Scandinavian Working Papers in Economics
Discussion Papers on Economics,
University of Southern Denmark, Department of Economics
No 1/2019: Kommunal medfinansiering og kampen for at forebygge indlæggelser: Viden om effekt / Municipal co-financing of regional health services and the fight to prevent hospital admissions: Knowledge about effects
Kjeld Møller Pedersen ()
Additional contact information
Kjeld Møller Pedersen: Department of Business and Economics, Postal: University of Southern Denmark, Campusvej 55, DK-5230 Odense M, Denmark
Abstract: Municipal co-payment is an arrangement where municipalities pay a variable amount to the regions whenever municipal citizens utilize regional health services, e.g. hospital services og GPs. The 5 Danish regions provide somatic and mental health services while municipalities mainly provide home nursing, home help, health visitors, rehabilitation, and child and youth dental services. Municipalities cannot employ physicians who actively treat patients. Municipal co-payment was introduced in 2007 in connection with the structural reform of municipalities and counties. The main idea was that economic incentives in the form of potential savings on co-payment would lead municipalities to look for alternatives to (some) regional health services. The municipalities have developed, among other things, acute beds (usually in conjunction with nursing homes) staffed by experienced home nurses that GPs can refer patients to instead of hospitalizing them, acute nursing teams that provide services in the homes of citizens, follow-home-service where home nurses follow discharged hospital patients to their homes (occasionally together with a GP) and evaluate care needs – in the hope of avoiding rehospitalizations. To the extent that these arrangements have been evaluated they are discussed in this paper. None have shown clear-cut indications of preventing or postponing hospitalizations. The paper services two aims: A literature review of above reports and an econometric analysis of panel data for 2007-2016/17. The econometric analysis did not show any significant effects on hospital admissions.
Keywords: Co-financing; hospital admission; municipality; evaluation; fixed effect; difference-in-difference
JEL-codes: H51; H70; H73; H75; I10
101 pages, February 4, 2019
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