Denmark is a small country (about 5 million inhabitants) and has a unique registration of hospital admissions, surgical procedures and specific person-numbers in national registers. However, there is currently no system to monitor the overall quality of surgical care. Also, surgical services are provided in a large number of hospitals. In order to provide a rational basis of professional and administrative strategies to monitor and improve the quality of surgical care, establishment of a nation-wide monitoring system and quality improvement programme is required as well as regionalisation of major procedures.