HHE HOPE 2019 - Page 15

regional health insurance funds into a single one covering almost the 80 % of the population. Savings in administration and efficiency gains are expected. Could you present two/three elements on the impact of such reforms on hospital and/ or healthcare sectors that your organisation/ country has identified? A significant reform activity was the development of a new approach to the provision of primary healthcare, which is traditionally provided by individual general practitioners working alone in private practices, contracted to one or more social insurance funds. In 2017, the Primary Health Act was adopted, laying down uniform requirements for the new primary care across Austria. In the same year, the establishment of a total of 75 multi- professional and interdisciplinary primary care centres and networks, respectively, by the end of 2021 was agreed. The new primary care units are to be achieved by attracting existing GPs and other health professionals working together in teams, thus being able to provide more comprehensive services and more opening hours for the patients while, coincidently, the working time is better distributed between the team members, favouring a better work–life balance. A few primary care units are already in operation and are well accepted by the patients. The medical staff also seems to be satisfied. In order to promote the new concept, appropriate contractual agreements are under negotiation and start-up programmes are being developed. Strengthening primary care is crucial as the Austrian health system has still a strong focus on hospital (inpatient) care. The introduction of the Electronic Health Record (ELGA), together with its e-medication and e-report applications, is making good progress. Since the end of 2015, ELGA is being rolled-out in stages, starting with public hospitals. Between March 2018 and September 2019, ELGA and e-Medication are being made available step by step to doctors in private practices, group practices, pharmacies and outpatient clinics. The aim of ELGA is to reduce organisational barriers, improve coordination and strengthen patients’ rights. Whether the recent reform of the organisational structure of the health insurance funds will affect the healthcare system will only become apparent in the coming years. DENMARK Mrs Eva M Weinreich-Jensen HOPE President, Danish Regions Could you describe the last hospital and/ or healthcare reforms implemented in your country in the past 5 years? A major reform of the Danish healthcare sector took place in 2007. Following the reform, the number of hospitals was heavily reduced and concentrated, and the specialised hospital services were centralised. Whatever has been done after 2007 has been an attempt to add to, and to adjust, the 2007 reform. One example is the National Strategy for Personalised Medicine 2017–2020, involving a national infrastructure working on both treatment and research. Moreover, regional data support centres will be established, providing researchers, clinicians and health personnel with reliable data. 1 Another example is the National Digital Health Strategy 2018–2022, based on 25 specific initiatives empowering patients by giving them a complete overview of their digital health data and by offering them a digital copy of their health records. 2 A third example is the National Strategy for Cyber and Information Safety in the Healthcare Sector 2019–2022, which aims to make the digital system in health secure and trustworthy, given the amount of patient data handled. At the moment, the Danish Region is looking at a national wish to reform the outpatient system and to make patients’ paths easier and more flexible while ensuring a better coordination of care. The focus shall be also on how to face the demographic challenges by changing the structural mind-set. This may come in the form of defining health communities around 21 acute hospitals; an increased cooperation between general practitioners and the hospitals and an overall strengthening of the pre-hospital effort and the acute functions. The overall trend is a change from focus on treatment activity and volume, to prevention and quality treatment (outcomes). The basic goal is to give In Austria, the growing pressure on health systems during, and in the aftermath of the economic crisis gave impetus for a reform aiming to overcome the traditional fragmentation and to improve coordination and policy coherence DENMARK Total current health expenditure as % of Gross Domestic Product (GDP) General government/compulsory current health expenditure as % of total current health expenditure Hospital current health expenditure, as % of total current health expenditure Household out-of-pocket health expenditure as % of total current health expenditure All hospital beds per 100,000 inhabitants Acute care hospital beds per 100,000 inhabitants Acute care admissions/discharges per 100 inhabitants Average length of stay for acute care hospitals (bed-days) Practising physicians per 100,000 inhabitants Practising nurses per 100,000 inhabitants 15 HHE 2019 | hospitalhealthcare.com 2002 2008 2016 8.7% 9.5% 10.4% 83.8% 84.0% 84.1% 43.9% 44.5% 44.3% 14.7% 14.1% 13.7% 429.0 351.0 260.0 426.0 629.0 252.0 14.2 13.1 n.a. 3.7 3.5 n.a. 304.0 349.0 368.0 1347.0 1490.0 1690.0