OECD Reviews of Health Care Quality: Denmark 2013

Raising Standards

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This review of health care quality in Denmark examines policies related to quality and includes chapters covering primary and integrated care, hospital specialisation and equity. It finds that with a dense array of disease- and service-focused quality initiatives, and with information on the quality of care stored in separate data repositories, Denmark needs to create effective links and synergies between them to drive up quality in the healthcare system as a whole, rather than in disconnected elements.

Primary care will be central in meeting Denmark’s future healthcare challenges of an ageing population with multiple chronic conditions. Therefore, an urgent need is to create a national vision of how a modernised primary care sector will fulfill this new coordination role. National standards, clinical guidelines, accreditation of clinical pathways and targeted financial incentive programmes could support this role, along with more transparent and formalised continual professional development.

To facilitate quality improvement from the ambitious hospital rationalisation, Denmark should collect and disseminate data on the quality of individual physicians as well as the hospitals. Undergraduate training and medical research should be reviewed in light of the new service arrangements.  Close surveillance will be needed to monitor whether certain patient groups forego healthcare because travel times to providers are too long. Limited data availability complicate Denmark’s ability to monitor its commitment to equitable healthcare. There is an urgent need for renewed action to tackle risk factors of chronic ill-health that disproportionately affect low-income groups. Better information on the impact of user-charges on unmet need in low-income groups is needed.    


Promoting equity in health and health care in Denmark

Whilst health equity is a stated priority of the Danish health care system and the current Danish government, until recently there have been few policies or interventions designed to safeguard equity, or to address inequity. There are indications that health inequalities in Denmark are rising, and although gaps in data make it difficult to get a full picture across all areas, evidence suggests that there are disparities in health status, access to health care and health outcomes. This chapter examines Denmark’s need to build upon the principle of equity that is a cornerstone of the Health Act, and work across all levels of government to put in place appropriate policies that promote equity across the health care system. The chapter suggests that policies that prevent structural inequalities should accompany existing initiatives targeting health risks, and that close examination should be given to possible barriers to equitable access to services. Efforts to promote equity in health and health care will be most successful with a comprehensive data infrastructure, and recommendations about strengthening areas of data weakness are made. Changes and improvements in policies around quality of care, the primary care system, and the hospital system all have the potential to impact upon equity, and the analysis and recommendations made in this chapter are closely tied to those of the three preceding chapters.


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