Main Article Content
Background Many countries and regions undergo structural changes that intent to improve the effectiveness and quality of care. Until 2007, the municipalities, counties, hospitals and pharmacies shared the smoking cessation activities almost equally in Denmark. Among others, the Danish Healthcare Reform 2007 intended to add responsibility for smoking cessation intervention at county level to the municipality level. New regions should run the hospital services; exclusively.
Aim To evaluate the influence of the Danish Healthcare Reform 2007 on national smoking cessation interventions.
Methods From 2006 to 2010 35,087 smokers were registered in the Danish Smoking Cessation Database. The large majority underwent the 6-weeks gold standard programme for smoking cessation; a manual based patient education, motivational counseling and nicotine replacement therapy. The data collection included the setting and compliance, self-reported quitting and overall satisfaction.
Results The total number of interventions reduced from 7,320 in 2006 to 6,119 in 2010 (16.4%). The municipalities doubled their smoking cessation interventions from 2007, when the counties closed down. The pharmacies stayed relatively stable, but the hospitals significantly reduced to almost no intervention. Accordingly, patients and pregnant women contributed to 85.5% (1,027 persons) of the overall reduction. A replacement from employees as a target group to general citizens took place. The follow-up rate increased after the implementation of the Healthcare Reform, but completing the programme, quit rates and satisfaction were relatively stable throughout the study period.
Conclusion One sixth of the smoking cessation interventions were lost after the Danish Healthcare Reform 2007, especially those reaching hospital patients and pregnant women. A major shift from employees to general citizens took place in the other settings.