kmf

KMF 2019 — Danish Municipal Healthcare Co-financing: Data & Visualizations

Kommunal Medfinansiering af Sundhedsvæsenet (KMF) 2019
Per-capita analysis of Denmark’s municipal healthcare co-financing across all 98 municipalities (kommuner), with interactive choropleth map and dashboard.

This repository accompanies research on Danish intergovernmental fiscal sociology.
Data and visualizations are made freely available for academic and public use.

Background

Denmark’s Municipal Healthcare Co-financing (KMF) was introduced in 2007 as part of the structural reform, requiring municipalities to contribute a share of healthcare costs incurred by their residents in regional hospitals and GP practices. The system was designed to incentivize preventive care investment at the municipal level.

In 2019, the activity-based payment model was frozen and replaced by fixed monthly payments (a conto), based on each municipality’s 2019 budget level. This effectively eliminated the incentive mechanism and permanently locked in the distribution of contributions across municipalities — regardless of subsequent changes in population or health service utilisation.

In November 2024, the KMF system was formally abolished as part of the Sundhedsreform 2024, with a transition period in 2027–2028.

The 2019 data in this repository thus represents the final year of the activity-based model — the baseline that became permanently frozen — making it a critical reference point for analysing the fiscal consequences of the reform and the urban–rural disparities it embedded.

Repository Structure

kmf-2019-denmark/
├── README.md
├── LICENSE
├── data/
│   ├── kmf_2019_kommuner.csv       # Main dataset (98 municipalities)
│   └── dk_kommuner.geojson         # Municipality boundaries (simplified)
└── viz/
    ├── KMF_2019_Dashboard.html     # Interactive bar/scatter dashboard
    ├── KMF_2019_Map.html           # Choropleth map (per-capita ratio)
    └── KMF_2019_Data.xlsx          # Excel workbook with analysis sheets

Dataset: `kmf_2019_kommuner.csv`

Column	Description
`region`	Region (Hovedstaden / Sjælland / Syddanmark / Midtjylland / Nordjylland)
`kommune`	Municipality name (Danish)
`kmf_1000dkk`	KMF expenditure, 1,000 DKK (source: REGK31)
`kmf_mdkk`	KMF expenditure, million DKK
`population_2019q1`	Population as of 1 January 2019 (source: FOLK1A)
`kmf_per_capita_dkk`	KMF per capita (DKK/person)
`national_avg_ratio`	Ratio to national average (1.000 = national average of 3,797 DKK/person)
`national_share_pct`	Municipality’s share of total national KMF (%)

National aggregate (2019):

Total KMF: 22,045,188,000 DKK (≈ 22.0 billion DKK)
National average per capita: 3,797 DKK/person
Total population: 5,806,081

Visualizations

Choropleth Map (`KMF_2019_Map.html`)

Interactive D3.js map showing per-capita KMF as a ratio to the national average across all 98 municipalities. Red = above national average (high contribution); Blue = below national average (low contribution).

Features:

Toggle between national average ratio and absolute per-capita value
Click any municipality for detailed statistics
Ranked sidebar with zoom-to-municipality functionality

Dashboard (`KMF_2019_Dashboard.html`)

Three-panel interactive dashboard:

Total distribution — bar chart of total KMF by municipality
Per-capita distribution — bar chart with national average reference line
Scatter plot — population (log scale) vs. per-capita KMF, visualising the urban–rural disparity

Key Findings

The per-capita analysis reveals a systematic urban–rural disparity that was embedded into the frozen contribution structure from 2019 onward:

Large urban municipalities (København, Aarhus, Odense, Aalborg) tend to show below-average per-capita KMF, reflecting relatively younger and healthier urban populations.
Peripheral and rural municipalities, particularly in Syddanmark, Sjælland, and Nordjylland, tend to show above-average per-capita KMF, reflecting older population structures and higher healthcare utilisation.

This asymmetry has direct implications for the fiscal redistribution effects of the 2024 abolition of KMF, which — without corrective mechanisms — would benefit urban municipalities disproportionately while imposing relative losses on rural municipalities.

Data Sources

Source	Description	URL
Danmarks Statistik, REGK31	Municipal accounts by function — 4.62.81 Aktivitetsbestemt medfinansiering af sundhedsvæsenet	dst.dk
Danmarks Statistik, FOLK1A	Population by municipality, Q1 2019	dst.dk
magnuslarsen/geoJSON-Danish-municipalities	Municipality boundary GeoJSON (Geodatastyrelsen)	GitHub

All Danmarks Statistik data is published under the Danmarks Statistik data licence which permits academic and non-commercial reuse with attribution.

Aftale om kommunernes økonomi for 2019 (June 2018) — final activity-based KMF agreement
BEK nr. 78 af 25/01/2024 — KMF fixed-payment regulation (2019–2025)
Aftale om sundhedsreform 2024 (November 2024) — KMF abolition decision
Dataproces (2024) — “Hvilken økonomisk effekt har det at afskaffe den kommunale medfinansiering?”

Citation

If you use this data or visualizations in academic work, please cite:

Kurachi, Shintaro (2025). KMF 2019 — Danish Municipal Healthcare Co-financing:
Per-capita Analysis across 98 Municipalities.
Roskilde University / Meiji University.
https://github.com/[username]/kmf-2019-denmark

License

Code and visualizations: MIT License
Data (derived from Danmarks Statistik): Danmarks Statistik data licence — attribution required
GeoJSON boundaries: MIT License

Maintained by Shintaro Kurachi, Visiting Researcher, Roskilde University (RUC), 2026.
Research themes: fiscal sociology, intergovernmental finance, Danish welfare state.

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