Table 1.
The Danish “health benefit basket”: overview of main legislation
| Hospital Act (and ancillary legislation) | Public Health Insurance Act (and ancillary legislation) | Medicines Act (and ancillary legislation) | Social Services Act (and ancillary legislation) | Other (specific) legislation | |
|---|---|---|---|---|---|
| HC.1.1 Inpatient curative care | + | – | (+) | – | – |
| HC.1.2 Day-cases of curative care | + | – | (+) | – | – |
| HC.1.3 Outpatient care | (+) | + | (+) | – | – |
| HC 1.4 Curative home care | + | + | (+) | – | – |
| HC.2.1 Inpatient rehabilitative care | + | – | – | (+) | – |
| HC.2.2 Day cases of rehabilitative care | + | (+) | – | (+) | – |
| HC 2.3 Outpatient rehabilitative care | (+) | + | – | + | – |
| HC 2.4 Services of rehabilitative home care | (+) | (+) | – | + | + |
| HC.3.1 Inpatient long-term care | + | – | – | + | – |
| HC.3.2 Day cases of long-term care | + | – | – | + | – |
| HC 4.1 Clinical laboratory | + | + | + | – | – |
| HC.4.2 Diagnostic imaging | + | + | + | – | – |
| HC.4.3 Patient transport | + | + | – | + | – |
| HC.4.9 All other miscellaneous services | + | + | – | (+) | – |
| HC.5.1 Pharmaceuticals, etc. | – | + | + | – | – |
| HC 5.2 Therapeutic devices etc. | (+) | (+) | – | + | – |
| HC.6.1 Maternal and child care | + | + | – | (+) | + |
| HC 6.2 School health services | – | – | – | – | + |
| HC.6.3 Prevention of communicable diseases | – | (+) | – | – | + |
| HC.6.4 Prevention of noncommunicable diseases | – | (+) | – | – | + |
| HC.6.5 Occupational health services | – | – | – | – | + |
| HC.6.9 All other services | – | – | – | – | + |
| Legal status | Law | Law | Law | Law | Laws |
| Decision maker | County + physician | County + GP | County, GP (physician) | Municipality + county | County + municipality + GP |
| Purpose | Entitlements, delegation and defining responsibility of counties | Entitlements, reimbursement, copayment | Role of Danish Medicines Agency, process of approval of medicines | Entitlements, delegation and defining responsibility of counties and municipalities | Entitlements, defining roles and responsibilities of actors etc |
| Positive/negative definition of benefits | Positive | Positive | Positive | Positive | Positive |
| Degree of explicitnessa | 1 | 1 (2 and 3) | 2 (and 3) | 1 (2 and 3) | 1, 2, 3 |
| If itemized: goods, procedures, indications | Not itemized | Procedures (indications) | (Goods) | (Goods, indications) | Indications |
| Updating | No | No | No | No | No |
| Criteria used for defining benefits | |||||
| Need | + | + | + | + | + |
| Costs | – | – | – | – | – |
| Effectiveness | – | – | + | – | – |
| Cost-effectiveness | – | – | – | – | – |
| Budget | + | – | – | – | – |
| Other | – | + | – | – | – |
a 1, “All necessary”; 2, areas of care are described; 3, services are linked to specific items