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Rating of Danish Public Hospitals

Country: 
Denmark
Partner Institute: 
University of Southern Denmark, Odense
Survey no: 
(8)2006
Author(s): 
Kjeld Mller Pedersen
Health Policy Issues: 
Quality Improvement, Others, Access, Responsiveness
Others: 
Implementation of information system to allow ( more) informed choice of hospital and relative performance of hospitals.
Reform formerly reported in: 
An open and a transparent health care system
Current Process Stages
Idea Pilot Policy Paper Legislation Implementation Evaluation Change
Implemented in this survey? no no no no yes no no

Abstract

Following a recommendation in a 2003-report on 'yard-stick' competion, e.g. public comparison of performance of hospitals, the first version of an internet based rating system of Danish hospitals has been published in October 2006. It is an incomplete attempt at present, but signals a new direction in trying to influence hospital behaviour and to provide the public and future patients with important information. See www.sundhedskvalitet.dk (in Danish). The web-site has been critisized.

Purpose of health policy or idea

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Characteristics of this policy

Political and economic background

Purpose and process analysis

Current Process Stages

Idea Pilot Policy Paper Legislation Implementation Evaluation Change
Implemented in this survey? no no no no yes no no

Initiators of idea/main actors

  • Government: It is an administrative measure taken by central government - basically without involving or consulting with the Danish counties that are responsible for providing hospital care. The counties have, however, not openly been against it, but has warned about data quality. Formally the systems is implemented and run the National Board of Health.
  • Parliament: All parties in parliament have expressed support for the initiative.
  • Providers: The Association of Counties publicly support the initiative, but is somewhat sceptical about the validity of the data used and the limited scope of the current system.
  • Others: the Association of Senior Consultants have expressed scepticism about the value of the initiative.

Stakeholder positions

The idea of publishing comparative performance data has been discussed for several years. One issue has been the desirablity of an explicit rating of hospitals ('stars'). Several important actors have been against the latter: the Danish Medical Association and somewhat underplayed, also the Association of Counties. Another issue has been the availability of relevant data, i.e. information on professional quality, productivity etc. It should be expected that the Association of Counties as representatives of providers and payers had been active in pursuing a solution. However, the association has been largely passive, implicitly not approving of such an initiative, although outwardly supporting the now established website. The initiative therefore has been government driven through the National Board of Health. 

The position of the minister of health has been that a rating system, mainly to provide information for patients, should be implemented despite acknowledged problems with validity of data and inadequacy of scope of areas covered. At present only five dimensions are covered: a bit about hospital facilities, patient safety, patient satisfaction, hygiene, including post-surgery infection rates, and punctuality.  Regarding data quality the minister repeatedly has noted that only data provided by the hospitals themselves is used. If there are data inaccuracies it is up to the hospital to improve the quality of reporting.

Actors and positions

Description of actors and their positions
Government
Government partiesvery supportivevery supportive strongly opposed
Parliamentary support partyvery supportivevery supportive strongly opposed
Parliament
Opposition partiesvery supportivesupportive strongly opposed
Providers
Association of Countiesvery supportivesupportive strongly opposed
Others
Senior consultantsvery supportiveopposed strongly opposed

Actors and influence

Description of actors and their influence

Government
Government partiesvery strongvery strong none
Parliamentary support partyvery strongvery strong none
Parliament
Opposition partiesvery strongneutral none
Providers
Association of Countiesvery strongstrong none
Others
Senior consultantsvery strongneutral none
Government parties, Parliamentary support partyOpposition partiesAssociation of CountiesSenior consultants

Positions and Influences at a glance

Graphical actors vs. influence map representing the above actors vs. influences table.

Expected outcome

References

Sources of Information

www.sundhedskvalitet.dk

Reform formerly reported in

An open and a transparent health care system
Process Stages: Policy Paper

Author/s and/or contributors to this survey

Kjeld Mller Pedersen

Suggested citation for this online article

Kjeld Mller Pedersen. "Rating of Danish Public Hospitals". Health Policy Monitor, November 2006. Available at http://www.hpm.org/survey/dk/a8/4