Descriptors
Documents disponibles dans cette catégorie (6)



Extend search on down-posting(s)
Interventions to reduce emergency department utilisation / Koen Van Den Heede in Health Policy, 120(2016)12 ([12/01/2016])
![]()
[article] Interventions to reduce emergency department utilisation : A review of reviews [printed text] / Koen Van Den Heede, Author ; Carine Van de Voorde, Author . - 2016 . - 1337-1349.
Languages : English (eng)
in Health Policy > 120(2016)12 [12/01/2016] . - 1337-1349
Descriptors: Classification
W 1 Serials. Periodicals
Indexation
2014-08 ; Belgium ; Emergency Medical Services ; Health Services Research ; Journal ArticleAbstract: Objective
To describe policy interventions that have the objective to reduce ED use and to estimate their effectiveness.
Methods
Narrative review by searching three electronic databases for scientific literature review papers published between 2010 and October 2015. The quality of the included studies was assessed with AMSTAR, and a narrative synthesis of the retrieved papers was applied.
Results
Twenty-three included publications described six types of interventions: (1) cost sharing; (2) strengthening primary care; (3) pre-hospital diversion (including telephone triage); (4) coordination; (5) education and self-management support; (6) barriers to access emergency departments. The high number of interventions, the divergent methods used to measure outcomes and the different populations complicate their evaluation. Although approximately two-thirds of the primary studies showed reductions in ED use for most interventions the evidence showed contradictory results.
Conclusion
Despite numerous publications, evidence about the effectiveness of interventions that aim to reduce ED use remains insufficient. Studies on more homogeneous patient groups with a clearly described intervention and control group are needed to determine for which specific target group what type of intervention is most successful and how the intervention should be designed. The effective use of ED services in general is a complex and multi-factorial problem that requires integrated interventions that will have to be adapted to the specific context of a country with a feedback system to monitor its (un-)intended consequences. Yet, the co-location of GP posts and emergency departments seems together with the introduction of telephone triage systems the preferred interventions to reduce inappropriate ED visits while case-management might reduce the number of ED attendances by frequent ED users.Link for e-copy: https://doi.org/10.1016/j.healthpol.2016.10.002 Format of e-copy: PDF [Requires Subscription] Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=4004 [article]Organisatie en financiering van spoeddiensten in België / Koen Van Den Heede / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2016)
![]()
Organisatie en financiering van spoeddiensten in België : huidige situatie en opties voor hervorming - Synthese [printed text] / Koen Van Den Heede, Author ; Cécile Dubois
, Author ; Stephan Devriese
, Author ; Natalie Baier, Author ; Olivier Camaly, Author ; Eveline Depuijdt, Author ; Alexander Geissler, Author ; Annelies Ghesquiere, Author ; Sarah Misplon, Author ; Wilm Quentin, Author ; Christophe Van Loon, Author ; Carine Van de Voorde, Author . - Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre, 2016 . - 36 p. : ill., ; A4. - (KCE Reports A. Health Services Research (HSR); 263As) .
ISSN : D/2016/10.273/21 : 0,00
Studie 2014-08
Languages : Dutch (nla)
Descriptors: Indexation
2014-08 ; After-Hours Care ; Emergency Medical Services ; Emergency Service, Hospital ; Health Care Reform ; R263
Classification
WX 215 - Emergency serviceAbstract: In ons land heeft elk ziekenhuis een spoed, sommige zelfs meer dan één, die zich dan op verschillende locaties bevinden. Dit komt neer op 1,24 spoeddiensten per 100 000 inwoners, wat uitzonderlijk hoog is in vergelijking met andere landen. De helft van deze spoeddiensten heeft op 24u tijd echter gemiddeld minder dan 55 contacten, en nog geen 6 contacten per nacht. Ook de spreiding over het grondgebied is niet steeds rationeel. Het Federaal Kenniscentrum voor de Gezondheidszorg (KCE) beveelt daarom aan om het aantal spoeddiensten te beperken. Bovendien kan een groot deel van de patiënten die zich op de spoed aanbieden even goed door een huisarts geholpen worden. De 70 huisartswachtposten die de laatste jaren werden opgericht, doen echter het aantal spoedcontacten niet dalen. Daarom beveelt het KCE aan om naast de spoeddiensten, op de ziekenhuissite, ook een 24/7 huisartspermanentie onder te brengen. Deze moet wel autonoom van het ziekenhuis kunnen functioneren, onder de coördinatie van de lokale huisartsenkringen. Spoeddienst en huisartspermanentie vormen samen een centrum voor ongeplande zorg, dat één centrale toegangspoort met een triage-zone heeft. Het klinisch geschoolde triage-team onthaalt de patiënt en stuurt deze dan door naar de huisartspermanentie of naar de spoed, afhankelijk van zijn medische situatie. Contents note: VOORWOORD 1 -- KERNBOODSCHAPPEN. 2 -- SYNTHESE . 4 -- 1. INLEIDING 6 -- 1.1. SPOEDAFDELINGEN, SPOEDDIENSTEN OF KORTWEG DE SPOED. 6 -- 1.2. STIJGEND AANTAL CONTACTEN OP SPOEDDIENSTEN. 7 -- 1.3. WAAROM DEZE STUDIE? . 7 -- 1.4. ONDERZOEKSAANPAK 8 -- 2. SPOEDAFDELINGEN: HUIDIGE ORGANISATIE EN VOORSTELLEN TOT HERVORMING 9 -- 2.1. GESPECIALISEERDE SPOEDGEVALLENZORG IN BIJNA ALLE ZIEKENHUIZEN 9 -- 2.2. GROTE TOEGANKELIJKHEID, MAAR OOK VERSNIPPERING VAN BUDGET EN PERSONEEL.10 -- 2.3. AANTAL SPOEDCONTACTEN PER ZIEKENHUIS IS ZEER VARIABEL 10 -- 3. EERSTELIJNSZORG: HUIDIGE ORGANISATIE EN VOORSTELLEN TOT HERVORMING.15 -- 3.1. ORGANISATIE VAN DE EERSTELIJNSZORG BUITEN DE KANTOORUREN 15 -- 3.1.1. Klein deel van de huisartsenactiviteit, maar met een potentiële impact op het gebruik van de spoed. 15 -- 3.1.2. Evolutie van lokale rotatiesystemen naar wachtposten 15 -- 3.1.3. Wachtposten: bottom-up initiatieven om de werkomstandigheden van huisartsen te verbeteren 17 -- 3.2. VELE SPOEDCONTACTEN KUNNEN EVEN GOED DOOR DE HUISARTS WORDEN BEHANDELD 17 -- 4. HUIDIGE FINANCIERING EN VOORSTELLEN TOT HERVORMING .23 -- 4.1. HOE WORDEN DE SPOEDDIENSTEN EN DE ARTSEN DIE ER WERKEN GEFINANCIERD? 23 -- 4.1.1. Het ziekenhuisbudget voor spoeddiensten wordt meer en meer gebaseerd op hun activiteiten 23 -- 4.1.2. Vergoeding van de artsen 25 -- 4.1.3. Uitgaven voor het personeel op de spoeddienst 26 -- 4.2. HOE WORDT EERSTELIJNSZORG BUITEN DE KANTOORUREN GEFINANCIERD?.26 -- 4.2.1. Betaling per prestatie blijft ook daar de belangrijkste inkomensbron 26 -- 4.2.2. In een wachtpost werken loont overdag maar niet s nachts 27 -- 4.2.3. RIZIV-budget voor de wachtposten 27 -- 4.3. REMGELD VOOR EERSTELIJNSZORG EN SPOEDDIENSTEN IS ONVOLDOENDE OP ELKAAR AFGESTEMD 29 -- REFERENTIES 34 Link for e-copy: http://kce.fgov.be/sites/default/files/page_documents/KCE_263_As_Organisatie_en_ [...] Format of e-copy: PDF (1 Mb) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=3825 Organisation and payment of emergency care services in Belgium / Koen Van Den Heede / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2016)
![]()
Organisation and payment of emergency care services in Belgium : current situation and options for reform [printed text] / Koen Van Den Heede, Author ; Cécile Dubois
, Author ; Stephan Devriese
, Author ; Natalie Baier, Author ; Olivier Camaly, Author ; Eveline Depuijdt, Author ; Alexander Geissler, Author ; Annelies Ghesquiere, Author ; Sarah Misplon, Author ; Wilm Quentin, Author ; Christophe Van Loon, Author ; Carine Van de Voorde, Author . - Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre, 2016 . - 245 p. : ill., ; A4. - (KCE Reports. Health Services Research (HSR); 263) .
ISSN : D/2016/10.273/24 : 0,00
Study 2014-08
Languages : English (eng)
Descriptors: Indexation
2014-08 ; After-Hours Care ; Emergency Medical Services ; Emergency Service, Hospital ; Health Care Reform ; R263
Classification
WX 215 - Emergency serviceContents note: 1 INTRODUCTION AND SCOPE 13 -- 1.1 WHAT ARE EMERGENCY CARE SERVICES? 13 -- 1.2 WHY THIS REPORT? 15 -- 1.2.1 Objective of the study .15 -- 1.2.2 Scope of the study 15 -- 1.3 ORGANISATION OF THE REPORT16 -- 2 SCOPE AND METHODS 17 -- 2.1 INTRODUCTION17 -- 2.2 METHODS17 -- 2.2.1 Legal documents and text books .17 -- 2.2.2 Belgian data 17 -- 2.2.3 Literature 18 -- 2.2.4 Review of the literature and Belgian reports .18 -- 2.2.5 Qualitative study design18 -- 3 BELGIAN EMERGENCY DEPARTMENTS: ORGANISATION AND ACTIVITY 20 -- 3.1 EMERGENCY DEPARTMENTS IN BELGIUM: PROFILE AND ACTIVITY.20 -- 3.1.1 Specialised and non-specialised emergency departments 20 -- 3.1.2 Geographical distribution 21 -- 3.1.3 Activity profile .22 -- 3.2 CRITICAL APPRAISAL: A RELATIVELY HIGH NUMBER OF EMERGENCY DEPARTMENTS WITH LARGE DIFFERENCES BETWEEN URBAN AND RURAL AREAS.37 -- 3.2.1 Current capacity is a consequence of (not always harmonized) policy measures: programming, recognition, financing .37 -- 3.2.2 Advantages and disadvantages of the current ED capacity 38 -- 3.3 CRITICAL APPRAISAL: ARE EMERGENCY DEPARTMENTS THE MOST APPROPRIATE ORGANISATIONAL LEVEL FOR ALL CURRENT ACTIVITY? .39 -- 3.3.1 Not all emergency department visits are urgent, but are they inappropriate? A uniform definition is lacking 39 -- 3.3.2 Throughput and outflow problems are also burdening emergency departments 44 -- 3.4 SOLUTION ELEMENTS .45 -- 3.4.1 Planning of the required number of emergency departments in the larger spectrum of acute care services 45 -- 3.4.2 Reduction of emergency department capacity 47 -- 3.4.3 Concentration of highly-specialised services in reference centres51 -- 4 EMERGENCY DEPARTMENT WORKFORCE 55 -- 4.1 PHYSICIANS AND NURSES SPECIALISED IN EMERGENCY CARE .55 -- 4.1.1 Physicians working in Belgian emergency departments.55 -- 4.1.2 Nurses with a special title in intensive and emergency care .59 -- 4.2 CRITICAL APPRAISAL: THE ED IS A DEMANDING WORKPLACE AND STAFFING SHORTAGES ARE REPORTED .60 -- 4.2.1 Emergency physician shortage: need for evaluation in larger policy context .60 -- 4.2.2 A stressful work environment with high levels of burnout for physicians and nurses 61 -- 4.2.3 Are the current policy measures sufficient to tackle the shortage? .63 -- 4.3 SOLUTION ELEMENTS .66 -- 4.3.1 Focus on emergency care .66 -- 4.3.2 Adequate remuneration 66 -- 4.3.3 New roles and workforce innovations in the emergency department.66 -- 5 OUT-OF-HOURS SERVICES FOR ACUTE CARE: THE ROLE OF PRIMARY CARE SERVICES 69 -- 5.1 OUT-OF-HOURS PRIMARY CARE SERVICES 69 -- 5.1.1 The context of primary care and out-of-hours services in Belgium .69 -- 5.1.2 Payment system for general practitioners 74 -- 5.2 CRITICAL APPRAISAL OF ORGANISED DUTY CENTRES 78 -- 5.2.1 Rationale for ODC implementation: isolated focus on better working conditions for GPs or part of a larger vision?78 -- 5.2.2 Implementation of ODCs: increased use of out-of-hours GP services did not result in a decreased use of ED attendances .80 -- 5.2.3 ODCs are geographically well dispersed but is their location well chosen?.91 -- 5.2.4 Paying for ODCs: are the budgets covering investments and operational costs and the fee-forservice payments for GPs well-balanced? 97 -- 5.3 SOLUTION ELEMENTS .99 -- 5.3.1 Integration of EDs and ODCs .99 -- 5.3.2 Payment and organisation of acute care requires one general approach 102 -- 5.3.3 The role of primary care services during office hours in acute care .103 -- 6 TELEPHONE TRIAGE FOR PATIENTS WITH NON-EMERGENCY MEDICAL CONDITIONS .106 -- 6.1 ACCESS TO THE EMERGENCY CARE SYSTEM: REFERRALS, SELF-REFERRALS OR CONTACTING THE EMERGENCY CALL CENTRE 106 -- 6.2 CRITICAL ANALYSIS.107 -- 6.3 SOLUTION ELEMENTS 109 -- 7 THE ROLE OF PATIENT COST SHARING IN PROVIDER CHOICE .115 -- 7.1 PATIENT COST SHARING FOR GP AND EMERGENCY DEPARTMENT SERVICES .116 -- 7.1.1 Patient cost sharing for emergency department services 116 -- 7.1.2 Patient cost sharing for GP services .117 -- 7.1.3 Direct payment versus third-party payer system 119 -- 7.2 CRITICAL APPRAISAL OF THE ROLE OF PATIENT COST SHARING IN THE CHOICE BETWEEN GP AND EMERGENCY DEPARTMENT SERVICES 120 -- 7.3 SOLUTION ELEMENTS 121 -- 8 PAYMENT MODELS FOR THE EMERGENCY DEPARTMENT AND ITS WORKFORCE 123 -- 8.1 THE BUDGET OF FINANCIAL MEANS 123 -- 8.1.1 Components of the closed-end hospital budget .123 -- 8.1.2 Calculation of the B2-budget for clinical costs .124 -- 8.1.3 The B2-budget for the emergency department 127 -- 8.2 THE REMUNERATION SYSTEM OF MEDICAL SPECIALISTS PROVIDING SERVICES IN AN EMERGENCY DEPARTMENT .139 -- 8.2.1 How are physician fees determined? 139 -- 8.2.2 The fee schedule for emergency physicians and other medical specialists providing services at the emergency department 140 -- 8.2.3 Fees for physicians providing services in the ED: evolution of reimbursements and cases142 -- 8.2.4 Combination of one A-fee and one or more C-fees per emergency department visit .142 -- 8.2.5 A-fees by type of emergency physician .142 -- 8.3 PERFORMANCE MEASUREMENT AND PAY FOR PERFORMANCE .147 -- 8.3.1 Quality of care in emergency departments traditionally relies on a policy of recognition norms .147 -- 8.4 CRITICAL APPRAISAL OF THE OLD CALCULATION METHOD OF THE B2 BUDGET FOR THE EMERGENCY DEPARTMENT .147 -- 8.4.1 The B2 budget is not sufficient to guarantee minimum staffing ratios 147 -- 8.4.2 Distribution of the budget among hospitals: parameters are insufficiently related to ED activity and favour large hospitals148 -- 8.4.3 The old emergency department payment system better reflected the case-mix of the hospital .149 -- 8.4.4 Hospital responses.149 -- 8.5 CRITICAL APPRAISAL OF THE NEW CALCULATION METHOD OF THE B2 BUDGET FOR THE EMERGENCY DEPARTMENT .150 -- 8.5.1 New rules did not solve the structural underpayment but only changed the distribution of the closed-end budget 150 -- 8.5.2 Emergency department caseload and workload is better reflected 150 -- 8.5.3 The pros and cons of a patient classification system for emergency department payments150 -- 8.5.4 Hospital responses.151 -- 8.6 CRITICAL APPRAISAL OF THE REMUNERATION SYSTEM OF MEDICAL SPECIALISTS PROVIDING SERVICES AT THE EMERGENCY DEPARTMENT 151 -- 8.6.1 A fee-for-service payment system contributes to a productive workforce but incentivizes the quantity of services a physician provides .151 -- 8.6.2 The fee schedule helps us to keep track of what happens within the system.152 -- 8.6.3 The fee schedule for physians working in the ED: amount of the fee 153 -- 8.6.4 Large differences between hospitals in the share of ED visits for which a C-fee is charged 155 -- 8.6.5 A system of salaried emergency physicians: less appropriate for a flexible workforce and more expensive for society 156 -- 8.6.6 The fee schedule of emergency physicians: redundant or too restricted? .156 -- 8.6.7 The size of the hospital determines the budget available for physicans on duty in the ED.157 -- 8.7 CRITICAL APPRAISAL OF THE DEVELOPMENT AND IMPLEMENTATION OF QUALITY INDICATORS FOR EMERGENCY CARE .158 -- 8.8 SOLUTION ELEMENTS 159 -- 8.8.1 The ED budget should be sufficient to cover minimum staffing levels 159 -- 8.8.2 The new calculation method for the ED budget should be evaluated regularly 159 -- 8.8.3 A mix of fixed and variable payments 160 -- 8.8.4 Variable payments reflecting the ED caseload and patient case-mix .162 -- 8.8.5 Funding for sparsely populated and remote areas 163 -- 8.8.6 A payment system to support the development of an emergency care network 163 -- 9 ORGANISATION AND PAYMENT OF EMERGENCY CARE SERVICES IN SELECTED COUNTRIES .165 -- 9.1 INTRODUCTION 165 -- 9.1.1 Background 165 -- 9.1.2 Methodology.165 -- 9.1.3 Overview of emergency care services across countries .167 -- 9.2 ORGANISATION OF EMERGENCY CARE SERVICES 170 -- 9.2.1 Framework 170 -- 9.2.2 Organisation and planning .172 -- 9.3 PAYMENT OF EMERGENCY CARE SERVICES 185 -- 9.3.1 Framework 185 -- 9.3.2 Payment of Providers 187 -- 9.4 REFORMS AND DEBATES.194 -- 9.4.1 Overview .194 -- 9.4.2 Improved availability of urgent primary care services and better coordination with emergency care .194 -- 9.4.3 Rationalizing and concentrating emergency care .197 -- 9.5 CONCLUSIONS .200 -- 9.5.1 Guiding patients through the system 200 -- 9.5.2 Reconfiguring urgent primary and emergency care.201 -- 9.5.3 Supporting integrated emergency and urgent care structures through payment .201 -- 10 INTERVENTIONS TO REDUCE EMERGENCY DEPARTMENT UTILIZATION204 -- 10.1 OBJECTIVE.204 -- 10.2 METHOD 204 -- 10.3 RESULTS .206 -- 10.3.1 Search and inclusion 206 -- 10.3.2 Methodological assessment 207 -- 10.3.3 Type of target populations included in systematic reviews212 -- 10.3.4 Type of interventions and scope of reviews 212 -- 10.4 DISCUSSION AND CONCLUSION .223 Link for e-copy: http://kce.fgov.be/sites/default/files/page_documents/KCE_263_Organisation_and_p [...] Format of e-copy: PDF (4,8 Mb) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=3821 Organisation and payment of emergency care services in Belgium / Koen Van Den Heede / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2016)
![]()
Organisation and payment of emergency care services in Belgium : current situation and options for reform - Short Report [printed text] / Koen Van Den Heede, Author ; Cécile Dubois
, Author ; Stephan Devriese
, Author ; Natalie Baier, Author ; Olivier Camaly, Author ; Eveline Depuijdt, Author ; Alexander Geissler, Author ; Annelies Ghesquiere, Author ; Sarah Misplon, Author ; Wilm Quentin, Author ; Christophe Van Loon, Author ; Carine Van de Voorde, Author . - Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre, 2016 . - 58 p. : ill., ; A4. - (KCE Reports. Health Services Research (HSR); 263Cs) .
ISSN : D/2016/10.273/23 : 0,00
Study 2014-08
Languages : English (eng)
Descriptors: Indexation
2014-08 ; After-Hours Care ; Emergency Medical Services ; Emergency Service, Hospital ; Health Care Reform ; R263
Classification
WX 215 - Emergency serviceContents note: FOREWORD . 1 -- SHORT REPORT 2 -- 1 INTRODUCTION . 6 -- 1.1 WHAT ARE EMERGENCY CARE SERVICES? . 6 -- 1.2 SCOPE AND OBJECTIVES 7 -- 1.2.1 Objective and scope of the study 8 -- 1.3 METHODS. 8 -- 2 CURRENT ORGANISATION AND ACTIVITY PROFILE OF EMERGENCY DEPARTMENTS IN BELGIUM 10 -- 2.1 ACCESS TO EMERGENCY DEPARTMENTS: (SELF-)REFERRALS OR EMERGENCY CALLS .10 -- 2.2 ROLE AND TYPES OF EMERGENCY DEPARTMENTS . 11 -- 2.3 VAST MAJORITY OF HOSPITAL SITES HAVE SPECIALISED EMERGENCY DEPARTMENTS .12 -- 2.4 ACTIVITY PROFILE OF BELGIAN EMERGENCY DEPARTMENTS.14 -- 2.4.1 A high and increasing number of ED visits, especially ambulatory and self-referred ED visits 14 -- 2.4.2 Activity on EDs peaks during office hours. 15 -- 2.4.3 EDs have a highly variable caseload 16 -- 2.4.4 Not all emergency department visits are emergencies, but are they inappropriate?17 -- 2.5 WORKFORCE. 18 3 ORGANISATION AND ACTIVITY OF OUT-OF-HOURS PRIMARY CARE SERVICES .20 -- 3.1 THE CONTEXT OF PRIMARY CARE IN BELGIUM . 20 -- 3.2 ORGANISATION OF OUT-OF-HOURS PRIMARY CARE SERVICES 20 -- 3.2.1 Shift from local rotation systems to larger GP cooperatives .20 -- 3.2.2 ODCs are bottom-up initiatives mainly initiated to improve working conditions of GPs .21 -- 4 PAYMENT SYSTEMS FOR OUT-OF-HOURS PRIMARY CARE AND EMERGENCY DEPARTMENT SERVICES IN BELGIUM 26 -- 4.1 PUBLIC PAYMENTS FOR THE EMERGENCY DEPARTMENT AND ITS WORKFORCE .26 -- 4.1.1 The hospital budget for emergency departments is increasingly based on ED activity26 -- 4.1.2 Fee-for-service reimbursement is still the predominant payment method for physicians working in an emergency department . 28 -- 4.2 PUBLIC PAYMENTS FOR OUT-OF-HOURS PRIMARY CARE SERVICES.29 -- 4.2.1 Fee-for-service is also the dominant payment method for general practitioners 29 -- 4.2.2 ODC budgets have been streamlined . 30 -- 4.3 PATIENT COST SHARING FOR OUT-OF-HOURS PRIMARY CARE AND EMERGENCY DEPARTMENT SERVICES. 31 -- 5 REFORM PROPOSALS: A MULTI-FACTORIAL APPROACH THAT REQUIRES MONITORING .32 -- 5.1 TELEPHONE TRIAGE TO GUIDE PATIENTS TO THE APPROPRIATE CARE LEVEL AND PLACE, AT THE RIGHT MOMENT . 32 -- 5.2 HARMONIZATION ORGANISATION OF EMERGENCY DEPARTMENTS AND OUT-OF-HOURS GP CARE. 34 -- 5.2.1 Should ODCs decrease the number of ED visits? Stakeholders disagree and a clear policy directive is missing 34 -- 5.2.2 Implementation of ODCs: increased use of out-of-hours GP services did not result in a decreased use of ED attendances 34 -- 5.2.3 Increased collaboration between ODCs and EDs but to what extent?.35 -- 5.3 THE IMPACT OF PUBLIC INFORMATION CAMPAIGNS 37 -- 5.4 CO-PAYMENTS HAVE ONLY LIMITED EFFECT ON STEERING PATIENTS TO THE RIGHT CARE SETTING . 37 -- 5.5 RATIONALISATION OF ACUTE CARE RESOURCES: SMALL CHANGES OR A DRASTIC REFORM? . 37 -- 5.5.1 Belgium has a high (specialised) ED capacity 37 -- 5.5.2 Integrate redesigning of emergency departments in a larger reform of healthcare services38 -- 5.6 INTERVENTIONS THAT FOCUS ON FREQUENT ED USERS AND OTHER SPECIFIC TARGET GROUPS . 40 -- 5.7 GETTING PAYMENTS FOR OUT-OF-HOURS PRIMARY CARE AND EMERGENCY DEPARTMENT SERVICES RIGHT 40 -- 5.7.1 The current mix of ED revenue sources: a drive for production and no incentives for collaboration with primary care . 40 -- 5.7.2 Working in an ODC is rewarding during the day but not at night 44 -- 5.7.3 Comparing budgets and activity of ODCs and EDs: value for money? 44 -- 5.7.4 A larger share of fixed payments to emphasize the availability function of emergency care services . 44 -- 5.7.5 Volume-based payments to allocate resources to where care actually takes place 45 -- 5.7.6 A coordinated payment system across care settings .47 -- 6 CONCLUSION 47 -- REFERENCES 50 Link for e-copy: http://kce.fgov.be/sites/default/files/page_documents/KCE_263_Cs_Organisation_an [...] Format of e-copy: PDF (2 Mb) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=3822 Organisation and payment of emergency care services in Belgium / Koen Van Den Heede / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2016)
![]()
Organisation and payment of emergency care services in Belgium : current situation and options for reform - Supplement [printed text] / Koen Van Den Heede, Author ; Cécile Dubois
, Author ; Stephan Devriese
, Author ; Natalie Baier, Author ; Olivier Camaly, Author ; Eveline Depuijdt, Author ; Alexander Geissler, Author ; Annelies Ghesquiere, Author ; Sarah Misplon, Author ; Wilm Quentin, Author ; Christophe Van Loon, Author ; Carine Van de Voorde, Author . - Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre, 2016 . - 48 p. : ill., ; A4. - (KCE Reports. Health Services Research (HSR); 263S) .
ISSN : D/2016/10.273/25 : 0,00
Study 2014-08
Languages : English (eng)
Descriptors: Indexation
2014-08 ; After-Hours Care ; Emergency Medical Services ; Emergency Service, Hospital ; Health Care Reform ; R263
Classification
WX 215 - Emergency serviceContents note: 1 ANNEX TO CHAPTER 2 3 -- 2 ANNEX TO CHAPTER 3 7 -- 2.1 INAPPROPRIATE USE OF EMERGENCY DEPARTMENT: DEFINITION AND PREVALENCE7 -- 2.2 ECONOMIES OF SCALE 7 -- 2.3 IMPACT OF EMERGENCY DEPARTMENT CLOSURES8 -- 3 ANNEX TO CHAPTER 4 11 -- 3.1 SYSTEMATIC REVIEWS ON EMERGENCY CARE WORKFORCE ISSUES11 -- 4 ANNEX TO CHAPTER 6 12 -- 4.1 SYSTEMATIC REVIEWS ON TELEPHONE TRIAGE.12 -- 5 ANNEX TO CHAPTER 10 .13 -- 5.1 LIST OF EXPERTS13 -- 5.2 EXPERT SURVEY ON EMERGENCY CARE SERVICES IN SELECTED COUNTRIES.14 -- 5.2.1 Introduction .14 -- 5.2.2 Context 14 -- 5.2.3 Questionnaire.17 -- 6 ANNEX TO CHAPTER 10 .20 -- 6.1 SEARCH STRATEGY 20 -- 6.2 FULL AMSTAR EVALUATION.22 -- 6.3 EXTRACTION TABLES 24 Link for e-copy: http://kce.fgov.be/sites/default/files/page_documents/KCE_263_S_Organisation_and [...] Format of e-copy: PDF (1 Mb) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=3823 Organisation et financement des services durgence en Belgique / Koen Van Den Heede / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2016)
![]()
Permalink
