yes orthopedics, oncology, perioperative care (new developing), urology, municipal institutions

1.270.000

21%

11%

6%

54% female 46% male above 65. (no data for population above 60)

can not be answer (in hospital? , chronic?, reason of dead?)

In Denmark, morbidity in older adults is dominated by multimorbidity, particularly cardiovascular disease, chronic respiratory disease (including COPD), diabetes, cancer, cognitive impairment/dementia, and frailty with falls and fractures. 20% has more than one diagnosis. Mortality is mainly driven by cancer, cardiovascular disease, respiratory disease, stroke, and dementia, with cardiovascular disease and dementia becoming increasingly prominent with advancing age.

Dansk selskab for geriatri

victoria_gunmalm@hotmail.com

https://www.geriatri.dk/

200

yes

minimum 7 years

Admission to geriatric medicine specialty training in Denmark requires completion of the mandatory Foundation Programme (KBU – Basic Clinical Training), which lasts 1 year and is centrally allocated by the Danish Health Authority. After completing KBU, applicants independently apply for a 1-year introductory training position (Introductory Position) in Internal Medicine. Following successful completion of the introductory training, candidates apply competitively for Higher Specialist Training (Main Specialist Training Programme) in Internal Medicine: Geriatrics. The higher specialist training programme lasts 5 years. The total duration of postgraduate training from graduation to specialist recognition in geriatric medicine is therefore minimum 7 years.

Over the past decade, Denmark has actively worked to increase the number of specialist trainees in geriatric medicine. Historically, only about five Higher Specialist Training (HU) positions in geriatrics were offered per year. Through coordinated efforts between the Danish Health Authority, regional training offices, and the specialty society, this number has steadily increased, and currently around 19 HU positions in geriatric medicine are advertised annually. This expansion reflects a national priority to strengthen the workforce in a specialty that cares for a growing older population with complex multimorbidity.

There are no strict national age-based criteria for referral to a geriatrician in Denmark. Referral is based on clinical complexity rather than chronological age. Patients are typically referred to geriatric services when they present with multimorbidity, frailty, functional decline, cognitive impairment (including suspected or established dementia), recurrent falls, polypharmacy, or unclear diagnostic problems in older age. Geriatricians most commonly manage patients aged 65 years and older, but especially those aged 75+ with complex medical, functional, and social needs. Referral may occur from general practitioners, emergency departments, other hospital specialties, or municipal services. Comprehensive Geriatric Assessment (CGA) is a core component of geriatric management in Denmark. Access to geriatric care may vary somewhat by region and hospital organisation, but the overarching principle is needs-based rather than strictly age-based referral.

Denmark has a nationwide network of approximately 23 geriatric departments or units distributed across all five regions, providing both inpatient wards and outpatient geriatric sp

In Denmark, geriatric care is primarily delivered within hospital-based geriatric departments integrated into acute hospitals. The following types of units are typically involved: • Acute geriatric wards (including admission units receiving patients directly from emergency departments) • Subacute geriatric units for stabilisation and diagnostic clarification • Comprehensive Geriatric Assessment (CGA)-based inpatient wards • Outpatient geriatric clinics (including falls clinics, memory clinics, and polypharmacy clinics) • Mobile geriatric teams providing consultation to other hospital departments and, in some regions, to primary care or nursing homes • Orthogeriatric collaboration units (hip fracture pathways shared with orthopaedic departments) Denmark does not have separate long-stay geriatric hospitals within the hospital sector. Long-term care and rehabilitation are primarily managed by municipalities in nursing homes or community-based rehabilitation centres rather than hospital-based long-stay facilities.

yes orthopedics, oncology, perioperative care (new developing), urology, municipal institutions

Major challenges in geriatric care in Denmark include demographic pressure, workforce limitations, and structural factors within the medical profession. Denmark is experiencing a rapid increase in the number of older adults, particularly those aged 80+, leading to growing demand for geriatric expertise and complex multimorbidity management. At the same time, the number of board-certified geriatricians remains relatively low compared to the size of the ageing population. Although the number of training positions has increased significantly in recent years, workforce expansion has not yet matched demographic developments. Another challenge is the general trend toward increasing subspecialisation within medicine. Many younger doctors prefer highly technical or procedure-based specialties. Geriatrics, which focuses on complex, multimorbid, and often frail older patients, is sometimes perceived as having lower prestige compared to more technology-driven specialties. This can reduce recruitment interest despite the high societal need. Overall, the key challenges are balancing rising demand with limited specialist capacity and strengthening the attractiveness and recognition of geriatric medicine within the broader healthcare system.

First, the number of Higher Specialist Training (HU) positions in geriatric medicine has been significantly increased over the past decade in order to expand the specialist workforce. Second, there is a stronger emphasis on internal medicine competencies within other specialty training programmes. Since many older patients are treated outside dedicated geriatric departments, strengthening general internal medicine skills across specialties is seen as essential to improve care for complex older patients. Third, the use of telemedicine and remote consultation is expanding. Geriatricians increasingly provide video consultations, telephone advice, and outreach support to primary care physicians, municipal services, and nursing homes. This allows specialist expertise to reach more patients without requiring hospital admission.

Yes, moderate regional differences exist. All five Danish regions have hospital-based geriatric services, but there are variations in staffing levels, number of geriatricians, organisation of acute geriatric pathways, and availability of outpatient services such as falls or memory clinics. Differences are mainly related to hospital size and regional workforce capacity rather than formal policy differences. Overall access to geriatric care is nationwide, but the degree of integration and capacity may vary between regions.

Here is a realistic answer based on how geriatric services are organised in Denmark — but note: there are no official national rankings publicly published that say “Region X has the best/worst access to geriatric care.” However, available reports and planning documents suggest some patterns: In practice, access to specialised geriatric care tends to be strongest in and around larger urban university hospital areas (e.g., the Capital Region and Central Denmark Region), where there are multiple hospital sites with dedicated geriatric departments and more specialist staff. These areas typically have better local availability of acute geriatric wards, outpatient services and consultation support because of larger hospitals and academic training environments. Conversely, regions or areas that are geographically more rural or distant from major university cities (for example, more peripheral parts of the North Denmark Region or Zealand outside Greater Copenhagen) can have relatively lower immediate access to hospital-based geriatric specialist services simply due to fewer specialists stationed locally and greater travel distances for older patients. This does not mean that geriatric care is unavailable in those regions — Denmark has a nationwide network of geriatric units — but specialists and multidisciplinary teams may be harder to access outside the larger urban centres. Teleconsultation, regional outreach teams, and strengthened cooperation with municipalities are being developed to help mitigate those disparities.

There are no official national figures on the number of long-term care facilities offering specialised geriatric medical care in Denmark. Only a limited number of nursing homes or long-term care facilities have direct access to dedicated geriatric teams or formalised specialist collaboration. In most cases, medical care in nursing homes is provided by general practitioners, who are responsible for the ongoing treatment and coordination of care.

Formal co-management programmes in nursing homes are limited in Denmark. Medical responsibility typically lies with general practitioners, and geriatricians are involved mainly on a consultative or outreach basis rather than through structured shared-

Geriatric medicine is represented at all four Danish medical universities: University of Copenhagen Aarhus University University of Southern Denmark Aalborg University Teaching in geriatrics is integrated into undergraduate medical education, while specialist training is organised nationally through the postgraduate medical training system rather than by individual universitie

yes see 28

Yes

19

lotte usinger (email; usinger@dadlnet.dk)