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.
Denmark's impressive health care quality initiatives have been developed over more than 20 years; linkages across them must now be built so as to improve quality of the system as a whole, and not just focusing on individual initiatives.
Special focus ought to be on measuring and maximising the contribution of the primary care sector, including on the co-ordination between the primary, secondary, and community care sector.
To exploit the full potential of the hospital reform, Danish authorities should support the diffusion of good practices, strengthen pre-hospital care services and track data on individual physicians performance to stimulate continuous improvement by clinicians.
Better use of data from quality registers and other rich data sets would help documenting the extent of inequalities in health and health care and would leave Denmark better equipped to address inequalities in health.