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

Health Care – the Danish Model Janet Samuel, Danish Regions Danish Regions

The Danish Health Care Five Regions North Denmark Region Danish population: 5,6 mio. Central Denmark Region Capital Region of Denmark Region of Southern Denmark Region Zealand

The Danish Health Care Who is responsible for what? State • Legislation • National health care policy • The overall framework of the health care economy • Specialty planning Regions • Hospital (somatic and Municipalities psychiatric, in- and • Home care outpatient) • • Rehabilitation services Primary healthcare contracts (GP, specialists in private outside hospitals, • Treatment of drug and alcohol practice, adult dental abuse services, physiotherapists, • Prevention and health psychologists, chiropodist, promotion chiropractor) • • District nurses Reimbursement of medicine • Children's dental services Danish Regions

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 • The GP acts as gatekeeper • Patients choose their own GP (within geographical limits) • 9 out of 10 citizens consult their GP at least once a year • GP’s also cover out -of-hours services (except the Capital Region) • GP’s are private entities and own their own clinics Danish Regions

The Danish Health Care Budget 2014: 102,7 billion DKR (17 billion USD) 5% Hospitals 15% GP, specialists, dentists Medicine, reimbursement 80% Danish Regions

The Danish Health Care Capacity • 34 (50) public hospitals Hospital Doctors 14% 30% • 107.000 FTE Nurses • 3.600 GP’s and 1.100 Other health care personnel 33% specialists in private practices 23% Other personel (psychologist, administration, cleaning operatives, 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? • 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 Danish Regions

Challenges Within the system? • 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 Danish Regions

The Danish Health Care Plans and the Bermuda Triangle • Plan for highly specialized care Hospitals • Hospital plans • Plans for psychiatric care • Plans for maternity care • Plans for GP’s, specialists etc. • Health Care plan Municipality services • Health Care Agreements between General (e.g. rehabilitation, Practice home care) regions and municipalities • Contracts with GP etc. Linked together with IT, local agreements, contracts etc. Danish Regions

Health Care agreements – version 3.0 Agreements represent the framework for collaboration . One per region - covering all municipalities and focusing on: • 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