10 PERSPECTIVES ON BUSINESS AND ECONOMICS | VOL 41 | 2023 combines the Council on Ethics and the National Committee on Health Research Ethics; these agencies collaborate on ethical issues in health research, serving as an advisory board for parliament as well as a board of appeal for regional levels of health care. While the subdivisions of the MOH are relevant to each other, there is little overlapping of the agencies’ operations. A structural reform in 2007 introduced the fragmentation of Denmark’s health-care system by centralizing the geographical and administrative units across the country. The number of Danish regions was reduced from 13 to 5 and the number of municipalities decreased from 271 to 98 (Ministry of the Interior and Housing, 2023). In the health-care sector, these changes were accompanied by a reduction from 40 public hospitals in 82 locations in 2007 to 21 public hospitals in 68 locations in 2016 (Christiansen & Vrangbæk, 2018). While centralization of the workforce was introduced as a solution for the geographic fragmentation, this shift created new challenges for Danish patients, including the increased distance travelled for care. With fewer public hospitals in operation, private hospitals were constructed to compensate, and the incentive increased for Danes to purchase VHI for coverage at these locations. The negative impacts of the divided Danish healthcare system are coupled with inefficient utilization of collected patient data by the Health Data Authority (Schmidt et al., 2019). Denmark has employed a unique personal identification system since 1968 that links each Dane to health-care, banking, and real estate records through a personal registration number (Sørensen et al., 2016). This setup is a good starting point to reflect on the systemic cooperation of the Danish health-care hierarchy because it reveals information regarding the Danish social determinants of health (i.e., socioeconomic status). However, there are blind spots in the system that compromise the quality of patient care received at every level. For example, the National Patient Registry does not capture previous GP diagnoses unless a patient has been referred to a hospital for treatment (Schmidt et al., 2019). In some cases, previous patient diseases might be identified only by prescription data or laboratory results, slowing down the process for referral to proper specialists. Optimized use of information collected by the Health Data Authority is necessary to streamline patient care throughout levels of the hierarchy and maximize workforce efficiency, discussed later as part of the concluding integrated proposal. Regional health care Regional Danish health care includes the primary care system throughout the five regions of the country. Under this model, GPs handle 90% of all medical cases and serve as patients’ primary connection to the municipal (local) level of the health-care system through referrals to hospitals, psychiatric services, and specialized clinics as needed (Healthcare DENMARK, 2023). After referral, GPs are notified Figure 1 Danish health-care hierarchy, respective branches, and main duties Source: Healthcare DENMARK, 2023.
RkJQdWJsaXNoZXIy MTA0OTQ5OA==