Health Economics in the Ministry of Health
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The document discusses health economics strategies within the Ministry of Health in Denmark, highlighting key changes and expected outcomes from the Super Hospital Programme, which encompasses a €3.6 billion budget for 16 projects aimed at improving healthcare infrastructure and patient care. It emphasizes the importance of economic incentives, transparency, and the division of labor in healthcare to achieve efficiency gains and better patient outcomes, such as a reduction in average hospital bed days and increased outpatient treatments. Additionally, it outlines the use of telemedicine and a national shared medication record to enhance patient care and safety.
Health Economics in the Ministry of Health
- 1. Presentation Title Goes HereHealth Economics in the Ministry of Health Nanna Skovgaard, Head of Division Visit from Belgium April 20, 2015
- 2. “What, how and why” of health economics Long term structural changes More value for money Economic incentives Coordinated changes in organisational, physical and technical infrastructure and capabilities Promote transparency Activity Resources Results What we work with How we do it Short term Long term Why we do it
- 3. 1. Key figures 2. Expected gains 3. Main areas of change 4. Initial challenges 5. Reshaping the landscape of health care in Denmark The Super Hospital Programme
- 4. Key figures – budget and number of projects Government € 3,6 billion € 6 billion budget - 16 building projects Region of Southern Denmark North Denmark Region Central Denmark Region Region Zealand Capital Region of Denmark Regions € 2,4 billion 20 per cent of budget reserved for investments in ICT and medico-technical devices
- 5. Key figures – expectations Expected developments in hospital activity 2007-2020 - Reduction in average bed days from 3,5 to 2,9 - 50 per cent increase in outpatient treatment - 20 per cent reduction in number of beds
- 6. Key figures – expectations vs. actual developments 4,000 4,500 5,000 5,500 6,000 6,500 7,000 7,500 Numberofbeds Year Number of beds, 2007-2020 Actual development, 2007-2013 Linear extrapolation of actual development Initial expected development (-20% 2007-2020) 4,000,000 5,000,000 6,000,000 7,000,000 8,000,000 9,000,000 10,000,000 11,000,000 Outpatienttreatment,no.ofcases Year Outpatient treatment, 2007-2020 Actual development, 2007-2013 Linear extrapolation of actual development Intial expected development (+50%, 2007-2020)
- 7. Unique patients vs. bed days (2009 = index 100) 80 85 90 95 100 105 110 115 120 2009 2010 2011 2012 2013 Uniquepatients Year Cancer Patients Bed days 80 85 90 95 100 105 110 115 2009 2010 2011 2012 2013 Uniquepatients Year Cardiovascular diseases Patients Bed days 80 85 90 95 100 105 110 2009 2010 2011 2012 2013 Uniquepatients Year COPD Patients Bed days 80 90 100 110 120 130 140 2009 2010 2011 2012 2013 Uniquepatients Year Type II diabetes Patients Bed days
- 8. Main areas of change Three areas of change - New hospital structure: 50 per cent reduction in number of emergency departments - New organisation: The specialist in front - New division of labour in the health care system
- 9. Expected gains We expect improvements in - Patient flow - Patient safety - Efficiency - Quality By spending - more resources on early diagnosis and treatment - Less resources on hospitalisation
- 10. Initial challenges and drivers of change Initial challenges Actions Funding dependent on regional commitment to structural reform Strict supervisory regime Efficiency gains as condition for approval of project Closing local hospitals ”Over time, over budget, over and over again” Secure return on investment Regions as partners in structural reform Promotion of innovation Opportunity to rethink what we do and how Drivers of change
- 11. Expected efficiency gains % of total efficiency gains 100 80 60 40 20 0 Total for 6 building projects 756 38 16 6 32 9 7 2 3 11 4 Optimised patient journeys/length of stay Logistics/IT Satisfaction among staff Patient safety Centralisation of funktions (not mergers) Energy and water consumption Building maintenance Cleaning Transport Mergers Fewer sites 2 1 3 Optimised patient journeys make up 38% of the total savings The projects see different efficiency possibilities 65% 20% 15% % of total efficiency gains 100 80 60 40 20 0 Hvidovre 58 26 16 21 17 17 Gødstrup 158 322 191 Herlev 62 65 214 15 47 20 4 6 15 8 43 46 Kolding 8 0 Aalborg 15 6 13 12 OUH 26 7 157 10 295 10 71 13
- 12. Logistics and tracking technology Electronic registration boards for emergency care in all hospitals
- 13. Reshaping the healthcare landscape - From castles to lighthouses
- 14. Telemedicine – an example Telemedical ulcer assessment: The method - The nurse photographs the ulcer with her cell phone and mails the image to the doctor. - The doctor prescribes new treatment or new medication. - Communication between nurse and doctor is based on a shared web based patient record. - Positive Business case: - 30 per cent reduction of healing time - fewer visits by the municipal nurse - fewer outpatient visits to the hospital - 50 per cent reduction in number of amputations
- 15. Telemedicine – an example Telemedical ulcer assessment: The pay-offs Patients: - High satisfaction - Less travelling - Can log on to shared web record, monitor own treatment Nurses - High satisfaction - Improved ulcer care skills from the direct communication with the experts in hospital Doctors and specialists in hospitals - Only see the most complicated ulcers - More exciting jobs, better use of public resources
- 16. New eHealth strategy 2013-2017 22 initiatives within 5 focus areas: 1. Better use of e-health systems - ”no more paper” with in hospitals 2. Connected care: Better cross sector cooperation 3. Better use of health data 4. Patient empowerment - treatment at home and patient-centred data 5. Transparency on progress/commitment
- 17. Shared Medication Record • One national database: updated information about prescription medicine for all patients in Denmark • Access for all doctors, nurses, pharmacists and hospitals. • Viewing access for citizens (own data) • Fully implemented in all hospitals and GPs in 2014, all municipalities in 2015 Background: • Reducing number of medication errors • Better communication about medicine between all involved parties • Improving quality of the treatment
- 18. Use of Shared Medication Record Working with transparency – an example
- 19. New North Zealand Hospital
- 20. Thank you for your attention