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Commentary: Denmark’s health reforms are part of a wider trend

BMJ 2012; 345 doi: (Published 24 July 2012) Cite this as: BMJ 2012;345:e4994
  1. Richard B Saltman, professor health policy and management1,
  2. Karsten Vrangbaek, director of research2,
  3. Juhani Lehto, professor of social and health policy3,
  4. Ulrika Winblad, associate professor of social medicine4
  1. 1Emory University, Department of Health Policy and Management, Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, Georgia 30338, USA
  2. 2Danish Institute of Governmental Research, Copenhagen, Denmark
  3. 3University of Tampere, Tampere, Finland
  4. 4Uppsala University, Uppsala, Sweden
  1. Correspondence to: R B Saltman RSALTMA{at}

Rudkjøbing and colleagues’ article on Danish efforts to improve integrated care provides valuable insight into the current health reform process in publicly funded health systems.1 National policymakers—facing performance, outcome, and efficiency challenges in the care of chronically ill elderly patients—have implemented a series of mechanisms to better coordinate locally organised care. The new Danish approaches include mandatory agreements between regions (and their hospitals) and municipalities (which administer long term and social care services); targeted financial incentives to encourage general practitioners to better manage debilitating conditions like diabetes and to make more home visits; placing GPs inside designated hospital departments to advise in coordination with primary health services; and establishing patient pathways for the treatment of cancers, heart disease, and other complex conditions. Forthcoming measures that will impose a de facto national veto on municipal budgets (regional budgets are already …

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