Overview
The Danish healthcare system is universal and based on the principles of free and equal access to healthcare for all citizens. The healthcare system offers high-quality services, the majority of which are financed by general taxes. Approximately 84% of healthcare expenditure is publicly financed. The remaining 16% are financed primarily through patient co-payments. National legislation ensures that diagnosis and treatment are provided within certain time limits and establishes a free choice of hospital for patients. If the region cannot ensure that treatment will be initiated within 30 days, patients have the right to an ‘extended free choice of hospital’. This means that patients may choose to go to a private hospital in Denmark or to a public or private hospital abroad.
What happens if you need to see a doctor?
General practitioners fill a key position in the Danish healthcare system. The GP is the patient’s primary contact point to the healthcare system, and citizens contact their own GP with all questions related to health and illness. The GPs play an important role as gatekeepers between the primary level and the specialized healthcare system. When necessary, the GP will refer patients to specialists, hospital care or healthcare services. If not acute, you will need to be assessed by your GP in order to be referred to specialists, hospital care or other healthcare services. GPs are typically available between 8 am and 5 pm, and a telephone service called 1813 is available at all times.
You will never have to pay for a visit at your GP, unless they provide a special service such as vaccine injections. If you are referred to a specialist by your GP (for example, a physiotherapist), you will have to pay for a majority of the treatment yourself, but it will still be cheaper than if you aren’t referred by a GP. Hospital care in public hospitals is free of charge for the patients.
Who decides what doctors can prescribe?
The European Medicines Agency is responsible for the scientific evaluation of medicines developed by pharmaceutical companies for use in the European Union, thus also in Denmark. However, the National Institute for Rational Pharmacotherapy (a part of the Danish Medicines Agency) also plays an important role, and was founded to guide doctors in rational prescribing. It also has the function of elaborating treatment guidelines with respect to costs. Each region employs local groups of pharmacists and GPs to monitor prescription patterns and advise GPs on rational prescribing.
Practically, what is it like to live with type 1 diabetes in Denmark?
Living with type 1 diabetes in Denmark can of course vary, depending on you as a person and where you live. Overall we are pretty privileged here. We do pay between 40-65% in taxes, but it is a small price for having free healthcare. You pay for most of the insulin yourself, but materials including blood glucose test strips, ketone strips, pumps, syringes and treatment is free of charge.
To get an insulin pump, you have to live up to certain criteria. For example, if pen treatment is not giving you satisfying results. Insulin pumps are payed for by the region you live in, and testing materials, needles etc. are payed for by the municipality you live in. Continuous Glucose Monitors (CGMS) are also free of charge. However, the government are still deciding whether the region or the municipality should pay for them, which is why CGMs can be difficult to get approval for. Diabetes specialists are available in every region, and all 5 regions in Denmark are currently building top modern diabetes centers. Usually you see a diabetes specialist every quarter, but if you are well regulated, this can be limited to 2-3 times a year. At these appointments you will see a doctor or a nurse and get your HbA1c check. Once a year you get an extended checkup, including feet, eye, and full bloodwork. The new diabetes centers will include everything you need from Medical Laboratory Technologist, to Podiatrists and Optometrists, and some places already include these.
What about getting admitted to hospital?
If you have an emergency, you are free to go to the nearest hospital where they will help you immediately. Rescue cars are available under the number 112 and must be at your location within 10 minutes after you call. In bigger cities, rescue cars are often available in less than 5 minutes. If it is not an emergency, a doctor refers the patient to the hospital. Normally you get an appointment within a few weeks, but that depends. The hospital care is free, no matter how long you stay.
How does diabetes care vary throughout Denmark?
As described above, pumps and CGMs are provided by regions and municipalities, which can create a difference in how diabetes care is handled. Some municipalities only offer the cheapest solutions, especially in terms of blood glucose meters. However, setting a limit on how many test strips an insulin depended diabetic can use is illegal by law.
A huge thank you to Nete Holm, who provided this information about diabetes in Denmark.
Last updated 2018