Associate Professor Albert Marni JoensenMD, Specialist in Cardiology, PhDNational CVD Prevention Coordinator for Denmark
Aalborg University Hospital, Department of Cardiology, Aalborg, Denmark
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Group picture (from left): Magnus T. Jensen, Albert Marni Joensen,Thomas G. S. Sehested, Kirstine Lærum Sibilitz and Ulla Overgaard AndersenIndividual pictures (from top): Julia Vishram, Soetkin Versteyhe, Susanne Glasius Tischer, Gunnar Gislason
The central government outlines health policies and goals for the public health care system. Five counties govern and administer the health care system and the municipalities provide rehabilitation and general health-promoting information.
The Danish healthcare system is tax financed and there is equal access to general practitioners and hospital care at no individual charge, independent of income or participation in the labor market. Medication expenses are partly covered by the counties. Patients who cannot afford the remaining costs can apply for economic help from the municipalities.
Danish costs for health care are approximately equal to the median costs in Europe.
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In 2013, Denmark counted 5.6 million inhabitants and the life expectancy at birth was 78 and 82 years for males and females respectively. During the last decades the age-standardized CVD mortality has decreased substantially. The development 2006 – 2012 is shown in figure 1. Figure 1: Temporal trends in cardiovascular mortality. Age-standardized rates per 100,000 and total number of deaths.
Source: figure drawn based on data extracted from the Danish Heart Foundation. HjerteTal.dk [Internet]. 2015 [cited 2016 Feb 14].
Table 1: The prevalence of major CVD risk factors in Denmark 2013
Source: http://www.sundhedsprofil2010.dk/ (Danish only), *Data from survey Health 2007
The Danish Health authorities have released focus areas which are recommendations in specific areas to be implemented across the 98 Danish municipalities for use in public institutions. General guidelines also include requirements for basic knowledge for care providers, teachers, and other professionals. For cardiovascular disease prevention following recommendations and initiatives are included:
National guidelines recommend that patients with coronary heart disease (CHD), heart failure (HF), and those after heart valve surgery are systematically referred to cardiac rehabilitation (CR). CR is regarded as a part of the treatment and is financed by the taxpayer-funded system. Initiatives are taken to also include other cardiac patients e.g., atrial fibrillation (AF).
The municipalities are the principal responsible for rehabilitation with close cooperation with the treating hospital. Participation rates in CR for CHD, HF and heart valve surgery patients is above 70%, although only a part of these patients fulfill a complete comprehensive programme.
CR for CHD patients at hospitals is organised as an intersectional programme with a multidisciplinary approach supervised by a cardiologist.
The establishments of HF clinics offering education, control of fluid retention, and medication appear efficient in terms of therapy optimisation and decline in HF related readmissions.
Also, the number of AF clinics is increasing with the purpose to ensure a better treatment, guidance and education for AF patients.
National Treatment Quality Databases have been established to monitor and improve the treatment and rehabilitation for patients with CHD and HF. A similar database for AF patients is following.
The Danish Society of Cardiology and The Danish Heart Foundation will continue the work to prevent development of CVD through information, research, and by influencing policy makers. We have identified three areas which require increased focus in the coming years:
We propose further structural initiatives to
Note: The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.
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