An Analysis of Health Agreements as a policy tool to include public health within integrated care in Denmark

The aim of this study is to analyse health agreements in Denmark and to explore the content of the texts to reflect on how these agreements may have facilitated public health orientation in inte-grated care. A directed, deductive approach to qualitative content analysis was utilized to assess Danish health agreements from the five regions (Capital Region of Denmark, Region Zealand, Region of Southern Denmark, Central Denmark Region, Region of Northern Denmark) for the period 2019-2023. The content analysis showed that the health agreements focused primarily on clinical processes and generally neglected to address the wider determinants of health. The four pre-determined main categories were service delivery, person-centredness, IT system design and uti-lization, and decision-support and their respective sub-categories. The findings showed that the in-clusion of public health elements in the health agreements is still lacking; however, a few initia-tives associated with public health were presented. Therefore, thinking about integrated care as part of a broader shift away from fragmentation and towards population health, which will im-prove citizens’ experience and health outcomes, is of great importance. However, making this shift will require action and alignment across several different levels, from the central government, regional governments, and municipalities to local communities and individuals.