The report is available in English with a French summary - KCE

KCE Reporst 57 Musculoskeletal & Neurological Rehabilitation 257
In order to implement the different recommendations made in this report, the following
steps are proposed. First of all patients with rehabilitation needs and goals should be
indentified based on the conceptual definition to test the conceptual definition in clinical
practice. Systematic registration of the patients’ profiles and delivered rehabilitation
activities, in a central database, should be started as soon as possible in order to allow
for correction of the estimations mentioned above, based on real data. Then, a
classification system should be developed in order to assign an individual to the
appropriate level of rehabilitation services with regard to his rehabilitation needs and
goals at a certain point in the disease trajectory. The currently existing rehabilitation
services should be reoriented to respectively general, specific and highly specific
services. A network permitting collaboration between the services of the different
levels at the level of clinical activities as well as concerning research and education
should be installed. Patient referral can then be realised within this network using the
PCS. Finally, the appropriate payment systems need to be developed for the different
levels as described above. Quality control should be implemented.
13.2 COMPARISON WITH THE REPORT OF THE MINISTERIAL
WORKING GROUP (PROF. HEILPORN): “NETWORK OF
MUSCULOSKELETAL AND NEUROLOGICAL
REHABILITATION”
13.2.1 Introduction
On demand of Minister R. Demotte a “working group” was composed of different
stakeholders and experts within the whole rehabilitation sector, under the direction of
Prof. A.Heilporn. A subgroup concerning musculoskeletal and neurological rehabilitation
held 16 meetings between January 2005 and November 2006. The report was published
in 2007. The activities of the Ministerial group took place in parallel with the KCE
project 2005-18 HSR titled “Organisation and Financing of Musculoskeletal and
Neurological Rehabilitation in Belgium”.
The aim of the Ministerial subgroup was to elaborate a concrete proposal for the
organisation of musculoskeletal and neurological rehabilitation in Belgium, based on the
recommendations as formulated in the policy note of the Minister and the report of
the audit performed by Mr. Verhaevert of the budgetary commission of the
RIZIV/INAMI (June 2004).
The primary aim of the KCE project is to study the current RIZIV/INAMI conventions
for ‘locomotor rehabilitation’. As financing and payment is very much related to
organizational issues, the secondary aim of the study was to assess the organization and
financing of musculoskeletal and neurological rehabilitation.
13.2.2 Methodology
The methodology of the KCE project was described earlier in this report throughout
the different chapters. Summarised, the different issues were primarily approached in a
scientific way by means of a thorough search of the available scientific literature. In the
different steps of this project, evidence found in scientific literature was maximally used.
Where evidence lacked, other sources were used such as grey literature, national and
international expert opinion, expert meetings and surveys. Also, an exercise in analysis
of costs and expenditures and some financial simulations were performed.
The Ministerial Subgroup applied a completely different methodology. The
developed ideas are mainly based on expert opinion and dialogue between the different
stakeholders, members of the subgroup. For scientific data concerning for example
epidemiology reference is made to the KCE project.