title: Denmark health system review.
abstract: Denmark has a tradition of a decentralized health system. However, during recent years, reforms and policy initiatives  have gradually centralized the health system in different ways. The structural reform of 2007 merged the old counties  into fewer bigger regions, and the old municipalities likewise. The hospital structure is undergoing similar reforms,  with fewer, bigger and more specialized hospitals. Furthermore, a more centralized approach to planning and regulation  has been taking place over recent years. This is evident in the new national planning of medical specialties as well  as the establishment of a nationwide accreditation system, the Danish Healthcare Quality Programme, which sets national  standards for health system providers in Denmark. Efforts have also been made to ensure coherent patient pathways -  at the moment for cancer and heart disease - that are similar nationwide. These efforts also aim at improving  intersectoral cooperation. Financially, recent years have seen the introduction of a higher degree of activity-based  financing in the public health sector, combined with the traditional global budgeting.A number of challenges remain in the Danish  health care system. The consequences of the recent reforms and centralization initiatives are yet to be fully evaluated.  Before this happens, a full overview of what future reforms should target is not possible. Denmark continues to lag  behind the other Nordic countries in regards to some health indicators, such as life expectancy. A number of risk  factors may be the cause of this: alcohol intake and obesity continue to be problems, whereas smoking habits are improving.  The level of socioeconomic inequalities in health also continues to be a challenge. The organization of the Danish health  care system will have to take a number of challenges into account in the future. These include changes in disease patterns,  with an ageing population with chronic and long-term diseases; ensuring sufficient staffing; and deciding how to improve  public health initiatives that target prevention of diseases and favour health improvements.
authors.affiliation: Department of Public Health, University of Copenhagen.
authors.forename: Maria
authors.initials: M
authors.lastname: Olejaz
authors.forename: Annegrete
authors.initials: A
authors.lastname: Juul Nielsen
authors.forename: Andreas
authors.initials: A
authors.lastname: Rudkjøbing
authors.forename: Hans
authors.initials: H
authors.lastname: Okkels Birk
authors.forename: Allan
authors.initials: A
authors.lastname: Krasnik
authors.forename: Cristina
authors.initials: C
authors.lastname: Hernández-Quevedo
mesh_terms: D003695:Delivery of Health Care / Q000458:organization & administration*; D003718:Denmark; D005380:Financing, Government; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006291:Health Policy; D006801:Humans; D009313:National Health Programs / Q000458:organization & administration*; D020380:Needs Assessment; D011785:Quality Assurance, Health Care