“Denmark has a long tradition of public welfare (Vallgårda, 1989; 1999a; 1999b) and decentralized management of welfare tasks. The first hospitals were built by individual counties and towns. Initially, hospitals were intended for and used by the poor, but this gradually changed at the end of the 19th century. From the 1930s onwards, the state started subsidizing hospitals, but county councils were responsible for them.
“Although health insurance developed during the second half of the 19th century as mutual assistance funds for artisans and through philanthropy, from 1973 onwards, health care has been predominantly financed from general taxation. A 1970 reform of the political and administrative structure reduced the number of counties and municipalities in Denmark (see Section 2.3). It also placed the responsibility for the largest part of the health care sector on the counties. Previously, this responsibility was divided between the municipalities, counties, the central state and the health insurance schemes. In 2007, a structural reform (Strukturreformen) was implemented, further reducing the number of municipalities to 98 and establishing five regions, replacing the counties, responsible for providing hospital and outpatient care as well as contracting with general practitioners (GPs) and practicing specialists. The municipalities received more responsibility for rehabilitation, disease prevention, health promotion and the care and treatment of disabled people and people who misuse drugs or alcohol.”
Source: Birk HO, Vrangbæk K, Rudkjøbing A, Krasnik A, Eriksen A, Richardson E, Smith Jervelund S. Denmark: Health system review. Health Systems in Transition, 2024; 26(1): i–152.
“Controlling public spending on health care has been an important political aim since the 1980s. Many economic steering mechanisms have been applied to this end. However, the main instrument continues to be a tight control of budget adherence and a combination of global budgeting and some performance-based funding (see Chapter 3). In 1993, free choice of hospital was introduced, and in 1998, it was decided that hospitals should be reimbursed according to diagnosis-related groups (DRGs) for patients living in other counties. Waiting times have been a major political issue since the mid-1990s. Overall, a change in the role of hospitals towards providing more diagnosis and treatment and less care is reflected in trends such as a decrease in the number of hospitals, hospital beds and the length of stay; an increase in the number of doctors and nurses; a slight increase in admissions; and a steep increase in outpatient visits, both to hospital outpatient departments and GPs. For more information on the evolution of the Danish health system, see Olejaz et al. (2012).”
Source: Birk HO, Vrangbæk K, Rudkjøbing A, Krasnik A, Eriksen A, Richardson E, Smith Jervelund S. Denmark: Health system review. Health Systems in Transition, 2024; 26(1): i–152.
“Since 1973, residents over the age of 15 have been able to choose between two coverage options in the statutory health system, known as Group 1 and Group 2. The default is Group 1, and almost all citizens belong to this group (see Table 2.3). In Group 1, members are registered with a GP of their choice, practicing within 15 km of their home (5 km in the Copenhagen area) or further if the patient moves after registration, provided they waive their right to home visits by the GP. Group 1 members have free access to emergency services and general preventive, diagnostic and curative services. Without a prior referral, patients may consult dentists, chiropractors, ear, nose and throat specialists or ophthalmologists. Their GP must refer them for access to all other medical specialties, physiotherapy and hospital treatments. Consultation with a GP or specialist is free, while dental care, podiatry, psychology consultations, chiropractic and physiotherapy are subsidized in most cases. Patients seeking care from specialists other than ear, nose and throat or ophthalmologists without a GP referral are liable to pay the full fee. In Group 2, individuals can consult any GP and specialist without a referral. The region will subsidize expenses up to the cost of the corresponding treatment for a patient in Group 1. The same rules apply to treatment by podiatrists, psychologists, dentists, chiropractors and physiotherapists. There is no charge for treatment in hospital. Only a minority of the population (1%) chooses this group, probably because of general satisfaction with the referral system (see Section 5.2).
“Most hospitals in Denmark are general hospitals. There are very few specialized hospitals other than psychiatric hospitals. Legislative reform in 1993 gave patients the freedom to choose to be treated at any hospital in the country if treatment takes place at the same level of specialization. Since 2003, direct referral to highly specialized services can be made by a medical doctor, wherever they work. According to a national study of choice behaviour, patients prefer treatment close to their place of residence (Birk & Henriksen, 2003).”
Source: Birk HO, Vrangbæk K, Rudkjøbing A, Krasnik A, Eriksen A, Richardson E, Smith Jervelund S. Denmark: Health system review. Health Systems in Transition, 2024; 26(1): i–152.
Danish Health System Overview
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Page last updated April 20, 2025 by Doug McVay, Editor.