ABSTRACT

Over the years the Danish health system has seen significant reformed in relation to rationalizing its governance structure. Alongside reforms in the distribution of responsibilities for the provision of services, the central and regional Governments have embarked on major hospital reforms. The reforms have driven hospitals towards centralization, specialization, standardization, and higher efficiency. At the same time, healthcare has moved from hospitals into the primary sector, resulting in changed expectations and roles for family physicians, and there has been a major expansion of municipality-based healthcare responsibilities. General practice, however, has not been correspondingly reorganized

The effort during the past 20 years towards increased quality has transformed the agenda and management of quality improvement and patient safety. It has increasingly become a matter of central regulation, thus moving from local responsibility and private ownership to becoming an obligation for healthcare leaders based on standards defined at a national level. Transparency has increased as well as public access to data. The agenda has changed from ensuring high professional standards and efficiency, to include patient safety and a patient engagement agenda, aimed at enhancing patient-centered care. Quality improvement has also steadily become more data-driven.