Overview

Ensuring coordination and continuity of care is an ongoing focus area for policy discussions and reforms

The Danish universal tax-based health system has effective provision of quality care and high patient satisfaction with low levels of unmet health needs. However, it faces coordination and fragmentation challenges due to its decentralized structure and the provision of care by three different sectors: regions, municipalities, and the private sector, including general practitioners and specialists. Ensuring coordination and continuity of care has been an ongoing focus area for policy discussions and reforms; however, it remains an issue of concern.

An upcoming structural reform is expected to deal with the current and future challenges of the health care system

Several steps have been taken to address the current and fundamental challenges of the health system. In the Summer of 2022, the government set up a Resilience Commission to propose initiatives that can ensure more personnel in the future while also ensuring that personnel have more time to focus on core tasks related to citizens and patients. The Resilience Commission’s recommendations were published in September 2023, focusing on stronger prioritization and smarter task solutions, attractive workplaces and time for core tasks, the right competencies, and professional flexibility. Additionally, a Structural Commission has been set up to deal with long term structural challenges in the health system that include the demographic transition of the population, economic sustainability, lack of healthcare personnel, and care coordination. The Structural Commission proposals have the potential to change how the health system is organized.

The Danish health system is highly digitalized

Over the past decade, digitization in the health system has been strengthened, both in terms of internal IT systems and the increased use of telemedicine. Recruiting and retaining GPs in remote areas have proved difficult and digital tools are seen as an important means of maintaining access to services in these areas. The COVID-19 pandemic also accelerated the uptake of digital tools. The primary rationale behind the increasing use of telemedicine is to deliver more patient-centred care, including treating more patients in primary care and at home, ultimately easing pressure on hospitals. Aspirations for the future include full digital integration of data across all levels of health care.  

The COVID-19 pandemic exacerbated pre-existing shortages of nurses which also impacts the ability to deal with waiting times

The COVID-19 response of the Danish health system testified to its flexibility to external shocks. The country was able to rapidly scale up testing and laboratory capacity and roll out successful information and vaccination campaigns. However, it is hard to maintain resilience to external shocks over the longer term, and the pandemic exacerbated pre-existing shortages of nurses – particularly in intensive care and surgery. The key political challenge is coping with increasing waiting times for elective care as the health system struggles to clear the backlog, mainly of surgeries that arose as the system had to deal with the increased burden of treating COVID-19 cases. However, the shortage of nurses limits the scope for surging capacity to meet this need.

Profound changes to health workplaces and practices are required to ensure the sustainability of the health workforce

The main challenge to the sustainability of the health system is ensuring sufficient numbers of health workers, particularly nurses, to meet the health needs of the population. A comprehensive package of policies has been put in place to increase the number of nurses being trained and to retain nurses already working in the system, but such measures need time to work. There is no quick fix to staffing shortages, and profound changes in working practices and working environments will be required to ensure the sustainability of the health workforce and, by extension, the health system into the future.