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Regionsdannelsens betydning for sundhedsområdet i Danmark: med specielt fokus på sygehusenes finansiering
Nordic Council of Ministers, Nordic School of Public Health NHV.
2007 (Danish)Independent thesis Advanced level (degree of Master (Two Years))Student thesisAlternative title
The influence of the creation of regions on the health care in Denmark : with particular emphasis on financing of the hospitals (English)
Abstract [da]

Baggrund: D. 1. januar 2007 trådte kommunalreformen i kraft i Danmark. Regionsdannelsen er den største ændring af den offentlige sektor siden kommunalreformen i 1970. Ansvaret for sundheds-væsenet bliver regionernes hovedopgave.

Formål: At beskrive, analysere og diskutere de strukturændringer, der finder sted i sundhedsvæsenet, med hovedvægt på sygehusvæsenet i Danmark.

Metode: Opgaven tager afsæt i et litteraturstudie, hvor udgangspunktet er officielle kilder og udredninger samt videnskabelig litteratur.

Resultater: Strukturreformen, der er en centralisering, er inspireret af New Public Management-filosofien. Finansieringssystemet på sundhedsområdet er blevet væsentligt forandret med kommunalreformen. Det er en tvivlsom antagelse, at kommunale foranstaltninger er billigere end de regionale sundhedsydelser, og at nettobesparelsen er tilstrækkelig til at drive substitutionsprocessen. En nedsættelse af behandlingsgarantien fra to til en måned må forventes at stimulere markedet for private sundhedsydelser, med en underminering af den integrerede model med offentligt ejerskab og drift af sygehusvæsenet til følge.

Konklusion: Den nye finansieringsmodel påvirker aktørernes økonomiske incitamenter, idet de enkelte aktører kun belønnes for de ydelser, de selv leverer til patienten, uden sammenhæng med resten af behandlingsforløbet. Den stigende aktivitetsafhængige finansiering udgør en væsentlig styringsmæssig udfordring. Ventetidsgarantien får med nedsættelsen fra to til en måned karakter af at være et servicemål, frem for at være en garanti for behandling af høj faglig kvalitet.

Abstract [en]

Background: On 1 January 2007 the Local Government Reform came into force. The formation of regions is the biggest change of the public sector since the Local Government Reform in 1970. The regions’ main task will be the responsibility for health service.

Purpose: To describe, analyse and discuss the structural changes taking place in the Danish health service, with emphasis on hospitals.

Method: The starting point of the essay is official sources and explanations as well as scientific literature.

Results: The structural reform is a centralisation is inspired by the New Public Management philosophy. The financial system in the health care area has been changed significantly through the Local Government Reform. It is dubious to assume that local government measures are cheaper than the regional health services, and that the net saving is sufficient to drive the substitution process.

A reduction of the treatment guarantee from two to one month must be expected to stimulate the private health service market, thereby causing undermining of the integrated model with public ownership and operation of health service.

Conclusion: The new financing model will affect the financial incentives in the system as the individual players are only rewarded for the services they deliver to the patient with no relation to the remaining treatment. The increasing activity depending financing presents a significant management challenge. With the reduction from two months to one the waiting time guarantee will assume the character of being a service goal instead of a guarantee of treatment of high professional quality.

Place, publisher, year, edition, pages
2007. , 75 p.
Series
Master of Public Health, MPH, ISSN 1104-5701 ; MPH 2007:20
Keyword [en]
Structural Reform, Local Co-Financing, Financing of the Hospitals, Charge Control, New Public Management
Keyword [da]
Strukturreform, kommunal medfinansiering, sygehusenes finansiering, takststyring, New Public Management
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:norden:org:diva-3204OAI: oai:DiVA.org:norden-3204DiVA: diva2:725301
Presentation
2007-11-09, Nordic School of Public Health NHV, Box 12133, 404 42 Göteborg, Sweden, 10:48 (Danish)
Supervisors
Note

ISBN 978-91-85721-28-3

Available from: 2014-06-16 Created: 2014-06-16 Last updated: 2014-07-08Bibliographically approved

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