐related health inequalities across European countries," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 609-628, July.
    Full references (including those not matched with items on IDEAS)


    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.

    Cited by:

    1. Rodríguez-Sánchez, Beatriz & Cantarero-Prieto, David, 2019. "Socioeconomic differences in the associations between diabetes and hospital admission and mortality among older adults in Europe," Economics & Human Biology, Elsevier, vol. 33(C), pages 89-100.
    2. Camilla Sortsø & Jørgen Lauridsen & Martha Emneus & Anders Green & Peter Bjødstrup Jensen, 2017. "Socioeconomic inequality of diabetes patients’ health care utilization in Denmark," Health Economics Review, Springer, vol. 7(1), pages 1-22, December.

    More about this item


    Health inequality; diabetes; morbidity patterns; health care service usage; decomposition; socio-economic inequality;

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

    NEP fields

    This paper has been announced in the following NEP Reports:


    Access and download statistics


    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:hhs:sduhec:2016_002. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Christian Volmar Skovsgaard). General contact details of provider: .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.