Pay for Quality

KCE Reports 118 Pay for Quality 115
Content Common conditions for GPs and specialists:
A minimum amount of 60 continuing education units within the last 3
years, and among them 9 units in ethics/economy and 6 gained for
participation in the peer-review group (GLEM/LOK)
A minimal yearly activity rate (e.g. 1 250 contacts for a GP, and a
minimum of 5/day)
No repeated remarks from the medical profile commission (diagnosis
and prescription processes)
To participate in quality assessment organized by peers
To take part minimum twice a year in a peer-review group
(GLEM/LOK)
Specific conditions for GPs:
To hold a medical record for each patient and to communicate its
relevant elements to other providers when necessary
To be a “certified” GP
To exercise as a GP as main activity and to ensure the continuity of
care
Specific condition for specialists:
To transmit all relevant patient data to the patient’s GP
Conditions for dentists:
A minimum amount of 500 continuing education units per 5 years,
and among them 50 units in ethics/economy/organizational domain
To take part minimum twice a year in a peer-review group
To participate to sporadic data collection when requested
A minimal yearly activity rate of 300 contacts
Primary focus (structure, process, The focus is on structures and processes.
outcome)
Type of indicators used (if any) No direct indicators are measured.
Purpose of indicators used The providers’ accreditation was initiated to promote quality and
cost-effectiveness of care. The effectiveness of inter provider linkage,
through the communication of patients’ data and the
complementarities of their medical specificity, and the continuing
education of physicians were among the initial goals (1993). Currently,
the accreditation is a kind of quality label for those who perform
continuous medical education and use the medical technologies in a
wise and socially justified way.
Type of incentives Doctors: Revaluation of the consultation fee (+3.27 € for a GP, from
+1.07 € to +4.88 € for a specialist), fully paid by the Social Security. A
flat-rate amount per year of 580 € (2009).
Dentists: a flat-rate amount of 2 355.74 €/year (2009)
Results (if available) In 2003, a survey (see reference below) assessed the satisfaction of
participants. The doctors experienced an improvement of the quality
of and the participation in continuous medical education. They quoted
a better awareness of ethical, economical and qualitative aspects of
their job. They experienced an improvement of their practice through
a better knowledge, intercollegiate assessment and multidisciplinary
working.
The current conditions for obtaining the individual accreditation were
considered sufficient, but the retribution should have been increased.
Sources (most relevant ones)
246, 247
Total budget Flat-rate amounts: doctors €14 159 000, dentists €11 620 000
(budget 2009).
Costs within nomenclature (doctors only): €189 700 000 (2008).