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

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60

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Breast cancer – 5-year survival, 2006-2011

Pct.

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60

65

70

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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

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50

100

150

200

250

300

350

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Admissions due to COPD, 2011 per 100.000 population

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80

120

160

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240

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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!