2014 Health Statistics for the Nordic Countries Nordic Medico-Statistical Committee 102:2014 Health Statistics in the Nordic Countries 2014 Health Statistics in the Nordic Countries 2014 Members of the Editorial Committee for Health Statistics in the Nordic Countries Denmark Linda Saabye Kongerslev Statens Serum Institut Faroe Islands Chief Medical Officer Høgni Debes Joensen National Board of Health Branch Manager Terji Petersen National Board of Health Greenland Chief Medical Officer Flemming Kleist Stenz National Board of Health Finland Research Professor Mika Gissler National Institute for Health and Wel- fare THL Åland Axel Hansson Landskapsläkare Ålands landskapsregering Iceland Consultant Margrét Björk Svavarsdóttir Ministry of Welfare Norway Statistical Advisor Jorun Ramm Statistics Norway Sweden Researcher Ingalill Paulsson Lütz The National Board of Health and Wel- fare NOMESCO’s Editor: secretariat Jesper Munk Marcussen Layout and graphics: Lene Kokholm Translation: Executive Office, Christina Gry Paulsen © Nordic Medico-Statistical Committee Copenhagen 2014 ISBN 978–87-89702-86-5 ISSN 2245-9626 Contents Contents Preface ....................................................................... 8 Chapter I Organization of the Health Services ..................................... 9 Introduction ....................................................................................... 9 1.1 Current and future changes in the health services .................................. 10 1.2 Organization and responsibility for the health sector .............................. 19 1.3 Supervision of health services and health care personnel .......................... 29 1.4 Complaints about health services and health care personnel ..................... 31 Chapter II Population and Fertility .................................................. 33 Introduction ...................................................................................... 33 2.1 Population and population trends ...................................................... 34 2.2 Fertility, births, infant mortality and contraception ................................ 42 Chapter III Morbidity, Medical Treatment, Accidents and Medicinal Products ........................................................ 51 Introduction ...................................................................................... 51 3.1 Diseases related to lifestyle ............................................................. 52 3.2 Cancer ...................................................................................... 62 3.3 Immunization Schedules .................................................................. 74 3.4 Discharges, bed days, average length of stay and patients treated ............... 76 3.5 Surgical procedures ..................................................................... 103 3.6 Accidents and self-inflicted injury ................................................... 125 3.7 Development in consumption of medicinal products ............................. 126 5 Contents Chapter IV Mortality and Causes of Death ......................................... 156 Chapter V Resources ................................................................ 181 Introduction .................................................................................... 181 5.1 Financing of health services ........................................................... 182 5.2 User charges for health care services per 1 January 2014 ........................ 184 Medical visits ................................................................................... 184 Reimbursement for Pharmaceuticals ........................................................ 187 Treatment in hospitals ......................................................................... 190 Reimbursement for dental treatment ....................................................... 192 Maximum user charges ......................................................................... 195 5.3 Health care expenditure ............................................................... 198 5.4 Health care personnel ................................................................. 202 5.5 Capacity and Services in the Hospital Sector ....................................... 208 Appendix Further information ..................................................... 209 NOMESCO's Publications since 2000 ................................... 214 6 Contents Symbols used in the tables: Figures not available or too unreliable for use .. Information not applicable . Less than half of the unit used 0.0/0 Nothing to report (value nil) - Five year averages are always written as 20xx-xy Two year averages are always written as 20xx/xy Data are always calculated in relation to the respective age groups 7 Preface Preface The 2014 version of NOMESCO’s Health Statistics in the Nordic Countries is now avail- able. Since 1966, NOMESCO has worked to promote and publish comparable Nordic health statistics. As a permanent part of the work, this annual publication is published with the latest data in the health area. Health Statistics in the Nordic Countries presents data concerning population trends, illness, hospital treatment and causes of death. Furthermore, a description of the health sector in the Nordic countries, its structure and resources is provided. Health Statistics in the Nordic Countries consequently provides an annual cross section of the health care areas in the Nordic countries. This version comprises the latest available data as per the summer of 2014. The lat- est data year may consequently be 2013 or 2012. Previous versions are available at www.nowbase.org, where also our database and more specialized publications from projects carried out by NOMESCO can be found. As from 2011, the publication will no longer be designated by the latest data year, but instead by the year of production. Therefore, the title is Health Statistics in the Nordic Countries 2014. Nordic Medico-Statistical Committee (NOMESCO), January 2015 8 Organization of health services Chapter 1 Organization of Health Services Introduction In the Nordic countries, the health care sector is mainly a public matter. All the countries have well-established systems of primary health care. In addition to general medical practitioner services, preventive services have been established for mothers and infants, as well as school health care and dental care for children and young people. Preventive occupational health services and general measures for the protection of the environment have also been established in all the countries. The countries generally have well-developed hospital sectors with highly advanced specialist treatment. Specialist medical treatment is also offered outside hospitals. The health services are provided in accordance with legislation, and they are largely financed by public spending or through statutory health insurance schemes. Some patient charges are, however, payable for pharmaceutical products and to some extent also for treatment. Salary or cash allowances are payable to employees during illness. Self-employed people have the possibility of insuring themselves against illness. 9 Organization of health services 1.1 Current and future changes in the health care sector DENMARK: Introduction to diagnostic evaluation and treatment guarantee of psychiatric pa- tients In 2013, the Danish government proposed a bill regarding a change of the Health Act and the legislation regarding the access to appeals and compensations within the health care system. This Act introduces a diagnostic evaluation right of two months from September 1st 2014, which is reduced to one month (equalling the rights in all other parts of the health care system) from September 1st 2015. At the same time, a differentiated treatment right is introduced from September 1st 2014: One month at serious illness and two months at less serious illness. The diagnostic evaluation and treatment right will apply to both children and adults. The bill was passed in June 2014. Visibility reform The Government, KL - Kommunernes Landsforening (Local Government DK) and Dans- ke Regioner (Danish Regions) have with the Financial Agreement for 2014 agreed up- on a visibility reform. The purpose is to use health data in a more proactive way, which will propel the progress in the health care system and motivate the health care staff to create improvements in the treatment of patients. The reform is the framework for a continuous process with new initiatives and actions for a better use of data in the development of quality in the health area, which will be launched dur- ing the coming years. Over a period of four years, 32 million DKK has been allocated to this reform. Increased quality and diminishment of coercion in psychiatry In connection with the National Budget 2014, The Government and the political par- ties Venstre and Det Konservative Folkeparti have agreed to set a target about dimin- ishing by 50 percent the use of coercion in psychiatry. 50 million DKK has been allo- cated for the establishment of collaborations with the Regions about reduction of coercion. Furthermore, 100 million DKK has been set aside to improve the physical environment within psychiatric health care. New and improved treatment for children with cancer In connection with the National Budget 2014, The Government and the political par- ties Venstre and Det Konservative Folkeparti have strengthened cancer treatment with a state grant of 275 million DKK for the establishment