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Region of Southern Denmark and Odense
University Hospital
Dr. Peder Jest, Exect. Dir. CMO
Claus Duedal Pedersen, Chief Innovation Officer
AGENDA
1. A brief introduction to the Danish healthcare system
2. Background for the digital health strategy
3. New reimbursement structure in Denmark
THE DANISH HEALTHCARE SYSTEM
KEY PRINCIPLES
Universalcoverage
Free & equal access
Financed by general taxes
A high degree of decentralisation
Organization of the State
The average length of stay in hospitals is below OECD average…
5.5 5.9 6.1 6.2 6.4
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…and the share of GDP spent on health care is comparable to similar countries
THE DANISH HEALTHCARE SYSTEM
Family doctor (GP)
Specialist
Dentist
Private hospitals
Hospitals
Emergency departmentPatientOut-of-hours services
or 112
Gatekeeping
A SOLID FOUNDATION TO BUILD ON
DANISH HEALTHCARE IS EXTENDEDLY DIGITAL
Electronic health records at hospitals, GPs and municipalities (elderly care, rehabilitation)
All referrals and laboratory results are digital
The Shared Medication Record (SMR) between hospitals, GPs, municipalities, and pharmacies
Patients access health data at sundhed.dk
A TRADITION OF COMMON PUBLIC SECTOR DIGITAL STRATEGIES
A CHANGE IN OUR DEMOGRAPHY
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2010=100
0-64 år 65-74 år 75-84 år 85+ år
+75%aged 75-84
The population is getting older
In 2025, the number of citizens aged 0-64 will be the same as in 2010
- but the number om citizens aged 75-84 will have increased by 75 percent
Less tax payers and fewer health care workers
- and more people will suffer from chronic diseases
From 2013 to 2025 the number of citizens living with the most common chronic diseases is expected to increase by 60 pct.
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+60%chronic diseased
Prognosis
BACKGROUND
0-64 y 65-74 y 75-84 y +85 y
A CHANGE IN OUR STRUCTURING OF HOSPITALS
BACKGROUND
A CHANGE IN HOSPITALISATION AND TECHNOLOGY
BACKGROUND
A COMMON SECTOR STRATEGY WITH FIVE FOCUS AREAS:
FOR DANES, COHERENCY IN HEALTH CARE IS THE PRIMARY CONCERN
66% Do not believe that there is sufficient coherence between hospitals, GPs, and municipalitiesin the health system.
So, what is the problem?
And unfortunately this is not news
New Reimbursement structure in Denmark –‘Nærhedsfinansiering’ a new tool in the box?
1. Part of the agreement economy between the MoH and the Danish regions in 2018
2. 1.5 billions of the payment to the regions depends on whether the regions deliver “a movement in the right direction”
3. 5 “goals” where the regions have to deliver a better outcome than last year
4. Has to be better in 4 out of 5 –if this is achieved the regions keeps all the funding
5. If a region fails in 2 out of 5 they have to pay all the funding back to the government (for RSD this is 320m DKK)
6. The results in one region are independent of results from the other regions.
5 objective goals
1. Reduction in number of hospital courses per year per citizen
2. Reduction in DRG value per chronic disease with COPD and/or diabetes
3. Reduction in the proportion of admissions leading to an acute readmission within 30 days
4. Increase in number of virtual hospital courses
5. Implementation of digital solutions to increase coherence for the patients (implementation plan for system adaptations for data sharing)
Good and bad news
Good news:
1. The first time the reimbursement structure actively supports implementation of telemedicine solutions in large scale
2. New national projects for early detection and treatment of COPD in GP
3. New treatment programs and reimbursement structures for treatment of diabetes 2 in GP
Bad news:
1. Not a word about municipalities or GP in the planning document for the investment in new hospitals.
2. Still too little upscaling of telemedicine –implementation is a challenge
3. Lack of GPs and specialists
4. Increased work load for the municipalities
