Denmark and the Danish Health Care Services

1. Denmark and the Danish Health Care Services Dr. Else Smith, CEO Danish Health and Medicines Authority Meeting of the EU Chief Medical Officers, Chief Nursing Officers and Chief Dental Officers Copenhagen, 12th – 13th April 2012

2. Agenda • Danish Population • Political and Administrative Levels • The Health Care Sector– Organisation and Financing • The Danish Health and Medicines Authority – Main Responsibilities • Main Challenges in the Health Area • Trends in the Health Area 2

3. Denmark • 5,4 million inhabitants • 43.098 km2 • Constitutional monarchy • Member of the EU • Parliament (Folketinget) (4 year terms) • Central government • 5 regions (97 % health-care) • 98 municipalities

5. The Health Care Sector – Organisation and Financing Free and equal access to public health care Universal coverage (same system for everyone) Tax financed (84%) (progressive income tax) Private co-payment in certain areas (16%) Private insurance (½ mill. personal and ½ mill. employer-paid insurances)

6. The Danish Health Care System There are 3 levels in the public health care system in Denmark: • The State • The Regions • The Municipalities 6

7. Regions

8. Regional responsabilities Hospital and Psychiatric treatment Primary Health Care / Public Health Care Scheme General Practitioners (family doctors) Private Practicing Specialists Adults Dental Services Physiotherapy Average population: 1,060,000

9. Municipalities

10. Municipal responsabilities Preventive care and health promotion Rehabilitation outside hospital Treatment of alcohol and drug abuse Co-financing regional health care Child nursing Child dental services and special dental care School health care Home nursing Average population: 55,000

11. Public and private payment Public financed health care • GP’s and specialists (with reference from GP) • All hospital treatment • All pharmaceuticals and aides received in hospital Private co-payment • Dentists • Out-hospital pharmaceuticals and aides

12. Health Expenditure per inhabitant US $ Public Private 12 Source: OECD Health at a glance, 2009

13. Public expenditure in the health area in Denmark 2001-08 Billion Danish Kroner 01 02 03 04 05 06 07 08 Source: Ministry of Health and Prevention, 2010 13

14. Number of Physicians per 1,000 inhabitants 14 Source: OECD Health at a Glance, 2009

15. The Danish Health and Medicines Authority - Mandate • To assist the Minister for Health by administrering obligations within health care • To follow the health state of the population and be abreast of knowledge and experiences on the health area • To supervise and evaluate the health area • To inform the population on particular health issues • To advise the Minister for Health and other authorities • To supervise doctors, hospitals, residental homes etc. 15

16. The Danish Health and Medicines Authority – Main responsabilities • Surveillance, Guidance, Supervision, Development • To lay down rules and schemes, give recommendations and prepare general information and campaigns • To develop new approval powers and competencies kompetencer • To set standards and follow up in regard to the relevant authorities 16

17. Main Challenges: Life Expectancy Male Female Source: OECD Health at a Glance, 2009 17

18. Causes of Death Source: National Institute of Public Health The Public Health Report 2007 18

19. Life Style: Alcohol Consumption Percentage of Danish citizens who exceed the limit for high risk alcohol consumption (14 units for women, 21 units for men) – defined by DHMA Source: The Danish Profile of Health 2010 19

20. Life Style: Tobacco use – number of smokers Source: Investigations led by Gallup, Rambøll og Userneeds 20

21. Life Style : Obesity Percentage of obese Danish citizens distributed on sex and age (Obesity = BMI > 25) Source: The Danish Profile of Helath 2010 21

22. Main challenges in the Health Area • Life expectancy – still not satifactory • Life style related diseases – increase in chronic diseases • Shortage of health professionals in the health care sector • Inequality in health • Lack of coherence in the health care system 22

23. Trends in the Health Area - 1 • Health on the top of the political agenda • Quality improvement of the health care servises for less money – prioritization • More options for treatment delivered by private supplyers • Increased centralization of the hospital sector • Increased use of technology, incl. telemedicine • Increased digitalization 23

24. Trends in the Health Area - 2 • Enhanced coherence in health care, incl. path ways programs, national clinical guidelines etc. • Increased out-of-pocket payment, incl. differentiation of services free of charge • Enhancement of a strong primary and community health care, incl. GPs and local health care services • Focus on chronic diseases, incl. elderly patients and cancer patients 24

25. Trends in the Health Area - 3 • Patient Empowerment, incl. self management and patient education • Involvement of the civil society • Strengthened cooperation between the health care sector and the social sector at all levels • Strengthened focus on health promotion and disease prevention 25

26. Five strategic focus areas for The Danish Health and Medicines Authority 2010- 2013 • Enhanced coherence in health care • Increased health promotion and disease prevention • Quality improvement through accessible knowledge • Efficient division of responsibilities between highly qualified health professionals • Patient centered health care – safety and involvement 26

27. Thank you for your attention! Copenhagen 27