CEO's address - Annual report 2023
It has been over a year since I joined a strong team of professionals and specialists in the field of health insurance. The staff is developing the institution and working hard to bring it into a new era with enthusiasm and professionalism as their guiding principles.
Iceland Health plays an important role in our healthcare. It is our ambition to promote positive development of services for the public. This we do, among other things, by ensuring that Iceland Health provides a dynamic, positive and competitive work environment that promotes initiatives and reforms. That guiding light makes our workplace attractive and a good place to work.
Heart of Iceland Health is the service we provide, but it plays a crucial role in driving the healthcare system. The institution does not only carry out statutory duties, but the staff strives to understand the circumstances of everyone who seeks our services, and does its work with care and understanding. We respect everyone and their rights because we are for all people.
It is an act of negligence to disregard the importance of all the projects we work on at the Iceland Health, as this is a key institution in Icelandic healthcare. Whether it is courses, tenders, contracts, payments, improvements to digital solutions, processing of applications or allocation of assistive devices, the projects are very few and the arrests are almost uncountable.
With the use of digital solutions, we process a large amount of information. This creates data that we can use to analyse and better understand our tasks. Targeted use of data helps us and others to make informed decisions. With such analysis, transparency can be increased and contribute to targeted policy making. It is our intention that data will be disseminated in a targeted manner to the public, users and providers. This will make the service better and more cost-effective.
A few key numbers
Total expenditures for all areas of Iceland Health in 2023 totalled more than ISK 157 billion, which accounts for nearly 12% of the total expenditures of the government. The largest part of these contributions is allocated to healthcare providers on the basis of contracts and specific payment models.
The number of people needing a prosthetic leg increased by 40%, but although the number of people needing a prosthetic leg has not increased significantly in the past, it is an important question for the quality of life of 18 people who received their first prosthetic leg in 2022 compared to four years earlier and then 13 in 2021, and therefore it is necessary to deal with such matters quickly and professionally.
DRG contracts continued to be a focus of attention. For example, in 2023, 3,520 births were paid for, with an average price of 916,285 ISK per birth.
The National Hospital and the Akureyri Hospital are funded by DRG contracts (service-related funding). This means that all hospitals’ operations are now calculated and the state pays for every treatment that the country receives.
In the last year, Iceland Health participated in paying for 2,226 dental implant treatments and 1,103 implant implants. In addition, Iceland Health paid for 45,889 fluoride treatments for children.
In the last year, Iceland Health participated in paying for 9,141 X-rays of the shoulder, 4,450 CT scans of the coronary arteries, but only 144 received X-rays of the upper arm.
The issue of the European Health Insurance Card has also been fluctuating over the years. In 2023, 53,564 cards were issued, in 2022, 83,468, and in 2022, 46,413.
The diabetes drug Ozempic was also a major topic of discussion, but regulations for the drug were tightened in November 2023 to prevent a shortage of medication for those with diabetes. 2.4.910 people relisted the drug at the beginning of 2023, of whom 1,398 paid the drug in full themselves, while 3,512 received payment from Iceland Health. At the end of the year, there were 5,889 people who relisted the drug, of whom 2,750 paid the drug in full themselves, while 3,139 received payment.
* Detailed information on expenses and the scope of Iceland Health activities
By nature, contracts are a major issue for Iceland Health, as one of our roles is to promote the operational and macroeconomic viability of healthcare. About 300 contracts are currently in effect, but here are examples of some key contracts that were concluded in the last year.
In 2023, the first comprehensive contracts were signed that cover all dental care outside hospitals. This brings to the moment an agreement that covers dental care for children, disabled people and elderly people. The agreement also covers dental care for serious congenital defects, accidents or diseases. The agreement strengthens their position significantly and the agreement provides opportunities to enhance the quality and efficiency of the service.
In the last year contracts were awarded for joint replacement operations on the knee and hip outside hospitals in order to reduce the waiting period for these operations. In the last year, Iceland Health paid for 1,154 joint replacement operations in the hospitals, but also awarded contracts with private healthcare companies where 611 additional joint replacement operations were performed.
We also made more agreements with private health clinics, including Heilsugæslan Höfði in Suðurnes, which opened on September 1, 2023.
In addition, Iceland Health concluded an agreement to operate 50 general daycare facilities for elderly people at the Höfði Healthcare Center in Reykjavík.
In the new Iceland Health contract for the services of specialist doctors, which was signed in June last year, specialist doctors were enabled to use electronic communication and telemedicine to a greater extent. In the last year, 180 specialist physicians used this possibility and provided services in this way to a total of 15,9 clients. Electronic communication is placing an increasingly large place in our work and there are many opportunities for an organisation like Iceland Health.
Go digital
Iceland Health always places information security and personal protection at the forefront of its work, but the more detailed audit of the Data Protection Authority confirms the agency’s strong position in these matters. The audit also shows that there is room for improvement in some aspects, and that Iceland Health has indeed ended the continuous improvement work to ensure that the requirements for personal protection are met alongside new digital solutions.
Digital environments are constantly placing a greater place in all of our work and it is equally important to develop a clear and ambitious policy based on responsibility and security. We were therefore extremely pleased when Iceland Health received a prize for digital development at the conference Connect the State. The prize was awarded for digitalisation of public sector entities that use open and common tools developed by Digital Iceland.
Iceland Health has had a successful collaboration with Stafrænt Ísland in numerous other projects. Last year, we worked on the biggest collaborative project so far, which was the transfer of information that was previously in Réttindagátt to My pages on Ísland.is. It now contains basic information on everything related to medicine, physical, occupational and speech therapy, assistive devices and nutrition, health care and dentistry. These were not the only digital application opportunities during the year, as an application for the European health insurance card was installed in the application system on Ísland.is, along with a chat and service web site being installed on Iceland Health website.
It is not necessary to argue that successful co-operation is of great importance to us. It is equally important for ministries, institutions, the public and partners. We believe that this has been the case in 2023, and we hope and want this to continue to be the case in the years to come.
The biggest challenge
When we look to the next few years, one of our biggest challenges is to strengthen Iceland Health as a whole, in all its extensive work. It must be considered a key prerequisite for Icelandic healthcare to develop and prosper in a normal way. There is strong evidence that we as a society today contribute less to this important infrastructure than many other countries with which we like to compare ourselves. This needs to be improved. Iceland Health manages important key infrastructure in healthcare in this country, and therefore our responsibility is great, to work on improvements in this matter. With such a powerful and competent group of experts within our network, I am confident that we can achieve good results here.