1. 1 Introduction to Denmark -the Danes - Storstrom region and - Occupational health at hospitals

2. 2 The Kingdom of Denmark Greenland + Pharaoe Island + Denmark

3. 3 The Kingdom of Denmark

4. 4 Denmark Population 5.342.000 42.000 km2 7314 km coast-line

5. 5 The Danes Total population: 5.342.000 18% under age 14 15% over 65 Life expectancy at birth: Males 74,1 years Females 78,9 years

6. 6 Persons with education and professional training Kilde:EUROSTAT&WHO

7. 7 What more do they have in common ?

8. 8 They pay TAX – TAX - TAX Direct tax on personal income Indirect tax e.g. VAT on duties and goods Property tax An example: Personal income: 400.000 d.kr. Direct tax on personal income To state :75.000 d.kr To county: 48.000 d.kr To municipality: 77.00 d.kr. Indirect tax: more than 50.000 d.kr. 100 d. kr. = 16,5 USD

9. 9 The Royal Family

10. 10 the Danish Parliament

11. 11 Regions and regional councils

12. 12 Storstrom Region 260.498 inhabitants 24 municipalities

13. 13 Countys total budget 2003 = 6.3 billion d.kr. Storstrom Region 260.500 inhabitants 9000 employees of which 3.293 in Health Care and 3.583 i Social Care

14. 14 Storstrom Region Health care Education & culture Social care Total Countys budget 2003 = 6.3 billion d.kr. Roads & environment

15. 15 Administrative levels, organizational structure and management of health care National Regional Municipal State government 14 Counties plus Copenhagen and Frederiksberg 273 Municipalities plus Copenhagen and Freriksberg Legislation, guidelines, standards Surveillance and supervision Targets for health care expenditure Incentives for local action Level Hospitals and prenatal care centers, General practitioners, specialists, dentists, physioterapist etc. Nursing homes, home nurses, health visitors, school health care Social services – life long care for the elderly and disabled Bigger hospital regions Municipal general care centers Trend

16. 16 19802000 No. of hosp. 11771 No. of beds 30.96718.683 Discharges894.4851.123.245 Bed days 8.413.4005.964.586 No. of out.pt’s 3.154.6425.453.283 Average lenght of stay (days) 9.45.3 Capacity and activity in somatic hospitals all Denmark Source: Ministry of Health

17. 17 Health care in Denmark - some characteristics Concensus: Access to health care should be independent of ability to pay or place of residence Free access to care in primary sector Health care publicly financed through taxes and run by public authorities

18. 18 Family doctor (General Practitioner) by patients own choise GP as gatekeeper (and adviser) to secondary sector (hospitals) Agreed shared care and action between counties and municipalities Patients are very satisfied with hospital services and especially with GP´s Health care in Denmark - some characteristics

19. 19 Cooperation between county and municipal level Based on: Agreed shared care Joint action on prevention and health promotion as an integrated part of health care and social services an integrated part of health care and social services

20. 20 Population Patients State government County councils Municipal councils Voluntary health insurance Municipal health services Home visitors and school h.c. Children dentists Care for elderly and disabled County health services Hospitals and maternity care General practitioners Specialist Dentists Private hospitals Taxes Premiums Out of pocket payments Block grants Global budgets Fee for service Capitation and fee for service

21. 21 the Danish Minister of Employment National Institute of Occupational Health The factories inspectorate The working environment complaints board - they take care of complaints related to the factories inspectorate Departments of Occupational Health The enterprices Occupational Health Service in Denmark -the Danish work environment consultantsystemthe Danish work environment consultantsystem of multidisciplinary preventive serviceunits Occupational health service Sector occupational health service The danish occupational health system

22. 22 What are we doing to make a safety in handling the patients ? -Safety organization with members from the leaders and the staff -Workplace valuation -Education to selected employees, who has to give -Short instruction to new employees and students -Advices to their colleges -Appropriate arrangement in the rooms - Appropriate assistive technology

23. 23 Incidents of reported work related suffering per 10.000 employees 1995 1996 1997 1998 1999 2000 2001 2002 63 66 68 67 55 60 63 57 Hospital employees suffering and accidents Incidents of reported work related accidents per 10.000 employees 1995 1996 1997 1998 1999 2000 2001 2002 170 178 167 163 158 165 137 122 The number of employees 1995 1996 1997 1998 1999 2000 2001 2002 103.091 103.745 103.416 101.731 102.712 102.235 103.162 104.235

24. 24 Selfestimated health Center of Public Health 2004 Kilde: Sundheds-& sygelighedsundersøgelserne Statens Institut for Folkesundhed Female Male

25. 25 Fit to do what you want to do Folkesundhedscenteret maj 2004 Kilde: Sundheds-& sygelighedsundersøgelserne Statens Institut for Folkesundhed Female Male

26. 26 Don’t feel stressed Center of Public Health 2004 Kilde: Sundheds-& sygelighedsundersøgelserne Statens Institut for Folkesundhed Female Male

27. 27 Good physical mobility Center of Public Health 2004 Kilde: Sundheds-& sygelighedsundersøgelserne Statens Institut for Folkesundhed Female Male

28. 28 Occupational Health Udd. = education Center of Public Health 2004 Kilde: Sundheds-& sygelighedsundersøgelserne Statens Institut for Folkesundhed