Huisartsgeneeskunde: aantrekkingskracht en beroepstrouw ... - Lirias

6 Making General Practice Attractive: Encouraging GP attraction and Retention KCE Reports 90
1 CHAPTER 1: GP INACTIVITY IN BELGIUM:
THE FIGURES
1.1 INTRODUCTION
This chapter analyses the evolution of the inactivity in the curative sector for all medical
doctors b (MDs) and the inactivity of young GPs in the curative sector after their degree
as MD c . It uses data from two databases. This chapter first defines the research
questions and then describes the methods, the results and their discussion.
1.2 OBJECTIVES
This part describes the evolution of the numbers and percentages of medical doctors
who are inactive in the curative sector. This evolution is studied using two different
approaches i.e., a repeated cross-sectional approach and a cohort analysis. The research
questions addressed in this chapter are the following:
1.3 METHODS
1.3.1 Databases
• What is the evolution of the percentage of licensed or unlicensed GPs
who are inactive in the curative sector under the AMI and of the
percentage of those who have a small practice (by gender, age group
and linguistic community)?
• What is the evolution of the percentages of medical doctors who were
inactive in the curative sector 4 to 6 years after their graduation as MD
(or 9 to 11 years after their graduation as MD)?
This section describes the databases and the statistical analyses. For the glossary and the
terminology used in the analyses, see appendix 1.1.
Three Belgian databases could theoretically be used for the analyses:
• The federal register of medical practitioners set up by the Public
Health Ministry since 2003 (called “Cadastre of Health Care
Professions”). However, it could not provide time-series data. So this
study used both other available databases i.e. the INAMI/RIZIV
database and the CIPMP database.
• The INAMI/RIZIV d database is a register with all registered MDs
allowed to practice within the Belgian Health Insurance e as well as the
type of their activity. This file is fully described in appendix 1.2. Details
on the qualification, situation codes and variables are in appendix 1.3,
1.4 and 1.5.
• The CIPMP database managed by the SESA/CIES at the UCL is a listing
of all MDs based on the compilation of various information sources:
provincial councils of the Order of Physicians, phonebooks, Belgian
b One should be aware of the meaning of the term “GP” and its evolution. In this study, it includes all
medical doctors who are not specialists, including those who are registered in other categories in other
countries, e.g.; in nursing homes, Red Cross, public health, and until 1999, occupational medicine.
c Thus the 7 years degree needed to be a medical doctor before 1995 and the 9 years (7 + 2) needed after
1995, at least to work under the Health Insurance (INAMI/RIZIV)
d National Institute of Health and Disability Insurance
e All medical students can obtain this registration after their graduation (7 th year of study) or based on an
equivalent degree acquired abroad and recognised by the Ministry of Health. Moreover, the INAMI uses
different qualification codes to differentiate physicians (in training or not) and thus the types of acts that
they are allowed to perform according to the legislation (see appendix 1.3.).