Denmark

Danish residents enjoy universal access to a comprehensive package of health services free of charge.

The Danish health system is organized into three administrative levels: the state, the regions and the municipalities. The state holds the overall regulatory, supervisory and fiscal functions. The five regions are, among other things, responsible for hospitals as well as for planning and paying for primary care services delivered by self-employed health care professionals. The 98 municipalities are responsible for rehabilitation, home and institutional long-term care, and public health. However, there are major reforms on the policy agenda which could radically reorganize the health care system.

The regions and municipalities are the administrative levels responsible for financing health care in Denmark. The municipalities derive their revenue from a proportional income tax, proportional land tax and block grants from the state. The regions derive their revenue from a block grant from the state (around 83% of their income) combined with performance-based financing reflecting continuity of care (around 1%) from the state, and municipal co-payment for services provided to the residents in the municipality (around 16%).

Primary care is provided by private practitioners (such as GPs, psychologists, physiotherapists, dentists, chiropractors, podiatrists, dietitians and pharmacists, who are self-employed but have negotiated collective agreements on remuneration with the regions) and municipal health services, such as nursing homes, social and home nurses, health visitors and municipal dentists. General practice is a central part of the Danish health care system. General practitioners treat 90% of all patient contacts at the primary care level and act as gatekeepers, referring patients to hospitals, specialists, physiotherapists, psychologists and selected municipal services. Secondary and tertiary care takes place in public hospitals owned and operated by the regions.