Developing a typology of proximity healthcare interventions and system-level characteristics in Denmark: an exploratory qualitative interview study.

Abstract

Proximity healthcare interventions aim to provide or support health services geographically close to, or in, citizens' own homes, involving the actors needed to deliver appropriate care across sectors. However, the field remains conceptually ambiguous, and systematic knowledge of how such interventions are organised is limited. This study therefore aims to develop an empirically grounded typology of proximity healthcare interventions in Denmark and explore system-level characteristics that characterise their development and organisation. Exploratory qualitative study based on semi-structured interviews with key informants responsible for cross-sectoral healthcare planning and implementation. The Danish healthcare system, a publicly funded, decentralised system undergoing structural reform to strengthen proximity healthcare and cross-sectoral coordination. 28 informants across the 5 Danish regions, including health cluster coordinators, regional administrators and municipal representatives. Data were collected through 20 semi-structured interviews and analysed using thematic analysis informed by Braun and Clarke's approach. A typology was developed inductively from the data and iteratively refined through collaborative coding and analytical discussion. The analysis revealed a heterogeneous field of proximity healthcare interventions differing in objectives, organisation and scope. The typology comprised healthcare delivery functions, including hospital outreach, delegation of treatment to municipal staff, shared healthcare models and self-administered healthcare supported by professionals, alongside supporting functions such as coordination roles, advisory partnerships, training and patient and family education. Across categories, three system-level characteristics were identified: substantial functional and organisational variation, including hospital anchoring of many interventions; reliance on short-term project funding and locally negotiated arrangements; and greater patient and relative involvement supported by digital infrastructure. These findings characterise proximity healthcare as both adaptive and fragmented within a decentralised system. This study provides a system-level overview of proximity healthcare in Denmark through a typology that brings together healthcare delivery and supporting functions. By highlighting their interdependence and the characteristics shaping intervention development, the study contributes conceptual clarity in a policy field often ambiguously defined. The typology and identified system-level characteristics offer a practical tool for policymakers and planners to navigate a complex intervention landscape and a foundation for comparative and practice-oriented research on strengthening sustainable proximity healthcare in decentralised health systems. Not applicable.