Denmark health system review.
Denmark health system review.
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丹麦卫生系统审查。
DOI：
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发表时间：
2012
影响因子：
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通讯作者：
C. Hernández
中科院分区：
文献类型：
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作者：
Maria Olejaz;Annegrete Juul Nielsen;A. Rudkjøbing;H. Okkels Birk;A. Krasnik;C. Hernández
丹麦有一个分散的卫生系统的传统。然而，近年来，改革和政策倡议以不同的方式逐步集中了卫生系统。2007年的结构改革将老县合并为更少的更大的地区，老市也是如此。医院结构也在经历类似的改革，医院数量更少、规模更大、专科更多。此外，近几年来一直在采取更加集中的规划和监管方法。这一点在新的国家医疗专业规划以及建立一个全国性的认证制度--丹麦医疗质量方案--中可见一斑，该方案为丹麦的医疗系统提供者制定了国家标准。还努力确保连贯的患者路径--目前癌症和心脏病--在全国范围内都是类似的。这些努力还旨在改善部门间合作。在财政方面，近年来在公共卫生部门引入了更高程度的以活动为基础的筹资，并结合了传统的全球预算。丹麦的卫生保健系统仍然存在一些挑战。最近的改革和集中举措的后果尚未得到充分评估。在此之前，全面概述未来改革的目标是不可能的。丹麦在预期寿命等一些健康指标方面继续落后于其他北欧国家。一些风险因素可能是导致这种情况的原因：饮酒和肥胖仍然是问题，而吸烟习惯正在改善。卫生方面的社会经济不平等程度也继续是一个挑战。丹麦医疗保健系统的组织将不得不考虑到未来的一些挑战。这些措施包括改变疾病模式，使患有慢性病和长期疾病的人口老龄化；确保充足的工作人员；以及决定如何改进旨在预防疾病和有利于改善健康的公共卫生倡议。
Denmark has a tradition of a decentralized health system. However, during recent years, reforms and policy initiatives have gradually centralized the health system in different ways. The structural reform of 2007 merged the old counties into fewer bigger regions, and the old municipalities likewise. The hospital structure is undergoing similar reforms, with fewer, bigger and more specialized hospitals. Furthermore, a more centralized approach to planning and regulation has been taking place over recent years. This is evident in the new national planning of medical specialties as well as the establishment of a nationwide accreditation system, the Danish Healthcare Quality Programme, which sets national standards for health system providers in Denmark. Efforts have also been made to ensure coherent patient pathways - at the moment for cancer and heart disease - that are similar nationwide. These efforts also aim at improving intersectoral cooperation. Financially, recent years have seen the introduction of a higher degree of activity-based financing in the public health sector, combined with the traditional global budgeting.A number of challenges remain in the Danish health care system. The consequences of the recent reforms and centralization initiatives are yet to be fully evaluated. Before this happens, a full overview of what future reforms should target is not possible. Denmark continues to lag behind the other Nordic countries in regards to some health indicators, such as life expectancy. A number of risk factors may be the cause of this: alcohol intake and obesity continue to be problems, whereas smoking habits are improving. The level of socioeconomic inequalities in health also continues to be a challenge. The organization of the Danish health care system will have to take a number of challenges into account in the future. These include changes in disease patterns, with an ageing population with chronic and long-term diseases; ensuring sufficient staffing; and deciding how to improve public health initiatives that target prevention of diseases and favour health improvements.