Hospital centralization and performance in Denmark-Ten years on

Area of Science:

• Healthcare policy
• Health services research
• Public administration

Background:

• Denmark reorganized its administrative structure in 2007, merging 13 counties into 5 regions and reducing municipalities.
• A key goal was to create larger administrative units to support a more centralized hospital structure with fewer acute care facilities.

Purpose of the Study:

• To analyze the reorganization of Denmark's somatic hospital sector post-2007 reform.
• To examine the mechanisms driving these changes and evaluate hospital performance.
• To assess the reform's impact on acute services and quality of care.

Main Methods:

• Analysis of the restructuring of acute hospitals from approximately 40 to 21 facilities.
• Review of the democratic process guiding hospital placement under central requirements.
• Examination of hospital productivity and cost data since the reform.

Main Results:

• Hospital productivity increased by over 2% annually, with stable costs.
• The number of acute hospitals significantly reduced, with new joint acute facilities established.
• While generally successful, concerns remain regarding accessibility in remote areas and staff workload.

Conclusions:

• The Danish hospital reform achieved increased productivity and stable costs.
• Centralization of acute care services appears successful, but equity and staff well-being require attention.
• Municipalities enhanced health services, focusing on prevention and health promotion concurrently.