Unclogging the hospital is possible! In the footsteps of the Danish system

What’s up Doc: Denmark changed its entire health policy in 2007, how?

Anne Smetana: We have oriented our health system towards proximity care. From now on, we have five regions which deal with hospitals and negotiations with general practitioners, and 98 municipalities with more than 50,000 inhabitants, which have a preventive role. Health centers can take care of most pathologies. This allowed us to reduce the number of hospitals instead of 128, we have 21. We are no longer hospital-centred. It is thanks to this that we have come out of the pandemic well. A new law regulates collaboration between hospitals, municipalities and general practitioners. The decentralized national health agency provides the framework. All the actors know each other.

On the other hand, the health agreements are not what we call, in our country, a paper tiger, ie an administrative millefeuille. Everything is digital, citizens and doctors have access to data.

What is the difference between a health center and a hospital?

AS. : There is no specialist in a health center, only general practitioners, nurses and physiotherapists. The specialists are at the hospital. We work a lot around prevention and rehabilitation. In Denmark, after an operation, patients stay less than three days in hospital. They are then transferred to a municipal rehabilitation centre.

What are the daily changes?

AS. : In the hospital, there are only the most complex patients. Anything that can be done at the lowest cost is done as primary care. You cannot go to the emergency room without first going through the general practitioner on duty. He is the key person to keep costs down and be as efficient as possible.

The OECD has declared Denmark to be a particularly efficient health system, despite everything do you think there are still improvements to be made?

AS. : We need even more prevention, work to reduce social inequalities and improve the supply of local care. This is our new initiative. We need to have an offer of care for the most vulnerable people.

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