Pay for Quality

118 Pay for Quality KCE Reports 118
Sources (most relevant ones) See http://www.topaseurope.eu/;
249-253, 254 , 255
Total budget The estimated costs are +/- €1 000 per practice per year (so for
Belgium €1 per patient per year)
Table 13: Global medical record
VII. GLOBAL MEDICAL RECORD
Initiated by NIHDI (INAMI/RIZIV)
Overall objective To support continuity of care between patients and GPs.
Date of implementation in Belgium May 1, 1999 for a predefined population
(May 1, 2002: for any patient)
Target audience General practitioner and patient
Content At the patient’s formal request the GP manages the GMR that
must include a selection of medical data. The objectives are to
centralize the patient’s medical data, to devote this central role
to the GP, to improve the communication of the patient’s data
between health providers and to reduce medical shopping by
gaining the loyalty of the patient.
Primary focus (structure, process Process
outcome)
Type of indicators used (if any) Existence of a GMR with at least one contact with the patient
per year
Purpose of indicators used Improve coordination of care.
Type of incentives Financial.
Payment of the GP for this new service: 27.50 €/year (2009)
Full reimbursement of this annual fee to the patient and a
decrease of the patient’s co-payment for other services provided
by the GP.
Results (if available) Continuous increase of the number of GMR (globally in Belgium:
44% of the insured population in 2005)
Sources (most relevant ones) NIHDI (INAMI/RIZIV), insurers
Total budget €104 966 317 (€27.50/GMR, based on figures 2007)
Table 14: Prescription feedback
VIII. PRESCRIPTION FEEDBACK (national council for quality promotion)
Initiated by National Council for Quality Promotion
Overall objective To reduce overuse of drug prescription in an evidence based way
Date of implementation in Belgium 2003
Target audience GP and specialists
Content The goal is to encourage an EBM-driven prescription attitude.
The individual feedbacks include:
Analysis of the doctor’s prescription of target drugs (antibiotics,
antihypertensive drugs) with reference to global Belgian
prescription of the same molecules and reference to peer review
group members of LOK. The median prescription level is used as
reference point.
Recommendations or guidelines concerning the use of the target
drugs.
Invitation to discuss the results in the local group of medical
evaluation (GLEM/LOK)
Primary focus (structure, process Process.
outcome)
Type of indicators used (if any) Volume and choice of prescription of target drugs
Purpose of indicators used To develop doctor’s awareness to be driven by EBM prescription
To decrease the volume and cost of prescribed drugs
To optimize adequate choice of antibiotic