Integrated care: a Danish perspective

Abstract

Despite three decades of reform Denmark’s health sector is still struggling to provide coordinated care for an ageing population with a high burden of chronic disease. Andreas Rudkjøbing and colleagues describe recent initiatives to improve continuity of care The Danish health system, in common with most Western health systems, is grappling with the dual challenges of strengthening public health initiatives to prevent disease and providing care to a growing number of patients with chronic disease and comorbidity. A recent review of the system suggests that it generally provides high quality services1 and patient satisfaction with primary care and hospital services is high.2 Nevertheless, despite a raft of policies aimed at integrating health services, the Danish system still suffers from a lack of coordination of care. Although Denmark’s health information systems are widely admired, barriers to integration include organisational fragmentation, perverse financial incentives, and the absence of a single electronic medical record. Denmark, a high income country with 5.6 million inhabitants, is divided into three political and administrative levels: the state, five regions, and 98 municipalities. This division is reflected in the organisation of the health system (box 1), which is a Beveridge-type system similar to that in the United Kingdom and other Nordic countries. #### Box 1: Health service delivery in Denmark The state is responsible for overall financing and regulation, and is increasingly taking responsibility for activities such as monitoring …