Author details
Author Maria-Isabel Farfan-Portet |
Available item(s) by this author (56)
Add the result to your basket Make a suggestion Refine your search Apply to external sourcesOndersteuning van mantelzorgers / Sibyl Anthierens / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2014)
ISSN : D/2014/10.273/37 : € 0,00
Languages : Dutch (nla)
Descriptors: Indexation
2013-23 ; Caregivers ; Financial Support ; Public Policy ; R223 ; Respite Care
Classification
WY 200 Home nursingAbstract: Familieleden, buren en vrienden die de zorg opnemen voor een oudere of zieke zijn zeer belangrijk in ons gezondheidszorgsysteem, en zij dragen een groot stuk van alle zorg die wordt geleverd. Ons sociaal en gezondheidssysteem zou dan ook veel beter voor deze mantelzorgers zelf moeten zorgen. Het Federaal Kenniscentrum voor de Gezondheidszorg (KCE) bekeek de ondersteuning die de overheid vandaag biedt aan mantelzorgers, in samenwerking met UA, UCL en Yellow Window. Er zijn weinig financiële vergoedingen voor hen. De mogelijkheden om sociaal verlof te nemen om zorg te verlenen worden dan weer wel als positief ervaren. Respijtzorg moet minder duur zijn, meer aangepast aan de behoeften en, net zoals psychosociale ondersteuning, proactief worden aangeboden. De bestaande diensten en ondersteuning moeten op elkaar afgestemd worden en informatie erover is best beschikbaar via één enkel informatiekanaal. Maar vooraleer de steunmaatregelen aan te passen moet er een breder maatschappelijk debat worden gevoerd over de plaats van de mantelzorger in het zorgsysteem en in de maatschappij in het algemeen, en over het soort financiële of andere steun die hieraan best aangepast is en die de ongelijkheid niet vergroot. Contents note: VOORWOORD 1 -- SAMENVATTING 3 -- SYNTHESE 5 -- 1. ACHTERGROND 7 -- 2. DOELSTELLINGEN, SCOPE EN METHODE 8 -- 2.1. DOELSTELLINGEN EN SCOPE 8 -- 2.2. METHODE 8 -- 3. RESULTATEN VAN LITERATUURONDERZOEK: HET COMPLEXE MILIEU VAN STEUNBELEID VOOR MANTELZORGERS 9 -- 3.1. ALGEMENE CONTEXT IN VERSCHILLENDE LANDEN 9 -- 3.2. BEOORDELING VAN DE STEUNMAATREGELEN OM INKOMENSVERLIES TE VERMIJDEN, EN VERLIES VAN SOCIALE RECHTEN OF WERKGELEGENHEID 11 -- 3.2.1. Financiële compensatie voor de informele zorg 11 -- 3.2.2. Sociale rechten 12 -- 3.2.3. Impact van een financiële vergoeding voor mantelzorgers 13 -- 3.2.4. Sociale verloven en flexibele werkregelingen 14 -- 3.3. BEOORDELING VAN RESPIJTZORG EN PSYCHOSOCIALE ONDERSTEUNING 17 -- 3.3.1. Beschikbaarheid en gebruik van respijtzorg en psychosociale ondersteuning 17 -- 3.3.2. Invloed van ondersteuningsinterventies op mantelzorgers 17 -- 3.3.3. Barrières voor het gebruik van ondersteunende interventies voor mantelzorgers 18 -- 4. BEHOEFTEN EN ERVARINGEN VAN DE MANTELZORGER IN BELGIË 18 -- 4.1. INFORMATIEBEHOEFTE VAN MANTELZORGERS 18 -- 4.2. BEHOEFTEN EN VERWACHTINGEN MET BETREKKING TOT PROFESSIONELE HULP EN RESPIJTZORG 19 -- 4.3. BEHOEFTE AAN ERKENNING 19 -- 5. RESULTATEN VAN HET CASUS ONDERZOEK 20 -- 5.1. BESCHRIJVING VAN DE STUDIESTEEKPROEF 20 -- 5.1.1. Redenen om zorg te verlenen 21 -- 5.1.2. Wat mantelzorgers doen 21 -- 5.2. ZIJN MANTELZORGERS OP DE HOOGTE VAN BESTAANDE STEUNMAATREGELEN? 21 -- 5.2.1. Wat weten zij? 21 -- 5.2.2. Wie verstrekt informatie? 21 -- 5.3. GEBRUIKEN MANTELZORGERS BESTAANDE STEUNMAATREGELEN EN ZO JA, OP WELKE MANIER? 22 -- 5.3.1. Financiële vergoeding, sociale rechten en verloven 22 -- 5.3.2. Maatregelen ten aanzien van respijtzorg en psychosociale ondersteuning 23 -- 5.3.3. Belang van steunmaatregelen voor zorgbehoevende ouderen 24 -- 5.4. WELKE INVLOEDEN/GEVOLGEN HEBBEN DE STEUNMAATREGELEN OP DE CONTINUÏTEIT VAN DE ZORG VOOR ZORGBEHOEVENDE OUDEREN EN OP HET RISICO OP INSTITUTIONALISERING? 24 -- 5.4.1. Continuïteit van de zorg 24 -- 5.4.2. Institutionalisering 25 -- 6. DISCUSSIE 26 -- 6.1. WAT MEN GELEERD HEEFT VAN DE MACRO-INSTITUTIONELE CONTEXT BETREFFENDE STEUNMAATREGELEN VOOR MANTELZORGERS 26 -- 6.2. ZIJN MANTELZORGERS OP DE HOOGTE VAN BESTAANDE STEUNMAATREGELEN? 27 -- 6.3. GEBRUIKEN MANTELZORGERS BESTAANDE STEUNMAATREGELEN EN ZO JA, OP WELKE MANIER? 27 -- 6.3.1. Financiële compensatie, sociale bijdragen en beleid ten aanzien van verlofregelingen 27 -- 6.3.2. Respijtzorg en psychosociale ondersteuning 28 -- 6.4. WELKE INVLOEDEN/GEVOLGEN HEBBEN DE STEUNMAATREGELEN OP DE CONTINUÏTEIT VAN DE ZORGVERLENING EN HET RISICO VAN INSTITUTIONALISERING? 28 -- 7. CONCLUSIE 30 -- AANBEVELINGEN 33 -- REFERENTIES 35 Link for e-copy: https://doi.org/10.57598/R223AS Format of e-copy: PDF (445 Kb) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=3388 Copies(0)
Status No copy
ISSN : D/2019/10.273/50 : € 0,00
Languages : English (eng)
Descriptors: Classification
WM 30 Administrative psychiatry
Indexation
2016-52 ; Mental Health Services ; Psychiatry ; R318Contents note: SCIENTIFIC REPORT 29 -- CHAPTER 00 – OUTLINE OF THE STUDY 29 -- 1 BACKGROUND 29 -- 2 RESEARCH OBJECTIVE 30 -- 3 OUTLINE OF THE STUDY 31 -- 4 LIMITATION/SCOPE OF THE STUDY 31 -- 5 REFERENCES 32 -- CHAPTER 01 DESCRIPTION OF THE BELGIAN MENTAL HEALTH CARE WITHIN THE GENERAL HEALTH CARE ORGANISATION 33 -- AUTHORS: DETOLLENAERE J1, CORNELIS J1, DEVRIESE S1, MISTIAEN P1, RICOUR C1. 33 -- 1 GENERAL ORGANISATION OF THE BELGIAN HEALTH CARE SYSTEM: AN OVERVIEW 33 -- 1.1 PRINCIPLES OF HEALTH CARE ORGANISATION IN BELGIUM 33 -- 1.2 FINANCING OF THE BELGIAN HEALTH CARE SYSTEM 33 -- 2 ORGANISATION OF THE MENTAL HEALTH CARE SYSTEM IN BELGIUM 35 -- 2.1 HISTORICAL OVERVIEW 35 -- 2.1.1 Mental health care organisation in its early days 35 -- 2.1.2 Reforms in Belgian mental health care 36 -- 2.1.3 Sixth institutional state reform 39 -- 2.1.4 Spending on mental health care (problems) 42 -- 2.2 EVALUATION OF THE BELGIAN MENTAL HEALTH CARE SYSTEM 45 -- 2.2.1 Evaluation of the mental health care system in general 45 -- SCIENTIFIC REPORT 29 -- CHAPTER 00 – OUTLINE OF THE STUDY 29 -- 1 BACKGROUND 29 -- 2 RESEARCH OBJECTIVE 30 -- 3 OUTLINE OF THE STUDY 31 -- 4 LIMITATION/SCOPE OF THE STUDY 31 -- 5 REFERENCES 32 -- CHAPTER 01 DESCRIPTION OF THE BELGIAN MENTAL HEALTH CARE WITHIN THE GENERAL HEALTH CARE ORGANISATION 33 -- AUTHORS: DETOLLENAERE J1, CORNELIS J1, DEVRIESE S1, MISTIAEN P1, RICOUR C1. 33 -- 1 GENERAL ORGANISATION OF THE BELGIAN HEALTH CARE SYSTEM: AN OVERVIEW 33 -- 1.1 PRINCIPLES OF HEALTH CARE ORGANISATION IN BELGIUM 33 -- 1.2 FINANCING OF THE BELGIAN HEALTH CARE SYSTEM 33 -- 2 ORGANISATION OF THE MENTAL HEALTH CARE SYSTEM IN BELGIUM 35 -- 2.1 HISTORICAL OVERVIEW 35 -- 2.1.1 Mental health care organisation in its early days 35 -- 2.1.2 Reforms in Belgian mental health care 36 -- 2.1.3 Sixth institutional state reform 39 -- 2.1.4 Spending on mental health care (problems) 42 -- 2.2 EVALUATION OF THE BELGIAN MENTAL HEALTH CARE SYSTEM 45 -- 2.2.1 Evaluation of the mental health care system in general 45 -- AUTHORS: DETOLLENAERE J1, BRUFFAERTS R2, GISLE L3, MISTIAEN P1 66 -- 1 INTRODUCTION 66 -- 2 METHODS 66 -- 2.1 THE EUROPEAN STUDY OF THE EPIDEMIOLOGY OF MENTAL DISORDERS (ESEMED) 66 -- 2.2 THE BELGIAN HEALTH INTERVIEW SURVEY (HIS) 66 -- 3 RESULTS 67 -- 4 CONCLUSION 71 -- 5 KEY MESSAGES 72 -- 6 REFERENCES 72 -- CHAPTER 04 INTERNATIONAL FRAMEWORKS FOR MENTAL HEALTH SERVICE ORGANIZATION 73 -- AUTHORS: RICOUR C1, DETOLLENAERE J1, CORNELIS J1, DEVRIESE S1, MISTIAEN P1. 73 -- 1 INTRODUCTION 73 -- 2 OVERVIEW OF THE FRAMEWORK DEVELOPMENT DURING THE 21TH CENTURY 74 -- 3 DESCRIPTION OF THE DEVELOPED INTERNATIONAL POLICIES 75 -- 3.1 THE WHO MENTAL HEALTH ACTION PLAN 2013-2020 75 -- 3.2 WHO/EUROPE ACTION PLAN 2013-2020 77 -- 3.3 FRAMEWORK FOR ACTION ON MENTAL HEALTH AND WELLBEING 2016 80 -- 3.4 SUSTAINABLE DEVELOPMENT GOALS OF THE UNITED NATIONS AND THE CONVENTION ON THE RIGHTS OF PERSONS WITH DISABILITIES 81 -- 3.5 OECD EVALUATION OF THE IMPACT OF MENTAL HEALTH ILLNESS IN OECD COUNTRIES 82 -- 4 STATUS OF BELGIUM IN THE DIFFERENT SURVEYS ORGANISED BY INTERNATIONAL ORGANISATIONS 83 -- 5 THE BELGIAN ART 107 REFORM PRINCIPLES IN THE LIGHT OF SOME OF THE INTERNATIONAL FRAMEWORKS 84 -- 6 KEY MESSAGES 86 -- 7 REFERENCES 86 -- CHAPTER 05 MAPPING MENTAL HEALTH CARE SERVICES IN BELGIUM 89 -- AUTHORS: LAGUESSE R1, LAMBERT M1, VAN NUFFEL R2, DE COEN M2, VAN SPEYBROECK J2, BONTEMPS C1 89 -- 1 LEXICON 89 -- 2 INTRODUCTION 92 -- 2.1 CONTEXT 92 -- 2.2 HISTORY 92 -- 2.3 BOUNDARIES OF MENTAL HEALTH CARE 93 -- 3 METHOD 95 -- 3.1 TYPE OF DATA AND STRUCTURE OF THEIR DESCRIPTION 95 -- 3.1.1 Distribution of services/institutions by levels 95 -- 3.1.2 Regions 95 -- 3.1.3 Data 95 -- 3.1.4 Overview of the situation 96 -- 3.1.5 Associations and networks involved in mental health 96 -- 3.1.6 Transfer of competences 96 -- 3.2 SCOPE (AND LIMITS OF THE SCOPE) 96 -- 3.2.1 Scope 96 -- 3.2.2 Limitations 96 -- 3.3 DATA DISCUSSION 97 -- 3.4 SOURCES OF DATA 97 -- 4 DESCRIPTION OF SERVICES CATEGORIES 98 -- 4.1 INFORMAL COMMUNITY CARE 98 -- 4.1.1 User associations and family associations 99 -- 4.1.2 Society 99 -- 4.1.3 Non-accredited accommodation structures 101 -- 4.2 MENTAL HEALTH SERVICES THROUGH PRIMARY HEALTH CARE AND RELATED SECTORS101 -- 4.2.1 General practitioner 102 -- 4.2.2 Centre for general welfare 103 -- 4.2.3 Family planning centre 105 -- 4.2.4 Health Relays 105 -- 4.2.5 Aid to maltreated elderly persons 106 -- 4.2.6 Helplines 106 -- 4.2.7 Child abuse 107 -- 4.2.8 Mental health in the related sectors 108 -- 4.3 COMMUNITY MENTAL HEALTH SERVICES AND PSYCHIATRIC SERVICES IN GENERAL HOSPITAL 114 -- 4.3.1 Community mental health centres 115 -- 4.3.2 Mobile teams 117 -- 4.3.3 Day centre 121 -- 4.3.4 Services on addiction 121 -- 4.3.5 Exile services (Wallonia and Brussels) / Psychological care for refugees (Flanders) 122 -- 4.3.6 Ambulatory private or hospital-related practice of mental healthcare professionals 122 -- 4.3.7 Suicide services 124 -- 4.3.8 Specialised rehabilitation centres with convention 125 -- 4.3.9 Psychiatric wards in general hospitals/specialised hospitals 126 -- 4.3.10 Psycho-social services in prisons 126 -- 4.3.11 Initiatives of sheltered living 127 -- 4.3.12 Psychiatric care homes 127 -- 4.4 LONG STAY FACILITIES & SPECIALIST SERVICES 128 -- 4.4.1 Hospitalization units inside psychiatric hospitals 128 -- 4.4.2 Internment 130 -- 4.5 E-MENTAL HEALTH 132 -- 5 OVERVIEW OF THE SECTOR 133 -- 6 THE NETWORKS AND ASSOCIATION OF HEALTH/MENTAL HEALTH CARE ACTORS 143 -- 6.1 THE PSY107 NETWORKS 143 -- 6.2 THE CONSULTATION PLATFORMS IN MENTAL HEALTH 144 -- 6.3 CHILDREN AND ADOLESCENT NETWORKS 145 -- 6.4 THE COORDINATORS OF THE CARE PATH FOR INTERNEES 146 -- 6.5 INTEGRATED CARE SERVICES AT HOME 146 -- 6.6 COORDINATION AND ADDICTION NETWORKS 146 -- 6.6.1 Networks of assistance and specialised care on addictions 146 -- 6.6.2 Flemish expertise centre on alcohol and other drugs 147 -- 6.6.3 Eurotox 147 -- 6.7 REGIONAL COORDINATION IN MH 147 -- 6.7.1 The centre of reference for mental health 147 -- 6.7.2 Mental Health Focal Point 148 -- 6.7.3 French-speaking Brussels league for mental health 148 -- 7 TRANSFER OF COMPETENCES (6TH STATE REFORM) 149 -- 8 DISCUSSION 150 -- 8.1 PRECAUTIONS ABOUT THE COLLECTED DATA 150 -- 8.2 MULTIPLICITY AND DIVERSITY OF THE OFFER 151 -- 8.3 DIVERSITY OF LOCAL AND REGIONAL REALITIES 151 -- 8.4 GAPS IN DATA 152 -- 8.5 COMPLEXITY OF THE OFFER 153 -- 8.6 OVERLAP 154 -- 8.7 ACCESSIBILITY 154 -- 8.8 RESIDENTIAL AND OUTPATIENT MHC 154 -- 8.9 TERRITORIAL COVERAGE 155 -- 8.10 PARTNERSHIPS 155 -- 8.11 COLLABORATION BETWEEN NETWORKS ACCORDING TO AGE GROUPS 155 -- 9 CONCLUSIONS 156 -- 10 SUGGESTIONS FOR RECOMMENDATIONS 158 -- 11 REFERENCES 159 -- CHAPTER 06 STRENGTHS, WEAKNESSES, GAPS, AND OVERLAPS IN THE CURRENT MENTAL HEALTH CARE SUPPLY: A FOCUS GROUP STUDY 166 -- AUTHORS: THUNUS S1, NEYENS I2, WALKER C1, HERMANS K2, SMITH P 1, NICAISE P1, VAN AUDENHOVE C2, LORANT V1 166 -- 1 AN EXPLORATION ON HOW MENTAL HEALTH CARE FOR ADULTS IN BELGIUM IS ORGANISED 166 -- 1.1 OBJECTIVES 166 -- 1.2 MATERIAL AND METHODS 166 -- 1.2.1 Development of focus group material 166 -- 1.2.2 Sampling process 168 -- 1.2.3 Recruitment method 170 -- 1.2.4 Description of sample 170 -- 1.2.5 Data collection 171 -- 1.3 DATA ANALYSIS 172 -- 2 RESULTS 173 -- 2.1 PROVISION OF MENTAL HEALTH CARE 173 -- 2.1.1 Characteristics of the current provision of mental health care 173 -- 2.1.2 Characteristics of providers of mental health care 174 -- 2.1.3 Provision needs 178 -- 2.2 ACCESS TO MENTAL HEALTH CARE 179 -- 2.2.1 Types of services and professionals 179 -- 2.2.2 Access for different groups of service users 181 -- 2.2.3 Access in rural versus urban areas 182 -- 2.3 COLLABORATION AND COORDINATION OF MENTAL HEALTH CARE 182 -- 2.3.1 Values and norms related to mental health care 183 -- 2.3.2 Factors influencing a collaborative culture shift 184 -- 2.3.3 Formal tools 186 -- 2.4 FINANCING OF MENTAL HEALTH CARE 189 -- 2.4.1 Allocation of financing across systems, sectors, services and networks 189 -- 2.4.2 Payment methods for professionals 191 -- 2.4.3 Resources’ allocation and decision-making power 193 -- 2.5 POLITICAL AND SOCIETAL CONTEXT OF MENTAL HEALTH CARE 195 -- 2.5.1 Political context 195 -- 2.5.2 Societal context 197 -- 3 CONCLUSION 198 -- 3.1 MAIN FINDINGS 198 -- 3.1.1 Provision 198 -- 3.1.2 Access to mental healthcare 199 -- 3.1.3 Mental healthcare coordination and collaboration 199 -- 3.1.4 Financing mechanisms 200 -- 3.1.5 Political context 200 -- 3.2 RECURRING CONTROVERSIES 200 -- 3.2.1 Priorities of the system 200 -- 3.2.2 Designing and building bridges in the mental healthcare system 201 -- 3.2.3 Paradigm shift and power divisions: policy-makers, professionals and the public 202 -- 3.3 REFLECTION ON THE RESEARCH PROCESS, MAIN LIMITATIONS AND NEXT STEPS 203 -- 3.3.1 Social embeddedness 203 -- 3.3.2 Limitations of this research 203 -- 3.3.3 The next steps 205 -- 4 REFERENCES 205 -- CHAPTER 07 VALUES AND SETS OF POSSIBLE ORGANISATIONAL SOLUTIONS: A CHOICE- BASED STAKEHOLDER ANALYSIS SURVEY 207 -- AUTHORS: SMITH P1, NICAISE P1, NEYENS I2, HERMANS K2, THUNUS S1, WALKER C1, VAN AUDENHOVE C2, LORANT V1 207 -- 1 INTRODUCTION: A TRANSITION TO MENTAL HEALTH CARE FOCUSED ON COMMUNITY CARE AND SOCIAL INTEGRATION 207 -- 2 OBJECTIVES 207 -- 3 DESIGN 208 -- 3.1 DEFINITIONS 209 -- 3.2 MATERIAL AND METHODS 209 -- 3.2.1 First part of the survey 209 -- 3.2.2 Second part of the survey 210 -- 3.2.3 Third part of the survey 212 -- 3.2.4 Part four to seven of the survey 214 -- 3.2.5 Validation of the content 214 -- 3.2.6 Sampling 215 -- 3.2.7 Data collection procedure 218 -- 3.2.8 Selection bias related to non-respondents 218 -- 3.3 DATA ANALYSIS 218 -- 4 RESULTS 220 -- 4.1 SAMPLING AND STAKEHOLDERS’ CHARACTERISTICS 220 -- 4.2 PRIORITY OBJECTIVES OF THE REFORM IN MENTAL HEALTH CARE IN BELGIUM 221 -- 4.3 DIFFERENCES BETWEEN REGIONS AND STAKEHOLDERS IN PRIORITY OBJECTIVES OF THE REFORM IN MENTAL HEALTH CARE 222 -- 4.4 COMPARISONS BETWEEN GOALS, SOCIAL INTEGRATION OR CARE IN THE COMMUNITY 224 -- 4.4.1 Differences in priority organisational interventions according to the objective to be achieved 224 -- 4.4.2 Differences in levels of the organisation of mental health care implicitly preferred according to the objective to be achieved 225 -- 4.5 CONJOINT ANALYSIS: EXPLICIT VALUES THAT UNDERLIE THE EXPECTATIONS ON THE ORGANISATION OF MENTAL HEALTH CARE IN BELGIUM 226 -- 4.5.1 Utility and importance of dimensions and levels of the organisation of mental health care 226 -- 4.5.2 Differences between regions and stakeholders in priority levels of the organisation of mental health care228 -- 4.5.3 A different organisation of mental health care according to the target group? 232 -- 4.6 ORGANISATIONAL INTERVENTIONS: PRIORITIES AND PREFERENCES 233 -- 4.6.1 Stakeholders' prioritized organisational interventions, for the overall sample, by region and by stakeholders’ profile 233 -- 4.6.2 Stakeholders' preferred organisational interventions 237 -- 4.6.3 Clustering of organisational interventions 239 -- 4.7 IMPLICIT VALUES OF THE ORGANISATION OF MENTAL HEALTH CARE BEHIND SELECTED ORGANISATIONAL INTERVENTIONS 242 -- 4.8 INTERVIEWS WITH STAKEHOLDERS 244 -- 4.8.1 Priority objectives of the reform in mental health care 244 -- 4.8.2 Conjoint analysis on the dimensions and levels of the organisation of mental health care 245 -- 4.8.3 Organisational interventions 247 -- 4.8.4 Final comment 249 -- 4.9 STAKEHOLDER COMMENTS IN THE ONLINE SURVEY 250 -- 5 CONCLUSION 251 -- 5.1 INTERPRETATION OF FINDINGS AND COMPARISON WITH PREVIOUS LITERATURE 251 -- 5.1.1 Objectives of the mental health care system 251 -- 5.1.2 A different mental health care organisation according to the target group? 253 -- 5.1.3 Coordination between providers and formalization of patients’ care pathways 255 -- 5.1.4 Funding of mental health care 256 -- 5.1.5 Organisational interventions focused on access to care 256 -- 5.1.6 Differences between stakeholders 257 -- 5.1.7 Differences between regions 258 -- 5.2 STRENGTHS AND LIMITATIONS 259 -- 5.3 FINAL RECOMMENDATIONS BASED ON THE QUALITATIVE AND QUANTITATIVE FINDINGS 259 -- 6 REFERENCES 266 -- CHAPTER 08 ACCEPTABILITY OF POSSIBLE RECOMMENDATIONS FOR FUTURE MENTAL HEALTH CARE ORGANISATION IN BELGIUM: A STAKEHOLDER SURVEY 272 -- AUTHORS: CORNELIS J1, DETOLLENAERE J1, DEVRIESE S1, MISTIAEN P1, RICOUR C1. 272 -- 1 INTRODUCTION 272 -- 2 METHOD 272 -- 2.1 CONSTRUCTION OF THE SURVEY 272 -- 2.2 STATISTICAL ANALYSIS OF THE ANSWERS 273 -- 3 RESULTS 274 -- 3.1 DESCRIPTION OF THE SAMPLE 274 -- 3.2 RESULTS OF THE MAIN THEMES 274 -- 3.2.1 Policy 274 -- 3.2.2 Intervention 276 -- 3.2.3 Registry 277 -- 3.2.4 Access 278 -- 3.2.5 Registration 280 -- 3.2.6 Research 281 -- 3.2.7 Participation 281 -- 3.2.8 Financing 282 -- 3.2.9 Priority 283 -- 3.2.10 Stigmatizing or health literacy 284 -- 3.2.11 Inclusion 284 -- 3.2.12 Cooperation 285 -- 3.2.13 Quality 286 -- 3.2.14 Respondent opinion on what to change 288 -- 3.3 RESULTS OF THE SUB-ANALYSES 289 -- 3.3.1 Sub-analysis by region of the organisation 289 -- 3.3.2 Sub-analysis by care organisation 289 -- 4 DISCUSSION 289 -- 5 KEY MESSAGES 291 -- 6 REFERENCES 292 -- APPENDICES 293 Link for e-copy: https://doi.org/10.57598/R318C Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=4607 Copies(0)
Status No copy Patient socioeconomic determinants for the choice of the cheapest molecule within a cluster / France Vrijens in European Journal of Health Economics (The), 13(2012)3 ([07/01/2012])
Languages : English (eng)
in European Journal of Health Economics (The) > 13(2012)3 [07/01/2012] . - 315-325
Descriptors: Classification
W 1 Serials. Periodicals
Indexation
2008-08 ; Belgium ; Cost-sharing ; Journal Article ; Peer Review ; R126 ; Socioeconomic FactorsAbstract: Reference pricing is a common cost-sharing mechanism, with the financial penalty for the use of costly drugs shifted from the third-party payer to the patient. Unintended distributional consequences might arise, if the weakest socioeconomic groups face a relatively higher financial burden. This study analyzed for a sample of Belgian individual prescription data for 4 clusters of commonly used drugs (proton pump inhibitors, statins and two groups of antihypertensives [drugs acting on renin-angiotensin system and dihydropyridine derivatives]) whether the probability to receive the least expensive molecule within a cluster was linked to the socioeconomic status of the patient. Logistic regression models included individual demographic, working, chronic illness and financial status and small area education data for 906,543 prescriptions from 1,280 prescribing general practitioners and specialists. For the 4 clusters, results show that patients with lower socioeconomic status consistently use slightly more the least expensive drugs than other patients. Larger effects are observed for patients residing in a nursing home for the elderly, patients entitled to increased reimbursement of co-payments, unemployed, patients treated in a primary care center financed per capita (and not fee-for-service) and patients having a chronic illness. Also, patients residing in neighborhoods with low education status use more less expensive drugs. The findings of the study suggest that although equity considerations were not explicitly taken into account in the design of the reference price system, there is no real equity problem, as the costly drugs with supplement are not prescribed more often in patients from lower socioeconomic classes. Link for e-copy: http://link.springer.com/article/10.1007/s10198-011-0367-2 Format of e-copy: PDF [Open Access] Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=3790 [article]
Languages : English (eng)
in European Journal of Health Economics (The) > 13(2012)3 [07/01/2012] . - p.301-313
Descriptors: Classification
W 1 Serials. Periodicals
Indexation
Adolescent ; Adult ; Aged ; Belgium ; Choice Behavior ; Cost-sharing ; Drugs, Generic ; Evidence-Based Practice ; Insurance, Health, Reimbursement ; Journal Article ; Odds Ratio ; Peer Review ; Pharmaceutical Services ; Prescription Drugs ; Socioeconomic Factors ; statistics and numerical data [Subheading]Abstract: The generic reference price system (RPS) can impose a financial penalty for patients using a brand name drug instead of its generic alternative. Previous studies on the impact of the RPS have not considered the potentially differential effect of using generic alternatives for individuals with a different socioeconomic background. However, patients' characteristics might determine their overall knowledge of the existence of the system and thus of the financial burden to which they may be confronted. The association between patients' characteristics and the use of generic drugs versus brand name drugs was analyzed for ten highly prescribed pharmaceutical molecules included in the Belgian generic reference price system. Prescriptions were obtained from a 10% sample of all general practitioners in 2008 (corresponding to 120,670 adult patients and 368,101 prescriptions). For each pharmaceutical molecule, logistic regression models were performed, with independent variables for patient socioeconomic background at the individual level (work status, having a guaranteed income and being entitled to increased reimbursement of co-payments) and at the level of the neighborhood (education). The percentage of generic prescriptions ranged from 24.7 to 76.4%, and the mean reference supplement in 2008 ranged from euro4.3 to euro37.8. For seven molecules, higher use of a generic alternative was associated with either having a guaranteed income, with receiving increased reimbursement of co-payments or with living in areas with the lowest levels of education. Globally, results provided evidence that the generic RPS in Belgium does not lead to a higher financial burden on individuals from a low socioeconomic background. Link for e-copy: https://doi.org/10.1007/s10198-012-0377-8 Format of e-copy: PDF [Open Access] Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=4083 [article]
€ 0,00
Languages : English (eng)
Descriptors: Classification
W 74 Medical economics. Health care costs (General)
Indexation
Cost-sharing ; Deductibles and Coinsurance ; Health Care Reform ; Health Services Accessibility ; R186Link for e-copy: https://kce.fgov.be/publication/report/principles-and-criteria-for-the-level-of- [...] Format of e-copy: Webpage Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=3091 Copies(0)
Status No copy
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