1. Danish Health and Medicines Authority  Denmark Dr. Else Smith, CEO Danish Health and Medicines Authority Meeting of the EU Chief Medical Officers, Chief Nursing Officers and Chief Dental Officers Copenhagen, 12 th – 13 th April 2012 Denmark and the Danish Health Care Services

2. Danish Health and Medicines Authority  Denmark 22 Agenda  Danish Population  Political and Administrative Levels  The Health Care Sector– Organisation and Financing  The Danish Health and Medicines Authority – Main Responsibilities  Main Challenges in the Health Area  Trends in the Health Area

3. Danish Health and Medicines Authority  Denmark 3 Denmark  5,4 million inhabitants  43.098 km 2  Constitutional monarchy  Member of the EU  Parliament (Folketinget) (4 year terms)  Central government  5 regions (97 % health-care)  98 municipalities

4. Danish Health and Medicines Authority  Denmark 4

5. 5 The Health Care Sector – Organisation and Financing  Free and equal access to public health care  Universal coverage (same system for everyone)  Tax financed (84%) (progressive income tax)  Private co-payment in certain areas (16%)  Private insurance (½ mill. personal and ½ mill. employer-paid insurances)

6. Danish Health and Medicines Authority  Denmark 6 The Danish Health Care System There are 3 levels in the public health care system in Denmark:  The State  The Regions  The Municipalities 6

7. Danish Health and Medicines Authority  Denmark 7 Regions GeographyFacts  5 Regions  Politically elected leadership  No taxing power – financed by state grant and co-payment by municipalities

8. Danish Health and Medicines Authority  Denmark 8 Regional responsabilities  Hospital and Psychiatric treatment  Primary Health Care / Public Health Care Scheme  General Practitioners (family doctors)  Private Practicing Specialists  Adults Dental Services  Physiotherapy Average population: 1,060,000

9. Danish Health and Medicines Authority  Denmark 9 Municipalities GeographyFacts 98 Municipalities Politically elected leadership Taxing powers

10. Danish Health and Medicines Authority  Denmark 10 Municipal responsabilities  Preventive care and health promotion  Rehabilitation outside hospital  Treatment of alcohol and drug abuse  Co-financing regional health care  Child nursing  Child dental services and special dental care  School health care  Home nursing Average population: 55,000

11. Danish Health and Medicines Authority  Denmark 11 Public and private payment Public financed health care  GP’s and specialists (with reference from GP)  All hospital treatment  All pharmaceuticals and aides received in hospital Private co-payment  Dentists  Out-hospital pharmaceuticals and aides

12. Danish Health and Medicines Authority  Denmark 12 Health Expenditure per inhabitant US $ Source: OECD Health at a glance, 2009 PublicPrivate

13. Danish Health and Medicines Authority  Denmark 13 Public expenditure in the health area in Denmark 2001-08 01 02 03 04 05 06 07 08 Billion Danish Kroner Source: Ministry of Health and Prevention, 2010

14. Danish Health and Medicines Authority  Denmark 14 Number of Physicians per 1,000 inhabitants Source: OECD Health at a Glance, 2009

15. Danish Health and Medicines Authority  Denmark 15 The Danish Health and Medicines Authority - Mandate  To assist the Minister for Health by administrering obligations within health care  To follow the health state of the population and be abreast of knowledge and experiences on the health area  To supervise and evaluate the health area  To inform the population on particular health issues  To advise the Minister for Health and other authorities  To supervise doctors, hospitals, residental homes etc.

16. Danish Health and Medicines Authority  Denmark 16 The Danish Health and Medicines Authority – Main responsabilities  Surveillance, Guidance, Supervision, Development  To lay down rules and schemes, give recommendations and prepare general information and campaigns  To develop new approval powers and competencies kompetencer  To set standards and follow up in regard to the relevant authorities

17. Danish Health and Medicines Authority  Denmark 17 Main Challenges: Life Expectancy MaleFemale Source: OECD Health at a Glance, 2009

18. Danish Health and Medicines Authority  Denmark 18 Causes of Death Source: National Institute of Public Health The Public Health Report 2007

19. Danish Health and Medicines Authority  Denmark 19 Life Style: Alcohol Consumption Percentage of Danish citizens who exceed the limit for high risk alcohol consumption (14 units for women, 21 units for men) – defined by DHMA Source: The Danish Profile of Health 2010

20. Danish Health and Medicines Authority  Denmark 20 Life Style: Tobacco use – number of smokers Source: Investigations led by Gallup, Rambøll og Userneeds

21. Danish Health and Medicines Authority  Denmark 21 Life Style : Obesity Percentage of obese Danish citizens distributed on sex and age (Obesity = BMI > 25) Source: The Danish Profile of Helath 2010

22. Danish Health and Medicines Authority  Denmark 22  Life expectancy – still not satifactory  Life style related diseases – increase in chronic diseases  Shortage of health professionals in the health care sector  Inequality in health  Lack of coherence in the health care system Main challenges in the Health Area

23. Danish Health and Medicines Authority  Denmark 23 Trends in the Health Area - 1  Health on the top of the political agenda  Quality improvement of the health care servises for less money – prioritization  More options for treatment delivered by private supplyers  Increased centralization of the hospital sector  Increased use of technology, incl. telemedicine  Increased digitalization

24. Danish Health and Medicines Authority  Denmark 24 Trends in the Health Area - 2  Enhanced coherence in health care, incl. path ways programs, national clinical guidelines etc.  Increased out-of-pocket payment, incl. differentiation of services free of charge  Enhancement of a strong primary and community health care, incl. GPs and local health care services  Focus on chronic diseases, incl. elderly patients and cancer patients 

25. Danish Health and Medicines Authority  Denmark 25 Trends in the Health Area - 3  Patient Empowerment, incl. self management and patient education  Involvement of the civil society  Strengthened cooperation between the health care sector and the social sector at all levels  Strengthened focus on health promotion and disease prevention 

26. Danish Health and Medicines Authority  Denmark 26 Five strategic focus areas for The Danish Health and Medicines Authority 2010- 2013  Enhanced coherence in health care  Increased health promotion and disease prevention  Quality improvement through accessible knowledge  Efficient division of responsibilities between highly qualified health professionals  Patient centered health care – safety and involvement 

27. Danish Health and Medicines Authority  Denmark 27 Thank you for your attention! Copenhagen 27