Organisation of health care in DenmarkThe
Danish health care service can be divided into 2 sectors: - Primary health
care and
- The hospital sector.
The primary sector deals with
general health problems and its services are available to all. This sector can
be divided into 2 parts: - One which chiefly deals with treatment and
care: general practitioners, practising spe-cialists, practising dentists, physiotherapists
etc. (the practising sector) and district nursing;
- The other part which is predominantly preventive and deals
with preventive health schemes, health care and child dental
care.
When contracting an illness, the population
first comes into contact with primary health care. The hospital sector deals
with medical conditions which require more specialised treatment, equipment and
intensive care. In addition to the treatment of patients, both general practitioners
and hospitals are involved in preventive treatment as well as in the training
of health personnel and medical research. The patient and the health
care service
In the Danish health care service, the general practitioners act
as "gate keepers" with regard to hospital treatment
and treatment by specialists. This means that patients usually
start by consulting their general practitioners, whose job it
is to ensure that they are offered the treatment they need and
that they will not be treated on a more specialist level than
necessary.
It is normally necessary to be referred by a general practitioner
to a hospital for medical examination and treatment, unless it
is a question of an accident or an acute illness. It will also
normally be necessary to be referred by a general practioner for
treatment by a specialist.
Besides referring patients to a hospital
or a specialist, the general practitioners refer patients to other health professionals
working under agreement with the health care service, and ar-range for district
nursing to be provided. Administrative levels
Like Denmark as
a whole, the health care sector has 3 political and administrative levels: the
State, the counties and the municipalities (national, regional and local levels). The
health care service is organised in such a way that responsibility for services
provided by the health service lies with the lowest possible administrative level.
Services can thus be pro-vided as close to the users as possible. The
Danish health care service seen in an international perspective
The Danish
health care service is characterised both by being publicly financed through taxes
and, for most of the services by being run directly by the public authorities. In
a number of Western European countries there is a much larger private element
in the health care service, a large number of the hospitals being run by private
organisations. The fi-nancing is, on the other hand, mainly public, although this
is mainly in the form of compul-sory insurance schemes rather than in the form
of general taxes. The different ways of organising and financing health
care services have different advantages and disadvantages, and the choice of model
is largely dependent on different priorities in the different countries. In
Denmark priority has been given to free access to most health services for all
regardless of their economic situation.
Even though financing is public, it does not necessarily follow
that the institutions which provide the services are public as
well. However, in Denmark the majority of the health sector, including
the hospital services, is run as publicly owned institutions.
The financing and run-ning of the services are thereby integrated.
In the publicly integrated
model those providing health services are civil servants receiving a fixed salary.
The integrated model with budgetary restrictions and fixed salaries gives budget
security, but in itself it does not give the staff any intrinsic incentive towards
efficiency. Effi-ciency must be ensured through other mechanisms such as professional
ethics and good man-agement.
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DENMARK