13 MARTINDALE CENTER FOR THE STUDY OF PRIVATE ENTERPRISE GP with an average of 1700 patients (OECD, 2021). Because hospital admittance and most specialty clinics require GP referral, it is a long process for Danes to get access to the care they need. This situation has negative implications for Danish health care overall because combining the extra strain on GPs with the understaffing of municipal health-care providers increases the probability of system collapse. Many GPs across the country have stopped accepting new patients; as seen in Figure 3, this tendency varies by geographic region. The result of this disparity is long travel time for patients outside of their hometown regions for access to primary care. Reforms must take place to ensure that public health workers are provided with the means necessary to continue positively contributing to the system. Proposal for an integrated system The organizational issues of the Danish public health-care system combined with the emerging private sector, an aging population, and physician burnout all point toward the need for significant improvements. A study conducted by the EU and the European Observatory on Health Systems and Policies found that approximately 70% of Danish adults reported being in good health; this proportion is close to the EU average (OECD, 2021). However, there was an evident discrepancy between individuals in different socioeconomic backgrounds: 81% of individuals in the highest income quintile reported being in good health, while only 62% of individuals in the lowest reported the same (OECD, 2021). To optimize the efficiency and quality of care for all individuals, systemic integration is necessary, which requires an open loop of communication between all three levels of the health-care hierarchy. With the implementation of staffing interventions as well as an updated compensation model for physicians educated in Denmark, the system can minimize waiting time for regional and municipal patients under the national guidelines and ensure high quality of patient care. Addressing the physician shortage An initial area for opportunity involves the medical education system. A news report in The Local (“Why many people…,” 2022) cited increased admissions at university medicine programs in Denmark, which is expected to lead to a 65% increase in the number of doctors by 2045. This increase in prospective health-care workers can be capitalized on by introducing financial incentives for Danish medical students intending to stay in-country following their education. For example, as part of this initiative, newly graduated physicians should owe one year of public medical service in Denmark for each year of their medical education, which is free under the Danish welfare state (Tikkanen et al., 2020); those who do Figure 3 Percentage of Danish GPS accepting new patients, divided by region Source: OECD, 2021.
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