Nordic healthcare systems and ongoing building/restructuring at a glance


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Terhi Rasmussen, Finpro. Changes in Scandinavian healthcare sector - oppportunities for Finnish companies. Finpro seminar materials 19.4.2012.

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Nordic healthcare systems and ongoing building/restructuring at a glance

  1. 1. Introduction to the seminar topics:Scandinavian healthcare systems & ongoingbuilding/restructuring at a glanceTerhi Rasmussen, ConsultantFinpro Scandinavia 19.4.2012
  2. 2. Common future scenario for all the Scandinavian countries• Due to aging population and life-style changes (increasing diabetes, obesity, chronic illnesses, etc.) the need for healthcare services will change and the demand for healthcare related services both in private and in public sector will increase • monitoring and treatment • often life-long medication• To meet the future challenges there is a demand for new, modern and effective hospitals, healthcare systems and solutions • Modern & flexible hospital facilities • New digital hospitals with welfare technology • Modern supportive functions: devices, logistics, IT • Home monitoring / self monitoring, interactive patient consultancy and distance dialogue • Increased partnerships with public and private actors 19.4.2012 Terhi Rasmussen, Finpro Scandinavia
  3. 3. Scandinavian healthcare sector in figures Denmark Norway SwedenPopulation: 5 580 516 (2012) Population: 4 985 900 (2012) Population: 9 486 591 (2012)Number of hospitals: Number of hospitals: Number of hospitals: 60 public hospitals/clinics  73 public  70 county public hospitals (incl.8 ca. 10-30 private hospitals  ca.12 private regional/university hospitals, special care) Private hospitals have about 2-5% of the  Role of private hospitals is rather limited  ca. 9 private activity between 5-10%  The counties and regions buy about 10- 15% of the healthcare services fromProfessionals: Professionals: private care providers 3500 GPs  4109 GPs  Ca. 12 000 doctors in hospitals Professionals: 14 500 doctors in hospitals  4600 GPs  ca. 13 0000 doctors in hospitalsHealth expenditure per capita: Health expenditure per capita: 4781 EUR  5840 EUR Health expenditure per capita:  3241 EURProcurement: Procurement: gathers information  Public hospital procurement is done on a Procurement: regarding purchasing and tenders in the 5 regional and local level  Each county has their own purchasing unit, Danish regions  e.g. SLL and Region Skåne   hp?id=YY834773YX  Regionservice-samlingsnod/Regionservice/ For_vara_entreprenorer/Upphandling/Planerad e-upphandlingar/ Source: OECD, RHF, Regionerne, County Councils and 19.4.2012 Terhi Rasmussen, Finpro Scandinavia regions, SINTEF, private hospital organizations, etc.
  4. 4. Structure of the Danish healthcare sector • The Danish public health insurance gives everybody in Denmark an equal and free access to health services • Denmark is divided into 5 state-owned regions and 98 municipalities  Regions are responsible for  the provision of hospital services  psychiatric services  general practitioners and specialists  Municipalities are responsible for  home nursing  public health  school health service & child dental treatment  prevention and rehabilitation  elderly care • Financed through taxation • Free choice of hospital19.4.2012 Terhi Rasmussen, Finpro Scandinavia
  5. 5. Structure of the Norwegian healthcare sector• Public healthcare system, which is mainly free of charge• The Ministry of Health and Care Services has supervisory Helse Nord responsibility for all hospitals in Norway, and the state owns the public hospitals• Divided into four health regions (RHF) with regional health trusts, which are responsible for  operating the hospitals as effectively as possible  ensuring adequate supply of specialist care services for people in their own region through own hospitals, private hospitals or hospitals in other regions• There are 430 municipalities with the responsibility to provide services such as  Regular General Practitioner Scheme Helse Midt-Norge  care of the elderly  work with addiction and psychiatric health  municipal social services  dental care services  alternative treatment  public physiotherapy services Helse Vest Helse Sør-Øst• Funded mainly through taxes• Free choice of hospital19.4.2012 Terhi Rasmussen, Finpro Scandinavia
  6. 6. Structure of the Swedish healthcare sector• Everyone has equal access to healthcare services• Responsibility for health and medical care is shared by the central government, county councils, regions and municipalities  Central government is responsible for establishing principles and guidelines for care and for setting the political agenda for health and medical care  County councils and regions are responsible for providing healthcare and general practicesSweden is divided into• 18 county councils and two regions  Responsible for organizing health care to citizens, hospitals, and primary care  Around 10 % of the work involves other areas, such as culture and infrastructure  It is becoming more common to buy services from private healthcare providers• 290 municipalities, which are responsible for • elderly care and care of the disabled, accounts for almost 30 %of their budgets, care and assistance is provided in the home and in sheltered accommodation • social services • providing support and services for people discharged from hospitals • school health care• Mainly taxpayer-funded• Free choice of hospital 19.4.2012 Terhi Rasmussen, Finpro Scandinavia
  7. 7. Hospital building projects in Denmark• In order to future-proof the health care in Denmark the hospital structure is currently undergoing a change process with the help of heavy investments in new hospitals, and renovating and expanding the existing• The government and the regions have agreed to invest 5,56 billion EUR in the renewal of hospital sector in the coming 10- 15 years.  Estimated 20-25% of the investment to be invested in technology  Includes 16 projects, 5 new hospitals and 11 renovation projects  Fewer, larger, and more specialized hospitals  Changed patient flow, flexible surroundings  Innovation in organization, logistics and use of IT  Use of telemedicine• Altogether now 38 ongoing hospital construction projects all over Denmark  E.g. new university hospitals in Aarhus 853,5 million EUR and Odense 846,7 million EUR Constructions financed Regionally financed  E.g. new hospitals in Alborg 551,1 million EUR, Køge by Kvalitetsfond constructions 537,6 million EUR, Hillerød 510,7 million EUR, (governmental fund) Gødstrup 423,4 million EUR19.4.2012 Terhi Rasmussen, Finpro Scandinavia Source:
  8. 8. Hospital building projects in Norway• Different building projects related to new hospitals, renovation of old ones, or retirement homes going on in all the four regions, examples:• Helse Sør-Øst  Østfoldsykehus project (2011-14), 657,5 million EUR• Helse Midt  St. Olavs Hospital  Full reconstruction and renovation of a university hospital in Trondheim, 1,66 billion EUR  Construction started in 2002, expected to finish in fall 2013  The project is in the last construction phases  In pre-planning phase hospitals in Møre and Romsdal• Helse Nord  Vesterålen 115,6 million EUR  Nordlandssykhuset Bodø 420,8 million EUR• Helse Vest  Child and youth center in Haukeland University hospital  460,3 million EUR, 63.000m2, 2011-202019.4.2012 Terhi Rasmussen, Finpro Scandinavia Source: the four health regions RHF, Tekniskugeblad
  9. 9. Hospital building projects in Sweden • Also in Sweden many hospitals are undergoing renovation, examples: • Nya Karolinska Solna  New university hospital in Stockholm  1,63 billion EUR, 320 000 m2, 2010-2017  Biggest construction site in Europe  Medico technical device procurement to start in 2012  Interior procurement is in the planning phase  Danderyd hospital  224,4 million EUR, 48.000m2, start in Nov. 2012 • Södertälje Hospital  134,7 million EUR  Reconstruction and renovation to start in 2013 • Löwenströmska hospital  Renovation project for 53,9 million EUR19.4.2012 Terhi Rasmussen, Finpro Scandinavia Source:, County councils and regions
  10. 10. E-health in Scandinavia Denmark Norway Sweden• Already has electronic health records • E- prescription already in use in some • Electronic transfer of prescriptions exists regions and underway in others• “” portal with wide register of • “” is a portal for information information for patients and professionals, • Health portal ”” opened in regarding sicknesses and for comparing developed since 2001 June 2011, includes information about hospitals’ treatment levels, etc.• Bring together relevant information from all  sickness, treatment, and parts of the health service prevention of sickness • ”My health care contacts” is a portal,• Offer a shared platform of communication  own prescription history where individuals can make contact with• Empower patients by offering maximum  access to own doctor doctors and book appointments, etc. insight and transparency in the health care  vaccinations sector  e- prescription • Nation wide patient summary (NPÖ) is• Offer health care providers easy access to  patient rights underway, already adopted in some clinical information about their patients’ regions medical history. • Norwegian government investing this • National e-health strategy focuses on• Current development areas: year 19,9 million EUR on e-health following areas:  telemedicine • Current development areas:  patient empowerment  to facilitate the communication  national patient records  usable and accessible patient data between the local authorities and (Kjernejournal) for the staff other healthcare sector players  e-health as part of training (primary and secondary care)  health portal  national health register  improving technical infrastructure  expansion of common medication  data usage and protection card  standardization  communication between different  standardization, legislation and  further development of e-records security, etc.  better communication between actors in the health sector laboratories and GPs  data protection •  National patient index (NPI)  e-prescription •• • 19.4.2012 Terhi Rasmussen, Finpro Scandinavia
  11. 11. Finpro Scandinavia • Offices in Copenhagen, Oslo and Stockholm • A team of 10 Nordic people with various industry expertise • Team headed by Sissi Silván, based in Copenhagen • Contact: Sissi Silván Tel. +45 2244 0338 Finpro Norway Finpro Sweden Finpro Denmark20/04/2012 © Finpro 11
  12. 12. Agenda for today 8:30 Registration and coffee 9:00 Introduction to the topic: Nordic healthcare systems & ongoing building/restructuring at a glance, Terhi Rasmussen, Consultant, Finpro 9:30 Denmark is building super hospitals, John Bendix, Building project director, Herlev Hospital 10:10 Telemedicine from the Nordic and Danish perspectives, Klaus Phanareth, Chairman, DSKT (Danish Society for Clinical Telemedicine) Terhi Rasmussen, Consultant, Finpro 10:50 Quick Break 11:00 Private health care sector in Sweden, Håkan Tenelius, Head of Public Affairs, The Association of Private Care Providers, ALMEGA 11:40 Industry summary & introduction to company clinics, Christine Grumbach, Head of Industry, Life Science, Finpro 12:00 Lunch 12:30 Company Clinics19.4.2012 Terhi Rasmussen, Finpro Scandinavia
  13. 13. More information Denmark Norway           Http://      ll-for-helsesektoren-2011/Publikasjoner/nokkeltall-for-  helsesektoren-2011.pdf  dheds-it.aspx Sweden         Terhi Rasmussen, Finpro Scandinavia