Lessons from Denmark in Healthcare System Performance Measurement and Management

Else Smith, Ph.d., M.D.Former Director General at The Danish

Health and Medicine Authority (2010-2015)

The Danish health care sector – Organisation and financing

Free and equal access to public health care

Universal coverage (same system for all)

Tax financed (85%) (progressive income tax)

Private co-payment in certain areas (15%)

Private insurance (20%: 0.5 mill. personal and 0.5 mill. employer-paid insurances)

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Healthcare sector in Denmark

Many laws on patients’ rights - latest an examination- and

treatment guarantee.

Digitalization of the healthsector: E-journals and telemedicine

widely used.

Re-admissions and waiting lists. Hospital-acquired infections.

Time spend in hospital and survival time, with special focus on cancer.

Social inequality in health (priority of present governement).

Focus on: Quality, effect and coordinated care pathways across sectors

• General national collection of many patientdata on all admittence to hospitals.

• 3. generation national health agreements (municipality, general practitioners and hospitals).

• National monitoring of flows in pathways for cancer and heart diseases.

• Laws on patients’ rights.• Personal medicine profile card.• E-journal – data sharing including with patients.• Speciality planning at national level under the

authority of DHMA by law.• National clinical guidelines. 6

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Speciality planning – quality by pooling expertise

Professional core requirements for all hospitals

Pooling expertise for rare and difficult conditions- because practice makes perfect!

High-quality treatment services for all patientsSame quality regardless of time and place

Fewer, bigger and higher specialised hospitals

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National clinical guidelines• State and regions agreed on spending 12 mio. US $ over 4

years to develop 50 national clinical guidelines. Regions are responsible for the implementation.

• A national clinical guideline is a set of systematically prepared, scientific recommendations describing diagnosis, treatment, care and rehabilitation for specific patient groups – based on evidence for the effect and best practice.

• Control of progress in a national stearinggroup.

• Expect to see more money allocated in the coming years, but…

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How do we manage the expectations and demands?

• Political commitment and priority.

• Plan for better integrated care.

• Look at our health educations – do we need other

competencies?

• Work across different sectors, e.g. education and work.

sector and social sector.

• Re-organizing hospitals –fewer beds, flexibility.

• Development of our primary health care sector.

• Communication to the public.

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Municipality health care systemHealth offers

GeneralPractitioner

ChiropractorPsychologist

Physiotherapist

Diagnostic centers

Specialisedhospital

Medical specialist

Alternative treatment

Pharmacy

Home

Rehabilitation

Telemedicine

Self mediciation

Dentist

Occupational therapist

Chirapodist

Municipality health care

Health offers, information etc.

Outpatient clinics, home visits

Social sector Employment Education Recreation

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Thank you for your attention!

Copenhagen in summertime