Danish Health Care System. Organization, coordination and finance Historically evolving institutional structure based on decentralized political management, universal welfare state coverage and pragmatic negotiated solutions Limited role for private actors in hospital services and financing.
Organization, coordination and finance
Historically evolving institutional structure based on decentralized political management, universal welfare state coverage and pragmatic negotiated solutions
Limited role for private actors in hospital services and financing
Fairly well performing on measurable indicators:
System development capacity,
Image and reputation issues
Changing cultural and socio-economic factors
Waiting time and quality issues
Changing ideological climate
Fear of long term financing problems
Have created a political opening for structural reform in 2002……
….The selected reform strategy will be implemented in 2007. 15 counties turn into 5 larger regions with responsibility for managing health care. Financing will change from the current county taxation to a mix of state taxation and municipal payment for service and per capita. Municipalities will assume a larger role in prevention and rehabilitation.
The changes may or may not resolve the issues mentioned above, but will change the institutional rules of the game
Opportunities and potential
New organizational forms. More diverse picture
Perhaps stronger role for private actors. Out sourcing. PPP.
Potential benefits of scale
Continued experiments with economic incentives e.g. to address waiting time issues
Issues and concerns
Financing and expenditure control
Planning and coherence
Transition and transaction costs in the short and long term
Loss of institutional capacity
Political legitimacy and functionability of new regions
Better platform for handling pressures and organizational change projects? Challenges and issues in the future.
Quality assessment and improvement
IT and introduction of electronic patient records. – A national standard is being developed and tested in the Copenhagen area
Research and application of knowledge
Evaluation and prioritization of health technology
Clever economic incentives
Changing needs and demands of the population
Policy learning and gradual adjustment of organizational choices