[Show abstract][Hide abstract] ABSTRACT: Denmark has a tradition of a decentralized health system. However, during recent years, reforms and policy initiatives have gradually centralized the health system in different ways. The structural reform of 2007 merged the old counties into fewer bigger regions, and the old municipalities likewise. The hospital structure is undergoing similar reforms, with fewer, bigger and more specialized hospitals. Furthermore, a more centralized approach to planning and regulation has been taking place over recent years. This is evident in the new national planning of medical specialties as well as the establishment of a nationwide accreditation system, the Danish Healthcare Quality Programme, which sets national standards for health system providers in Denmark. Efforts have also been made to ensure coherent patient pathways - at the moment for cancer and heart disease - that are similar nationwide. These efforts also aim at improving intersectoral cooperation. Financially, recent years have seen the introduction of a higher degree of activity-based financing in the public health sector, combined with the traditional global budgeting.A number of challenges remain in the Danish health care system. The consequences of the recent reforms and centralization initiatives are yet to be fully evaluated. Before this happens, a full overview of what future reforms should target is not possible. Denmark continues to lag behind the other Nordic countries in regards to some health indicators, such as life expectancy. A number of risk factors may be the cause of this: alcohol intake and obesity continue to be problems, whereas smoking habits are improving. The level of socioeconomic inequalities in health also continues to be a challenge. The organization of the Danish health care system will have to take a number of challenges into account in the future. These include changes in disease patterns, with an ageing population with chronic and long-term diseases; ensuring sufficient staffing; and deciding how to improve public health initiatives that target prevention of diseases and favour health improvements.
No preview · Article · Feb 2012 · Health systems in transition
[Show abstract][Hide abstract] ABSTRACT: The trends in population health in Denmark are similar
to those in most Western European countries. Major health issues
include, among others, the high prevalence of chronic illnesses
and lifestyle related risk factors such as obesity, tobacco, physical
inactivity and alcohol. This has pressed the health system towards
a model of provision of care based on the management of chronic
care conditions. While the Chronic Care Model was introduced in
2005, the Danish health system does not fulfil the ten key preconditions
that would characterise a high-performing chronic
care system. As revealed in a recent report,1 the fragmented structure
of the Danish health system poses challenges in providing effectively
coordinated care to patients with chronic diseases.