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.