OBJECTIVES

: Ageing populations and growing demand for health care has incentivized governments to get the most value from health care investments by improving efficiency and patient satisfaction. This has raised the interest for value based health care (VBHC) in many European health care systems, and recently, important steps have also been taken in Denmark towards recognising multiple dimensions of pharmaceutical value. However, there is little agreement and multiple challenges as to how to implement VBHC in practice.

The objective of this study was to map current initiatives of Danish and Swedish healthcare authorities to link remuneration of healthcare providers and reimbursement of health care to outcomes, and identify which outcome measures and indicators have been used or have been considered for use, which data are needed for the implementation and which payment models have been used. In addition we aim to identify the biggest challenges in the implementation.

METHODS

: Based on a literature review and semi-structured interviews with representatives from authorities.

RESULTS

: Numerous initiatives have been made in Denmark and Sweden on Regional Municipality or institutional level on testing value based health care. Denmark and Sweden have a long history of good quality registers which can provide for the high quality data that are deemed necessary in the effort to measure the impact of treatment and evaluate improvements. Different payment models has been suggested.

CONCLUSIONS

: Despite some efforts that have been made on implementing VBHC locally in both Denmark and Sweden, so far no solution has been reached as to how to overcome the challenges in the implementation and changing the culture will be time demanding.