A retrospective analysis of health systems in Denmark and Kaiser Permanente
<p>Abstract</p> <p>Background</p> <p>To inform Danish health care reform efforts, we compared health care system inputs and performance and assessed the usefulness of these comparisons for informing policy.</p> <p>Methods</p> <p>Retrospective ana...
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| Format: | Article |
| Language: | English |
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BMC
2008-12-01
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| Series: | BMC Health Services Research |
| Online Access: | http://www.biomedcentral.com/1472-6963/8/252 |
| _version_ | 1811320592353198080 |
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| author | Bellows Jim Diderichsen Finn Krasnik Allan Hsu John Strandberg-Larsen Martin Schiøtz Michaela L Frølich Anne Søgaard Jes White Karen |
| author_facet | Bellows Jim Diderichsen Finn Krasnik Allan Hsu John Strandberg-Larsen Martin Schiøtz Michaela L Frølich Anne Søgaard Jes White Karen |
| author_sort | Bellows Jim |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>To inform Danish health care reform efforts, we compared health care system inputs and performance and assessed the usefulness of these comparisons for informing policy.</p> <p>Methods</p> <p>Retrospective analysis of secondary data in the Danish Health Care System (DHS) with 5.3 million citizens and the Kaiser Permanente integrated delivery system (KP) with 6.1 million members in California. We used secondary data to compare population characteristics, professional staff, delivery structure, utilisation and quality measures, and direct costs. We adjusted the cost data to increase comparability.</p> <p>Results</p> <p>A higher percentage of KP patients had chronic conditions than did patients in the DHS: 6.3% vs. 2.8% (diabetes) and 19% vs. 8.5% (hypertension), respectively. KP had fewer total physicians and staff compared to DHS, with134 physicians/100,000 individuals versus 311 physicians/100,000 individuals. KP physicians are salaried employees; in contrast, DHS primary care physicians own and run their practices, remunerated by a mixture of capitation and fee-for-service payments, while most specialists are employed at largely public hospitals. Hospitalisation rates and lengths of stay (LOS) were lower in KP, with mean acute admission LOS of 3.9 days versus 6.0 days in the DHS, and, for stroke admissions, 4.2 days versus 23 days. Screening rates also differed: 93% of KP members with diabetes received retinal screening; only 46% of patients in the DHS with diabetes did. Per capita operating expenditures were PPP$1,951 (KP) and PPP $1,845 (DHS).</p> <p>Conclusion</p> <p>Compared to the DHS, KP had a population with more documented disease and higher operating costs, while employing fewer physicians and resources like hospital beds. Observed quality measures also appear higher in KP. However, simple comparisons between health care systems may have limited value without detailed information on mechanisms underlying differences or identifying translatable care improvement strategies. We suggest items for more in-depth analyses that could improve the interpretability of findings and help identify lessons that can be transferred.</p> |
| first_indexed | 2024-04-13T13:00:39Z |
| format | Article |
| id | doaj.art-87dd7d7cba124d308ff18f2644c0b297 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-04-13T13:00:39Z |
| publishDate | 2008-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-87dd7d7cba124d308ff18f2644c0b2972022-12-22T02:45:54ZengBMCBMC Health Services Research1472-69632008-12-018125210.1186/1472-6963-8-252A retrospective analysis of health systems in Denmark and Kaiser PermanenteBellows JimDiderichsen FinnKrasnik AllanHsu JohnStrandberg-Larsen MartinSchiøtz Michaela LFrølich AnneSøgaard JesWhite Karen<p>Abstract</p> <p>Background</p> <p>To inform Danish health care reform efforts, we compared health care system inputs and performance and assessed the usefulness of these comparisons for informing policy.</p> <p>Methods</p> <p>Retrospective analysis of secondary data in the Danish Health Care System (DHS) with 5.3 million citizens and the Kaiser Permanente integrated delivery system (KP) with 6.1 million members in California. We used secondary data to compare population characteristics, professional staff, delivery structure, utilisation and quality measures, and direct costs. We adjusted the cost data to increase comparability.</p> <p>Results</p> <p>A higher percentage of KP patients had chronic conditions than did patients in the DHS: 6.3% vs. 2.8% (diabetes) and 19% vs. 8.5% (hypertension), respectively. KP had fewer total physicians and staff compared to DHS, with134 physicians/100,000 individuals versus 311 physicians/100,000 individuals. KP physicians are salaried employees; in contrast, DHS primary care physicians own and run their practices, remunerated by a mixture of capitation and fee-for-service payments, while most specialists are employed at largely public hospitals. Hospitalisation rates and lengths of stay (LOS) were lower in KP, with mean acute admission LOS of 3.9 days versus 6.0 days in the DHS, and, for stroke admissions, 4.2 days versus 23 days. Screening rates also differed: 93% of KP members with diabetes received retinal screening; only 46% of patients in the DHS with diabetes did. Per capita operating expenditures were PPP$1,951 (KP) and PPP $1,845 (DHS).</p> <p>Conclusion</p> <p>Compared to the DHS, KP had a population with more documented disease and higher operating costs, while employing fewer physicians and resources like hospital beds. Observed quality measures also appear higher in KP. However, simple comparisons between health care systems may have limited value without detailed information on mechanisms underlying differences or identifying translatable care improvement strategies. We suggest items for more in-depth analyses that could improve the interpretability of findings and help identify lessons that can be transferred.</p>http://www.biomedcentral.com/1472-6963/8/252 |
| spellingShingle | Bellows Jim Diderichsen Finn Krasnik Allan Hsu John Strandberg-Larsen Martin Schiøtz Michaela L Frølich Anne Søgaard Jes White Karen A retrospective analysis of health systems in Denmark and Kaiser Permanente BMC Health Services Research |
| title | A retrospective analysis of health systems in Denmark and Kaiser Permanente |
| title_full | A retrospective analysis of health systems in Denmark and Kaiser Permanente |
| title_fullStr | A retrospective analysis of health systems in Denmark and Kaiser Permanente |
| title_full_unstemmed | A retrospective analysis of health systems in Denmark and Kaiser Permanente |
| title_short | A retrospective analysis of health systems in Denmark and Kaiser Permanente |
| title_sort | retrospective analysis of health systems in denmark and kaiser permanente |
| url | http://www.biomedcentral.com/1472-6963/8/252 |
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