1 Introduction to Denmark -the Danes - Storstrom region and - Occupational health at hospitals

11

Introduction to Denmark-the Danes

- Storstrom regionand

- Occupational health at hospitals

22

The Kingdom of Denmark

Greenland + Pharaoe Island + Denmark

33

The Kingdom of Denmark

44

Denmark

Population 5.342.00042.000 km2

7314 km coast-line

55

The Danes

Total population: 5.342.000 18% under age 14

15% over 65

Life expectancy at birth:Males 74,1 years

Females 78,9 years

66

Age FFeemmaalleess

% MMaalleess

% 25-59 79 88

55-59 55 77

25-29 89 92

Persons with education and professional trainingPersons with education and professional training

Kilde:EUROSTAT&WHOKilde:EUROSTAT&WHO

77

What more do they have in common ?

88

They pay TAX – TAX - TAX

Direct tax on personal incomeIndirect tax e.g. VAT on duties and goods

Property tax

An example:

Personal income: 400.000 d.kr.

Direct tax on personal income To state :75.000 d.kr

To county: 48.000 d.krTo municipality: 77.00 d.kr.

Indirect tax: more than 50.000 d.kr.

100 d. kr. = 16,5 USD

99

The Royal Family

1010

the Danish Parliament

1111

Regions and regional councils

1212

Storstrom Region

260.498 inhabitants24 municipalities

1313

Countys total budget 2003 = 6.3 billion d.kr.

Storstrom Region

260.500 inhabitants

9000 employeesof which 3.293 in Health Care

and 3.583 i Social Care

1414

Storstrom Region

Health care

Education & culture

Social care

Total Countys budget 2003 = 6.3 billion d.kr.

Roads & environment

1515

Administrative levels, organizational structure and managementAdministrative levels, organizational structure and managementof health careof health care

NationalNational

RegionalRegional

MunicipalMunicipal

State governmentState government

14 Counties plus Copenhagen and Frederiksberg14 Counties plus Copenhagen and Frederiksberg

273 Municipalities plus Copenhagen and Freriksberg 273 Municipalities plus Copenhagen and Freriksberg

Legislation, guidelines, standardsLegislation, guidelines, standardsSurveillance and supervisionSurveillance and supervision

Targets for health care expenditureTargets for health care expenditureIncentives for local actionIncentives for local action

Level

Level

Hospitals and prenatal care centers,Hospitals and prenatal care centers,

General practitioners, specialists, General practitioners, specialists, dentists, physioterapist etc.dentists, physioterapist etc.

Nursing homes, home nurses, health Nursing homes, home nurses, health visitors, school health carevisitors, school health care

Social services – life long care for the elderly and disabledSocial services – life long care for the elderly and disabled

Bigger Bigger hospital regionshospital regions

Municipal general care centersMunicipal general care centers

TrendTrend

1616

19801980 20002000

No. of hosp.No. of hosp. 117117 7171

No. of bedsNo. of beds 30.96730.967 18.68318.683

DischargesDischarges 894.485894.485 1.123.2451.123.245

Bed daysBed days 8.413.4008.413.400 5.964.5865.964.586

No. of out.pt’sNo. of out.pt’s 3.154.6423.154.642 5.453.2835.453.283

Average lenght of Average lenght of stay (days)stay (days)

9.49.4 5.35.3

Capacity and activity in somatic hospitalsCapacity and activity in somatic hospitalsall Denmarkall Denmark

Source: Ministry of HealthSource: Ministry of Health

1717

Health care in Denmark - some Health care in Denmark - some characteristicscharacteristics

Concensus:Concensus:Access to health care should be independent of ability to payAccess to health care should be independent of ability to pay

or place of residenceor place of residence

Free access to care in primary sectorFree access to care in primary sector

Health care publicly financed through taxes Health care publicly financed through taxes and run by public authoritiesand run by public authorities

1818

Family doctor (General Practitioner) by patients own choiseFamily doctor (General Practitioner) by patients own choise

GP as gatekeeper (and adviser) to secondary sector (hospitals)GP as gatekeeper (and adviser) to secondary sector (hospitals)

Agreed shared care and action between counties and municipalitiesAgreed shared care and action between counties and municipalities

Patients are very satisfied with hospital services and especially with GP´sPatients are very satisfied with hospital services and especially with GP´s

Health care in Denmark - some Health care in Denmark - some characteristicscharacteristics

1919

Cooperation between county and municipal levelCooperation between county and municipal levelBased on:Based on:

Agreed shared careAgreed shared care

Joint action on prevention and health promotion asJoint action on prevention and health promotion as an integrated part of health care and social servicesan integrated part of health care and social services

2020

PopulationPopulation

PatientsPatients

State government

County councils

Municipal councils

Voluntary health insurance

Municipal health services

Home visitors and school h.c.

Children dentists

Care for elderly and disabled

County health services

Hospitals and maternity care

General practitioners

Specialist

Dentists

Private hospitals

Taxes

Pre

miu

ms

Out

of

pock

et

paym

ents

Block grants

Global budgets

Fee for service

Fee for service

Capitationand fee for service

2121

the Danish Minister of Employment

National Institute of

Occupational Health

The factories inspectorate

The working environment complaints board - they take care of complaints related to the factories inspectorate

Departments of Occupational Health

The enterprices

Occupational Health Service in Denmark-the Danish work environment consultantsystem

of multidisciplinary preventive serviceunits 

Occupational health service

Sector occupational health service

The danish occupational health system

2222

What are we doing to make a safety in

handling the patients ?

-Safety organization with members from the leaders and the staff

-Workplace valuation

-Education to selected employees, who has to give

-Short instruction to new employees and students

-Advices to their colleges

-Appropriate arrangement in the rooms

- Appropriate assistive technology

2323

Incidents of reported work related suffering per 10.000 employees

1995 1996 1997 1998 1999 2000 2001 2002

63 66 68 67 55 60 63 57

Hospital employeesHospital employeessuffering and accidents suffering and accidents

Incidents of reported work related accidents per 10.000 employees

1995 1996 1997 1998 1999 2000 2001 2002

170 178 167 163 158 165 137 122

The number of employees

1995 1996 1997 1998 1999 2000 2001 2002

103.091 103.745 103.416 101.731 102.712 102.235 103.162 104.235

2424

Real good or good selfestimated health Storstrom Region

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

16-24 år 25-44 år 45-66 år 67-79 år 80 år +

Selfestimated health

Center of Public Health 2004

Kilde: Sundheds-& sygelighedsundersøgelserneStatens Institut for Folkesundhed

Female Male

2525

Fit to do what you want to do

Fit to do what you want to doStorstrom Region

0%

20%

40%

60%

80%

100%

16-24 år 25-44 år 45-66 år 67-79 år 80 år +

Folkesundhedscenteret maj 2004

Kilde: Sundheds-& sygelighedsundersøgelserneStatens Institut for Folkesundhed

Female Male

2626

Don’t feel stressed

Don't normaly feel stressedStorstrom Region

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

16-24 år 25-44 år 45-66 år 67-79 år 80 år +

Center of Public Health 2004

Kilde: Sundheds-& sygelighedsundersøgelserneStatens Institut for Folkesundhed

Female Male

2727

Good physical mobility

Good physical mobility (60+years)Storstrom Region

0%

20%

40%

60%

80%

100%

60-66 år 67-79 år 80 år +

Center of Public Health 2004

Kilde: Sundheds-& sygelighedsundersøgelserneStatens Institut for Folkesundhed

Female Male

2828

Rarely or never infuence on ones one job Storstrom Region

0% 5% 10% 15% 20% 25% 30%

<10 års udd.

10 års udd.

11-12 års udd.

13-14 års udd.

15+ års udd.

Occupational Health

Udd. = education

Center of Public Health 2004

Kilde: Sundheds-& sygelighedsundersøgelserneStatens Institut for Folkesundhed