Municipal intermediate care services in Denmark and Norway: a cross-country comparative analysis

BACKGROUND: Intermediate care is increasingly used to reduce hospital admissions and support early discharge from hospital. In Denmark and Norway, health reforms have shifted responsibilities from hospitals to municipalities, prompting the development of community-based intermediate care services. OBJECTIVE: To compare how Danish and Norwegian municipalities have organised and implemented municipal intermediate care services. DESIGN: A descriptive comparative study based on national legislation, policy documents, research literature and public statistics. RESULTS: Both countries have established municipal intermediate care structures centred on service types: acute and non-acute intermediate care. In Denmark, acute intermediate care includes statutory acute care teams and optional acute care beds, whereas Norway provides statutory acute care beds only. Acute services in both countries are regulated by national guidelines and aim to prevent unnecessary hospital admissions. Non-acute intermediate care mainly consists of temporary institutional beds used for early-supported discharge, rehabilitation, recovery, nursing home waiting placements and respite care. These services are less strictly regulated and vary between municipalities. In both countries, intermediate care primarily targets older adults with complex health needs exceeding the capacity of ordinary long-term care services. Differences were observed in referral pathways, clinical capacity and the degree of municipal autonomy, reflecting broader contextual conditions such as geography, governance structures and workforce availability. CONCLUSION: Although Denmark and Norway pursue similar policy goals, their organisational models for municipal intermediate care differ. Distinguishing between acute and non-acute intermediate care highlights the importance of adapting service models to local structural and demographic conditions and informs policy development and cross-country learning.