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The Danish health care system and
framework for investments in a new
hospital structure in Denmark: 2008 2020
Advisor Emilie Winther,
Centre for Health technology, Procurement and Regional
Development, Danish Regions
eew@regioner.dk
www.regioner.dk
Danish Regions

• Interest organisation
of the 5 regions in
Denmark
• 170 employees
• Established in 2006
• (Association of the
Counties was
established in 1913…
and closed down in
2006)

www.regioner.dk
The 5 regions

5,5 mio.
Danes
39
hospitals
104,000
FTE

www.regioner.dk
Basic principles in Danish Healthcare

•
•
•
•
•
•

A public health care system
Free and equal access for all citizens
Freedom of choice
Mainly financed through general taxes
Decentralized organization
General practitioners as gatekeeper

www.regioner.dk
Trends

•
•
•
•
•
•
•
•

Reduction in number of hospitals and beds
Centralization and specialization
Fewer hospitals with ED’s
Focus on pre-hospital emergency care
Focus on intermediate care
Hospitals to be renovated + new hospitals
GP’s collaborating in larger clinics
Huge increase in outpatient visits
www.regioner.dk
The historic time for length of stay
1954-2010

Liggetid 1954-2010
20
18
16
14
12
10
8
6
4
2
0
1950

1960

1970

1980

1990

2000

2010

Kilde: Sygehusvæsenet i dansk politik, Sundhedssektoren i tal diverse
årgange, tal på sundhed 1. april 2011.

www.regioner.dk
Investments are necessary

www.regioner.dk
The future hospital structure in
Denmark

Centralisation in terms of:
-A reduction in the number of hospitals
-Reduction of hospitals with highly specialised
functions and emergency wards
Decentralisation in terms of:
-Strengthening the pre-hospital capacity
-Strengthening the role of the GP’s (gate keeper)
-Co-operation with local municipalities
www.regioner.dk
New and modernized hospitals

Better planned patient pathways
Patient safety (i.e. single rooms will reduce infections)
Effective workflows through new technology/health innovation
Fewer transports of patients, staff and goods
Rationalization of staff on duty 24 h., laboratory functions, X-ray
Better use of equipment, scanners, labs and apparatus
Merging of administrative units and technical functions
www.regioner.dk
Finance and 16 big hospital
construction projects

• 41.4 billion Danish kroner = 5.5 billion euros
• 60 % from the government and 40 % from the regions
• Expert panel assessed the applications for each project
• 16 construction projects got an intermediary commitment
• 14 out of 16 projects now have the final commitment
• 22 construction projects financed solely by the regions
• The total conversion of the Danish health care system =
dynamic process lasting the next 10-15 years

www.regioner.dk
New and modernized hospitals

Modernization
/ extensions:

9

New builds
/ greenfield:

7
www.regioner.dk
Sharing knowledge and developing
new shared solutions

• Danish Regions launched an ambitious project on
sharing knowledge in hospital building in the end
of 2010
• The purpose is to strengthen that the regions
systematic share knowledge on central elements
in hospital building
• When appropriate the regions join and develop
shared solutions for the building projects

www.regioner.dk
10 landmarks for sharing knowledge
about hospital building

Joint purchase for hospital building
• Handling medicine
• Production of sterile goods
• Life cycle costs
• Best practice standards for types of rooms
• Virtual hospital
• Joint tools for the building process
• Transport technologies
• Tracing of equipment, apparatus, patients and staff
• Interaction with patients and relatives supported by new
www.regioner.dk
technology

•
8 focus areas for developing the
content in the new hospitals

- Organizational structure with the patients’ needs in the
middle
- New forms of management
- Boundaries and interaction with the other parts of the
health care sector
- Emergency departments and organizing the acute
treatment / care
- Easy and quick access to diagnostics in hospitals
- Workflows in operating rooms
- Workflows in day clinics / outpatient clinics
- Offices and mobile working stations
www.regioner.dk
www.danishhospitalconstruction.com

- Short on the framework and terms for the construction
projects
- Status of the building projects – follow the construction
processes
- Contact persons for each construction projects
- Information about the knowledge sharing project
- Catalogue of interior designs for different hospital rooms
- Expected time for procurements
- Relevant conferences and courses
www.regioner.dk
Thank you for your attention

Questions?

E-mail: eew@regioner.dk

www.regioner.dk

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The Danish Healthcare System

  • 1. The Danish health care system and framework for investments in a new hospital structure in Denmark: 2008 2020 Advisor Emilie Winther, Centre for Health technology, Procurement and Regional Development, Danish Regions eew@regioner.dk www.regioner.dk
  • 2. Danish Regions • Interest organisation of the 5 regions in Denmark • 170 employees • Established in 2006 • (Association of the Counties was established in 1913… and closed down in 2006) www.regioner.dk
  • 3. The 5 regions 5,5 mio. Danes 39 hospitals 104,000 FTE www.regioner.dk
  • 4. Basic principles in Danish Healthcare • • • • • • A public health care system Free and equal access for all citizens Freedom of choice Mainly financed through general taxes Decentralized organization General practitioners as gatekeeper www.regioner.dk
  • 5. Trends • • • • • • • • Reduction in number of hospitals and beds Centralization and specialization Fewer hospitals with ED’s Focus on pre-hospital emergency care Focus on intermediate care Hospitals to be renovated + new hospitals GP’s collaborating in larger clinics Huge increase in outpatient visits www.regioner.dk
  • 6. The historic time for length of stay 1954-2010 Liggetid 1954-2010 20 18 16 14 12 10 8 6 4 2 0 1950 1960 1970 1980 1990 2000 2010 Kilde: Sygehusvæsenet i dansk politik, Sundhedssektoren i tal diverse årgange, tal på sundhed 1. april 2011. www.regioner.dk
  • 8. The future hospital structure in Denmark Centralisation in terms of: -A reduction in the number of hospitals -Reduction of hospitals with highly specialised functions and emergency wards Decentralisation in terms of: -Strengthening the pre-hospital capacity -Strengthening the role of the GP’s (gate keeper) -Co-operation with local municipalities www.regioner.dk
  • 9. New and modernized hospitals Better planned patient pathways Patient safety (i.e. single rooms will reduce infections) Effective workflows through new technology/health innovation Fewer transports of patients, staff and goods Rationalization of staff on duty 24 h., laboratory functions, X-ray Better use of equipment, scanners, labs and apparatus Merging of administrative units and technical functions www.regioner.dk
  • 10. Finance and 16 big hospital construction projects • 41.4 billion Danish kroner = 5.5 billion euros • 60 % from the government and 40 % from the regions • Expert panel assessed the applications for each project • 16 construction projects got an intermediary commitment • 14 out of 16 projects now have the final commitment • 22 construction projects financed solely by the regions • The total conversion of the Danish health care system = dynamic process lasting the next 10-15 years www.regioner.dk
  • 11. New and modernized hospitals Modernization / extensions: 9 New builds / greenfield: 7 www.regioner.dk
  • 12. Sharing knowledge and developing new shared solutions • Danish Regions launched an ambitious project on sharing knowledge in hospital building in the end of 2010 • The purpose is to strengthen that the regions systematic share knowledge on central elements in hospital building • When appropriate the regions join and develop shared solutions for the building projects www.regioner.dk
  • 13. 10 landmarks for sharing knowledge about hospital building Joint purchase for hospital building • Handling medicine • Production of sterile goods • Life cycle costs • Best practice standards for types of rooms • Virtual hospital • Joint tools for the building process • Transport technologies • Tracing of equipment, apparatus, patients and staff • Interaction with patients and relatives supported by new www.regioner.dk technology •
  • 14. 8 focus areas for developing the content in the new hospitals - Organizational structure with the patients’ needs in the middle - New forms of management - Boundaries and interaction with the other parts of the health care sector - Emergency departments and organizing the acute treatment / care - Easy and quick access to diagnostics in hospitals - Workflows in operating rooms - Workflows in day clinics / outpatient clinics - Offices and mobile working stations www.regioner.dk
  • 15. www.danishhospitalconstruction.com - Short on the framework and terms for the construction projects - Status of the building projects – follow the construction processes - Contact persons for each construction projects - Information about the knowledge sharing project - Catalogue of interior designs for different hospital rooms - Expected time for procurements - Relevant conferences and courses www.regioner.dk
  • 16. Thank you for your attention Questions? E-mail: eew@regioner.dk www.regioner.dk