Case study from Heart failure policy and practice in Europe

Danish Heart Failure Registry

17 November, 2020

The Danish Heart Failure Registry was developed in 2003 to monitor and improve the quality of care provided to people living with heart failure across the country.1 2 Participation is mandatory for all hospital departments involved in heart failure care, with patients being added at the point of diagnosis.3 The registry has yet to include data from primary care settings, and experts report that such indicators are currently under review by the Danish College of General Practitioners (Dansk Selskab for Almen Medicin) for inclusion.4

The registry collects process and outcome measures of heart failure care, including the use of tests and treatments, as well as hospitalisation and mortality rates.3 It produces monthly feedback reports that enable performance assessment and comparison across care providers, and findings are reviewed every year to identify barriers to best practice. The quality indicators used in the registry were selected by a multidisciplinary panel, which was guided by national and international guidelines as well as published literature.2 The panel meets annually to review the indicator framework and make changes if needed.5 The fact that every Danish resident has a unique personal identification number enables data linkage between the heart failure registry and other administrative and medical registries.3 6 7

The introduction of the registry has improved guideline-based heart failure practice and helped to reduce mortality within one year of diagnosis.8 Experts state that the indicators have also helped to deliver better care systematically by providing a structure to the organisation of care in heart failure clinics.4


  1. Mainz J, Krog BR, Bjørnshave B, et al. 2004. Nationwide continuous quality improvement using clinical indicators: the Danish National Indicator Project. Int J Qual Health Care 16 Suppl 1: i45-50
  2. Nakano A, Johnsen SP, Frederiksen BL, et al. 2013. Trends in quality of care among patients with incident heart failure in Denmark 2003-2010: a nationwide cohort study. BMC Health Serv Res 13: 391
  3. Schjødt I, Nakano A, Egstrup K, et al. 2016. The Danish Heart Failure Registry. Clin Epidemiol 8: 497-502
  4. Schjødt I. 2020. Interview with Sara C Marques and Stephanie Whelan at The Health Policy Partnership (Secretariat for Heart Failure Policy Network) [Videoconference]. 20/08/2020
  5. The Heart Failure Policy Network. 2020. Spotlight on quality assessment in heart failure care. London: HFPN
  6. Adelborg K, Szépligeti S, Sundbøll J, et al. 2017. Risk of Stroke in Patients With Heart Failure. Stroke 48(5): 1161-68
  7. Adelborg K. 2018. Neurological and psychiatric comorbidity in patients with heart failure: risk and prognosis. Danish medical journal 65(4):
  8. Nakano A, Vinter N, Egstrup K, et al. 2019. Association between process performance measures and 1-year mortality among patients with incident heart failure: a Danish nationwide study. European heart journal Quality of care & clinical outcomes 5(1): 28-34


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The Heart Failure Policy Network is an independent, multidisciplinary platform made possible with financial support from AstraZeneca and Roche Diagnostics. The content produced by the Network is not biased toward any specific treatment or therapy. All outputs are guided and endorsed by the Network’s members. All members provide their time for free. The Network is hosted by The Health Policy Partnership .