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Asylum seekers in Belgium : options for a more equitable access to health care. A stakeholder consultation [printed text] / Marie Dauvrin , Author ; Jens Detollenaere , Author ; Chris De Laet , Author ; Dominique Roberfroid , Author ; Imgard Vinck , Author . - Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre, 2019 . - 135 p. : ill., ; A4. - (KCE Reports. Health Services Research (HSR); 319C) .
ISSN : D/2019/10.273/53 : € 0,00
Languages : English (eng)

Descriptors:	Indexation 2017-10 ; Delivery of Health Care ; Economics ; Health Policy ; Health Services Administration ; R319 ; Refugees Classification WA 300 Health issues of special population groups
Contents note:	1 INTRODUCTION .12 -- 2 SCOPE AND RESEARCH QUESTIONS 14 -- 3 METHODS 16 -- 4 CONTEXT OF INTERNATIONAL PROTECTION AND HEALTH CARE FOR ASYLUM SEEKERS IN BELGIUM .19 -- 4.1 INTERNATIONAL PROTECTION FOR ASYLUM SEEKERS .19 -- 4.1.1 Procedure for international protection: legal and administrative aspects 20 -- 4.1.2 Number of asylum seekers in Belgium .21 -- 4.1.3 Material assistance during the procedure for international protection 22 -- 4.2 HEALTH PROBLEMS, HEALTH CARE UTILISATION AND COSTS AMONG ASYLUM SEEKERS.26 -- 4.2.1 Health problems 26 -- 4.2.2 Health care utilisation and costs 26 -- 4.3 CURRENT ORGANISATION AND ACCESS TO HEALTH CARE FOR ASYLUM SEEKERS 27 -- 4.3.1 Legal framework 27 -- 4.3.2 Summary of the key organisational elements 33 -- 5 DESCRIPTION OF THE PROBLEMS .37 -- 5.1 PROBLEMS AT THE MACRO-LEVEL .37 -- 5.1.1 Lack of coordination 37 -- 5.1.2 Regional differences regarding health care for asylum seekers 37 -- 5.1.3 Lack of monitoring of health care use and health care costs 37 -- 5.1.4 Lack of transparency about health care expenses .38 -- 5.1.5 Lack of administrative support and of qualified personnel to manage administrative tasks 38 -- 5.2 PROBLEMS AT THE MESO-LEVEL .39 -- 5.2.1 Unclear administrative system for health care professionals 39 -- 5.2.2 Differences in health care system depending on place of stay 39 -- 5.2.3 Lack of health care professionals qualified to interact in health care for asylum seekers 40 -- 5.2.4 High turnover of health care professionals in reception centres 40 -- 5.2.5 Reluctance and/or overburdening of (some) health care professionals 40 -- 5.2.6 Poor and/or unclear collaboration between the different actors involved in health care for asylum seekers .41 -- 5.2.7 Tension regarding patient confidentiality .41 -- 5.2.8 Lack of appropriate health information for asylum seekers 41 -- 5.3 PROBLEMS AT THE MICRO-LEVEL 41 -- 5.3.1 Inequity in access .41 -- 5.3.2 Inequity in treatment 43 -- 5.3.3 Inequity in outcomes 44 -- 5.4 SPECIFIC PROBLEMS FOR HEALTH CARE WITH UNACCOMPANIED MINORS 45 -- 5.4.1 Lack of coverage through insurance funds for unaccompanied minors 45 -- 5.4.2 Difficulties to comply with the conditions to access the compulsory health insurance .45 -- 5.4.3 Shortage of guardians 45 -- 5.4 OTHER ISSUES 45 -- 6 OPTIONS TO IMPROVE EQUITABLE ACCESS TO HEALTH CARE FOR ASYLUM SEEKERS: RESULTS OF THE STAKEHOLDER CONSULTATION 48 -- 6.1 FUNDAMENTAL TRANSVERSAL PRINCIPLES TO IMPROVE EQUITABLE ACCESS .48 -- 6.2 DISTRIBUTION OF FUNDING OF HEALTH CARE FOR ASYLUM SEEKERS .49 -- 6.2.1 Option 1: Sickness funds acts as distributor of funding – integration of asylum seekers in compulsory Belgian health care insurance .49 -- 6.2.2 Option 2: Fedasil acts as distributor of funding .59 -- 6.2.3 Option 3: actual actors distribute the funding, administration by MedPrima for all asylum seekers and access to health care covered by health insurance 63 -- 6.3 FUTURE GOVERNANCE OF HEALTH CARE FOR ASYLUM SEEKERS 65 -- 6.4 IMPROVEMENTS TO THE CURRENT SYSTEM (QUICK WINS) 70 -- 6.4.1 Quick wins across organisations 70 -- 6.4.2 Quick wins on the level of the CPAS – OCMW 71 -- 6.4.3 Quick wins on the level of Fedasil 72 -- 7 CONCLUSION .72 -- 7.1 PREREQUISITES 72 -- 7.2 ESTIMATED EFFECT OF OPTIONS ON THE DESCRIBED PROBLEMS 73 -- 7.3 LIMITATIONS 76
Link for e-copy:	https://doi.org/10.57598/R319C
Format of e-copy:	PDF (3 MB)
Record link:	https://kce.docressources.info/index.php?lvl=notice_display&id=4610