Post on 04-Jul-2015
description
The sooner – the better- New Danish Health Strategy
Early diagnosis, better treatment
and more years of life for every one
Naja Warrer Iversen
Chief Consultant
Challenges in Danish Health Care system
• Cancer patients have lower
survival rates in Denmark than
in Sweden, Norway or Finland
50
60
70
80
90
GB DK DE NL FI NO SE
Breast cancer – 5-year survival, 2006-2011
Pct.
50
55
60
65
70
GB DK SE NL NO FI DE
Cancer – colon rectal cancer, 5-year survival, 2005-2010
Pct.
Challenges in Danish Health Care system
• More people live with chronic
diseases – and many don’t know.
• Too many acute admissions of
chronically ill patients
• Inequality in the prevalence of
chronic diseases, quality of life and
survival
0
50
100
150
200
250
300
350
FI SE NO DE GB DK
Admissions due to COPD, 2011 per 100.000 population
0
40
80
120
160
200
240
GB NO SE FI DK DE
Admissions due to non-controllable diabetes, 2011 per 100.000 population
Challenges in Danish Health Care system
• Too much focus on productivity and
too little focus on quality and
outcomes
• Limited use of experience and
results across sectors and
departments
• Too little patient involvement
Activity
Cost
Productivity
Unique
patients
Development in activity, cost, number of patients and
productivity
Danish Government Health Strategy
2015-2018
• Push for structural changes for a better health care system
• Five priorities:
1. Cancer must be detected earlier – so more can survive (1.1 billion kr.)
2. Chronic diseases must be detected earlier – and the weakest patients get extra help (1.5 billion kr.)
3. Investment in modern GP’s (1 billion kr.)
4. Better quality through patient empowerment (0.3 billion kr.)
5. Better quality in treatment through transparency of results (1.1 billion kr.)
• Economic investment: 5 billion kr. during four years. 1,4 billion kr. in permanent
financial means
• Invitation to a broad coalition and dialogue
A new strategy on top
of other initiatives
- Investment in psychiatric
treatment and equal rights for
patients with psychiatric illness
- The strategy “A healthier life for
all” – targets for health,
partnerships etc.
- Economic prioritization of
hospital treatment and medicine
- Investments in local prevention
efforts in communities
Priority 1: Early detection of cancer –
better survivalInitiatives
• GPs get better tools to discover cancer at
an earlier stage
• GP’s get better access to refer patients
directly to diagnostic testing
• More capacity in diagnostic centers
• Expanded capacity for gentler surgery
• Enhanced palliative care for terminally ill
children
What does the government want?
• Cancer treatment to be among
the best in the world
Target 2025: 75 % of cancer
patients are alive 5 years after
diagnosis
Priority 2: Early detection of chronic disease –
and extra help to vulnerable patients
Initiatives
• Targeted health checks at the GP for patients
in high risk of chronic diseases
• Clear plan for treatment (diabetes, COPD,
arthritis) and more quality of care
• National initiative for people with lung disease
• Specially trained nurse offered to vulnerable
patients with complex course in risk of many
acute contacts (case management targeted
the 1 %)
What does the government want?
• Early detection and better treatment
in the primary sector (GP’s)
Target 2025: Emergency admissions
for patients with COPD and diabetes
reduces by 20 pct.
Priority 3: Strengthening the GPs
Initiatives
• Investments in general practice and in
modern medical centers – more GP’s
working together + clinical personal
• Experiments with pay for performance in
general practice (chronic diseases)
• Associated GP’s to social care homes
What does the government want?
• Push for structural change and
modern GP’s
• Investment in GP’s that can treat
the chronically ill
Priority 4: Quality by patient empowerment
Initiatives
• Developing skills to involve patients actively in
decisions (shared decision-making, education)
• Use of patient knowledge of illness to target
and improve care – patient reported outcomes
• Better access to telemedicine when it results in
better and less costly treatment
• Better and faster access to the patients own
medical records
• Taskforce to spread good practice
What does the government want?
• “No decision about me – without
me”
• Push for cultural change in health
care
Priority 5: Better quality of care - through
visibility and transparency of results
Initiatives
• Visibility of results of health care and display
of best practice
• Rethinking of the Danish Quality Model (more
results - less process in accreditation)
• National experts to monitor and support
quality development at hospitals
• National program for management
• A reserve for pay for performance – rewarding
quality
• Increased focus on cleaning and hygiene
What does the government want?
• More focus on quality and results –
less on quantity and process
regulation
Current status
• The Health Strategy is a part of
the government’s proposal for
the state budget 2015
• Negotiations at the moment
• Dialogue with the different
actors in the health care sector
Thank You!