The Health Service approach - Interventions targeted citizens with chronic diseases and high weight
About this good practice
Since 2016 there has been a focus on ensuring an individual health assessment. This became a requirement in 2022 due to a political agreement ensuring a national plan incl. quality requirements and recommendations. The goal was to contribute to better health for the individual and thus postpone/ reduce the use of health services later in life. This, by giving the citizen insight, tools, and faith in own abilities.
The procedure is based on the required quality standards and ensures an uniform high-quality intervention. which mainly consists of an initial health consultation followed by individualized plan (often group interventions).
The initial health consultation is used by the employees at the local health care center (Haderslev).
The contact can happen after doctors and/or hospital have made a referral or if the citizen contacts the department themselves. It is the entrance to all preventive and health-promoting courses in the municipality and focus on creating a good relation and ensuring alignments of expectations. It is based on a health assessment tool which enables the health care professionals to map the citizens challenges, lifestyle (diet, smoking, alcohol, sleep, exercise), mental health, medical history, competences, relation, weigh and self-perception, and coping strategies.
Frequently used interventions are; Coping course with focus on sustainable habits and a weight-neutral approach, sessions with the contact person, stress and depression course.
Resources needed
To fulfill this procedure 11 employees are involved full-time. This covers on average 14 hours per citizen per course. The initial health consultation is implemented in all Danish municipalities with small variants
Evidence of success
Since 2020 we see that there is an increase in the use of this service. The influx of citizens using the interventions increases annually. Since 2020 we see an increase of 65,68 % of involved citizens (539 to 893).
Also, the complexity of cases has increased i.e. more multiple physical, psychological, social issues. The focus has shifted from weight loss to weight-neutral, and we have an increased focus on citizens being terminated to permanent health services or networks in civil society.
Potential for learning or transfer
This approach is driven by the municipality of Haderslev.
The approach ensures a focus on the needs and abilities of everyone. It ensures equity in treatment, collaboration across service areas and anchoring in the civil society. It gives practitioners the ability to see and analyze beyond the diagnosis, which enables them to identify underlying causes for certain issues.
Beneficiaries: Citizens with obesity, nicotine addiction, stress, depression, type 2 diabetes, heart disease, cancer, and COPD. The structure of the initial health consultation enables the practitioner to lead the conversation ensuring obtaining the needed information to proceed the relevant interventions.
The approach has a documented success of improvements of the regional policies and has since 2019 been used in most Danish municipalities. Hence, this process and structure can be used in different set-ups to identify and map underlying causes for diseases. Can be used by all type of health care professionals.
Further information
Images
