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