Pay for Quality
Pay for Quality
Pay for Quality
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112 <strong>Pay</strong> <strong>for</strong> <strong>Quality</strong> KCE Reports 118<br />
Primary care<br />
1. Breast cancer screening prevention bonus<br />
2. Capitation funding revaluation in the primary health care centres (MM,<br />
WGC)<br />
3. EPA tool<br />
4. Global medical record (DMG/GMD)<br />
5. Prescription feedback of the National council <strong>for</strong> <strong>Quality</strong> Promotion<br />
(CNPQ/NRKP)<br />
6. Preventive module in global medical record<br />
Hospital care<br />
1. Centres of reference<br />
2. Hospital accreditation<br />
3. Hospital benchmarking<br />
4. <strong>Quality</strong> and Patient Safety Framework <strong>for</strong> hospitals<br />
5. Reference payment<br />
These programmes are presented in a structured tabular <strong>for</strong>mat, addressing programme<br />
initiation, implementation, target audience, content, primary focus, type of indicators<br />
used, purpose of indicators used, type of incentives, results, publications and budget (if<br />
publicly available).<br />
Table 7: Care itineraries<br />
I. CARE ITINERARIES<br />
Initiated by RIZIV/INAMI. In 2001 RIZIV/INAMI took the decision to develop<br />
specific chronic care programmes, combining the contribution of<br />
GP, specialists and other disciplines in a scientific and<br />
coordinated way. These transmural programmes were called<br />
“Care itineraries / Zorgtrajecten / Trajets de Soins”. From 2003<br />
till 2007, field tests took place in Leuven and Aalst. The practical<br />
organization will start from June and September 2009 with two<br />
defined care itineraries: on chronic renal failure and diabetes<br />
mellitus type 2. Other chronic care fields are envisaged <strong>for</strong> the<br />
future: COPD, Chronic Heart Failure, Frail Elderly, osteoporosis,<br />
depression, cancer …<br />
Overall objective To rein<strong>for</strong>ce the continuity of care between patient, GP, and<br />
specialist and tackle underuse mutually<br />
Date of implementation in Belgium June and September, 2009<br />
Target audience Partnership between patient, GP and topic specialist around<br />
specified chronic conditions (first itineraries are diabetes and<br />
chronic renal insufficiency). Focus is on the patient with chronic<br />
conditions. The aim is to optimize the quality of the follow-up,<br />
and the outcome parameters, defined <strong>for</strong> the condition.<br />
Individual targets are defined, and an optimum treatment scheme<br />
together with an ideal follow up scheme is planned.<br />
Supporting disciplines like educators, home nurses and<br />
dieticians are brought together in a local primary care team.<br />
Local pharmacists are invited to play their role.<br />
Content Individual contract with patient (involvement in reaching targets),<br />
GP (coordination) and specialist (support, continuing education<br />
and updating)<br />
Installing local multidisciplinary networks to support professional<br />
dealing with chronic conditions.<br />
1. At the individual level, the patient, entering the care-itinerary<br />
and declaring to do the best of his/her possibilities, is completely<br />
reimbursed <strong>for</strong> all contacts with their GP and the topic-specialist.<br />
Some supporting disciplines are reimbursed following a defined