|Implemented in this survey?|
The central Government presented a bill in March 2004 suggesting that the Ministry of Health should be enabled to approve experiments with charging fines on non-attendees for hospital treatment. This bill was approved and introduced by law by the Parliament in June 2004. The purpose of this policy is to reduce patients? non-attendance rate for ambulatory appointments and appointments for operation.
The central Government presented a bill in March 2004 suggesting that the Ministry of Health should be enabled to approve experiments with charging fines on non-attendees for hospital treatment. This bill was approved and introduced by law by the Parliament in June 2004. The purpose of this policy is to reduce patients' non-attendance rate for ambulatory appointments and appointments for operation. The policy proposal allows hospitals to charge non-attending patients a fine which should influence the patients' financial incentive to miss an appointment.
To reduce non-attendance rate in hospitals .
Patients are charged a fine which should motivate them not to miss an appointment.
Hospitals are going to set up an administrative system to handle fines.
|Degree of Innovation||traditional||innovative|
|Degree of Controversy||consensual||highly controversial|
|Structural or Systemic Impact||marginal||fundamental|
|Public Visibility||very low||very high|
The Minister of Interior and Health presented the bill in March 2004 as part of the governments' policy. The suggestion to enable hospitals to fine non-attending patients is part of a broader policy which should enable public service produces to fine user for misuse (parents picking their children to late etc.).
|Implemented in this survey?|
The idea to fine non-attending patients has been discussed for some time. The possibility to fine misuse has been piloted in kindergarten but has not been used in hospitals. Some of the primary health care providers already are allowed to charge fines for non-attendance. Chiropractors, dentists, feet therapists, physiotherapists and psychologists are allowed to charge fines but the general impression is that they do not make use of this possibility. However, no systematic overview of the number of non-attendance or the amount of the fines for non-attendance exits. The policy proposal is the culmination of an ongoing debate about the size of waiting lists, efficiency of hospital services and patients' non-attendance. The policy proposal is innovative in a Danish context.
The approach of the idea is described as:
The proposal to fine non-attending patients is suggested by the central government. The counties who own, manage and finance the hospitals do not support the policy suggestion mainly because of potential bureaucratic problems. Hospitals do not have an administrative apparatus to handle fines and this will in itself increase the administrative burden. Secondly, the counties foresee a number of unsolved issues about the patients' rights and about the practical management of a fine system. Thirdly, the Association of Counties does not believe that fines only have marginal influence on the non-attendance rate.
The policy was presented as a bill March 2004 and was approved and introduced by law in June 2004.
The counties' negative commentary to the policy may not influence the legislation process but will undoubtedly influence the implementation of the policy because they own and manage the hospitals.
No evaluation is available and no system to monitor non-attendance rates are implemented systematically.
|Quality of Health Care Services||marginal||fundamental|
|Level of Equity||system less equitable||system more equitable|
|Cost Efficiency||very low||very high|
Finansministeriet, Justitsministeriet, Beskæftigelsesministeriet, Socialministeriet, Integrationsministeriet, Indenrigs- og Sundhedsministeriet. Rapport fra arbejdsgruppen vedr. betaling ved udeblivelse fra aftaler med det offentlige. København: Finansministeriet, 2004
Mickael Bech & Mette Birk-Olsen