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The Danish Health Care System October 1, 2014 regioner.dk

The Danish Health Care System October 1, 2014 www.regioner.dk Trine Petersen, Danish Regions, tpe@regioner.dk , phone +45 3529 8461. The basic principles. A public health care system Free and equal access for all citizens Freedom of choice Mainly financed through general taxes

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The Danish Health Care System October 1, 2014 regioner.dk

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  1. The Danish Health Care System October 1, 2014 www.regioner.dk Trine Petersen, Danish Regions, tpe@regioner.dk, phone +45 3529 8461

  2. The basic principles • A public healthcaresystem • Freeand equalaccess for all citizens • Freedomof choice • Mainlyfinancedthrough general taxes • Decentralizedorganization • GP/familydoctor as gatekeeper

  3. Political and administrative levels • Danish Parliament/Government • - Ministry of Health, National Board of Health etc. • 5 Regions – 5 Boards with 41 elected politicians • 98 Municipalities – 98 Boards with between 9 and 31 elected politicians

  4. Responsibilities • Regions (no tax income): Hospitals (somatic and psychiatric, in- and outpatient), primary healthcare contracts (GP, specialists in private practice, adult dental services, physiotherapists, psychologists, chiropodist, chiropractor), reimbursement of medicine. • Municipalities (tax income): Home nursing, rehabilitation services outside hospitals, treatment of drug and alcohol abuse, prevention and health promotion, district nurses, children's dental services • State (tax income): Legislation, national health care policy, overall framework of the health care economy

  5. Danish Health Care in brief (to watchwhenhome!?) “The Case of Denmark”: http://vimeo.com/89693420 “New Danish Hospitals”: http://vimeo.com/103503844 ”Hospital Solutions”: http://vimeo.com/105850624 ”Prehospitaltreatment in Denmark”: http://vimeo.com/96692510

  6. The five Danish regions The North Denmark Region 0,6 mio. The Central Denmark Region 5,6 mio. Danes The Capital Region 53 hospitals, 18.000 beds 1,3 mio. 1,8 mio. The Region of Southern Denmark 107,000 employees Region Zealand 1,2 mio. 0,8 mio.

  7. Yearly regional activity in brief • 2,6 million are treated at the hospital • 1,1 million Danes are hospitalised (somatic) • 50.000 in psychiatric hospitals • 11,5 million out-patient treatments • 1,3 million operations • 41 million visits at the normal GP • 5 million visits at the specialized private practitioners

  8. The GP/family doctor as gatekeeper • Patients choose their GP (within geografical limits) • 9 out of 10 patients consult their GP at least once a year • GP’s also cover out-of-hours services • GP’s are private entities and own their own clinics (generally)

  9. Demographicchanges – in oneyear!

  10. Expenses – only with age-change

  11. The demographicchallenge

  12. Regional budget (billion DKK) 2014 Overall budget 100,5 Of which Hospitals 72,6 GP’s 15,2 Hospital medication 7,1 Medicationreimburs. 5,5

  13. Ourhealth, e.g. The North Denmark Region 2010-2013 Lesssmokers (from 20,9 % to 17,0 %) Lessbigsmokers (from 10,9 % to 8,2%) Less (lowrisk) drinkers (from 24,3 to 20,6 %) Lesshighriskdrinkers (10,6 % to 8,5) 0,6 mio. The Central Denmark Region The Capital Region: 90% drink toomuch 1,3 mio. 1,8 mio. The Region of Southern Denmark: 19,2% smoke on daily basis Region Zealand: 52,6% areobese 1,2 mio. 0,8 mio.

  14. Some trends • - Reduction in number of hospitals and beds • - Centralization and specialization • - Fewer hospitals with ED’s • - Focus on prehospital emergency care • - Focus on intermediate care • - Hospitals to be renovated + new hospitals built (40 billion DKK to be spent) • - GP’s collaborating in larger clinics • Number of discharges over the last 8-10 years – slight increase • Outpatient visits – huge increase • Average length of stay is now 4 days – huge decrease

  15. The medicine approach Medicineexpenses (million DKK)

  16. The eHealth approach

  17. Electronic Health Record (EHR) • EHR consists of • Clinical documentation • Computerised provider order entry • Patient scheduling • Inpatient administrative systems

  18. Quality is a huge part of the solution to the challenges • Quality in health care means: • Putting the patient (and relatives) first • Doing what is right the first time • Having coherence in the action • Good quality is not an additional expenditure but bad quality is The quality agenda

  19. The Quality approach Triple aim

  20. Agenda • Quality • Patient involvement • Leadership • Realtime data • Patient safety • All teach all learn

  21. Spreadingbestpractise • www.VIS.dk Basedon openness and crowdsourcing • More team thanindvidual • More relation than profile • more healththansector • More problem sensingthancomfortseeking • More Ipodthanpioneer

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