The Rise, Heyday, and Incipient Decline of Specialization: Hospitals in Denmark, 1930–1990

Abstract

Between 1930 and 1990 Denmark's hospital sector and hospital policy underwent radical changes. In 1930 the sector was dominated by many small hospitals, with care as the central task. By 1990 the number of hospitals had almost halved, specialization had developed, and diagnostic and therapeutic procedures were hospitals' most important functions. There have been many claims that the shape of the health care sector is determined by the development of medicine. This article demonstrates that changes in other areas of society have greatly influenced the development of the Danish hospital sector. In the 1930s and 1940s, the focus was on equity and specialization; in the 1950s, on growth, rationalization, and division of labor; in the 1960s, on growth and planning; and during the last decades, on management, productivity, and cost containment. Since 1980 the specialization, growth, and political acceptability of the specialized hospital sector have decreased, a change that can be characterized as the incipient decline of the specialized hospital sector.