Health Care the Danish Model Janet Samuel, Danish Regions Danish - - PowerPoint PPT Presentation

Danish Regions

Health Care – the Danish Model

Janet Samuel, Danish Regions

Danish population: 5,6 mio.

The Danish Health Care

Five Regions

Capital Region of Denmark Region Zealand Region of Southern Denmark Central Denmark Region North Denmark Region

The Danish Health Care

Who is responsible for what?

Danish Regions

State

• Legislation
• National health care

policy

• The overall framework
• f the health care

economy

• Specialty planning

Municipalities

• Home care
• Rehabilitation services
• utside hospitals,
• Treatment of drug and alcohol

abuse

• Prevention and health

promotion

• District nurses
• Children's dental services

Regions

• Hospital (somatic and

psychiatric, in- and

• utpatient)
• Primary healthcare contracts

(GP, specialists in private practice, adult dental services, physiotherapists, psychologists, chiropodist, chiropractor)

• Reimbursement of medicine

Basic principles of Danish Health Care

• A public health care system
• Equal and free access for all citizens
• Freedom of choice
• Mainly financed through general taxes
• Decentralized organization
• General Practice (family doctor) as gatekeeper

Danish Regions

The GP – family doctor

Danish Regions

• The GP acts as gatekeeper
• Patients choose their own GP (within

geographical limits)

• 9 out of 10 citizens consult their GP at least
• nce a year
• GP’s also cover out-of-hours services (except

the Capital Region)

• GP’s are private entities and own their own

clinics

The Danish Health Care

Budget 2014: 102,7 billion DKR (17 billion USD)

80% 15% 5%

Hospitals GP, specialists, dentists Medicine, reimbursement Danish Regions

The Danish Health Care

Capacity

• 34 (50) public hospitals
• 107.000 FTE
• 3.600 GP’s and 1.100

specialists in private practices

14% 33% 23% 30%

Hospital Doctors Nurses Other health care personnel Other personel (psychologist, administration, cleaning

• peratives, technical

personel) Danish Regions

The Danish Health Care

Trends

• A slight decrease in the number of discharges over the

last 10 years

• Increase in outpatient visits – 35 percent since 2007
• Average length of hospitalization at somatic hospitals is

below 3.8 days in average

• Decrease from 4.4 days in 2008
• Average length of hospitalization in psychiatric

hospitals/departments is in average 19 days for adults and 31 days for kids

• Decrease - 16 % (adults) and 7 % (kids) since 2009

Danish Regions

• Avg. length of stay

Danish Regions

The Danish Health Care

Trends

• Reduction in number of hospitals and beds
• Centralization and specialization
• Fewer hospitals with ED’s
• Focus on pre hospital emergency care
• Focus on intermediate care
• Hospitals to be renovated + new hospitals built (41 billion DKR

to be spent)

• GP’s collaborating in larger clinics

Do we need a plan for organizing primary care?

Danish Regions

Challenges

What is facing us?

Danish Regions

• An increasing elderly population
• More people suffering from chronic diseases
• Keeping up with the development of new technologies and

medicines

• New kinds of treatments – eg. genetic medicine
• Pressures for documentation of results and quality
• Limited resources
• Increasing expectations and demands

……will put the health services under tremendous pressure

Challenges

Within the system?

Danish Regions

• Delivering integrated services across settings
• Sharing data
• Specialization – gone too far?
• Maintaining an overall good access to GP’s
• Patient safety issues
• Mortality rates – eg. cancer
• Patient involvement
• End of life care
• Psychiatric patients – life expectancy way below average
• Structures and reimbursement schemes do not focus on value

for patients

The Danish Health Care

Plans and the Bermuda Triangle

General Practice Hospitals Municipality services (e.g. rehabilitation, home care) Danish Regions

• Plan for highly specialized care
• Hospital plans
• Plans for psychiatric care
• Plans for maternity care
• Plans for GP’s, specialists etc.
• Health Care plan
• Health Care Agreements between

regions and municipalities

• Contracts with GP etc.

Linked together with IT, local agreements, contracts etc.

Health Care agreements –version 3.0

Agreements represent the framework for collaboration. One per region - covering all municipalities and focusing

• n:
• Involving patients and relatives
• Obtaining equality in health and access – and

specifically obtaining equality between psychiatric and somatic patients

• Setting goals and following up. Working with quality

and patient safety

• Coordinating capacity across regions and

municipalities – the Danish LEON-Principle

• Involving and committing the GP’s

Danish Regions

Danish Health Care – ambitions 2015 on wards

• Tripple Aim approach
• Focused on value for patients
• Delivers high quality and is accessible for every need
• Measuring what matters (e.g. PRO’s)
• Data driven and data sharing
• Strategic usage of IT – telemedicine, apps etc.
• Integrated care for patients with complex needs
• Specialist medical care – not limited by hospital walls
• New models of collaboration (and even organization)

between hospitals and primary care

Danish Regions