Le financement des soins infirmiers à domicile en Belgique - KCE

More documents

Recommendations

Info

10 Financing of Home Nursing KCE reports 122 Three profiles of patient groups were identified. The most common profile concerns people of an average age of 60 who are in need of home nursing for about one month following a hospital stay. The second most common profile relates to patients who need homecare for less than a month, mostly younger people. The third most common profile regards dependent people after the age of 75 who require chronic care. Findings of the Intermutualistic Agency 2 revealed that average expenditures for home nursing increased with age and were higher in Flanders than in the Walloon Region and Brussels (Figure 2). Figure 2: Average costs (in euros) of home nursing per inhabitant per age and per region Legend: Leeftijd/Classe d’âge : age categories; Kostprijs/coût : costs; Regions: Vlaanderen : Flanders / Wallonië : Walloon region / Rijk : Belgium Source: NIHDI, 2005 2
KCE Report 122 Financing of Home Nursing 11 2.3 THE NATURE OF HOME NURSING Although home nursing is on many occasions of a curative and temporary nature, it is very often considered as ‘long term care’. In an international context, there is a steadily developing ‘fading borderline’ between nursing care and other personal and social care for long term care, on issues as the delivery, professional groups as well as financing aspect. However, this report focuses particularly on home nursing, as this is financed within the federal NIHDI framework. Home nursing as a community care provider is on the borderline of cure and care. According to the International Standard Classification of Occupations (ISCO) defined by the International Labour organisation, nursing professionals (ISCO 08 2221) are seen as professionals being full members of the interdisciplinary team: “Nursing and midwifery professionals treat and care for the physically or mentally ill, the elderly, and mothers and their babies. They assume responsibility for the planning and management of the care of patients, including the supervision of other health care workers, working in teams with medical doctors and others in the practical application of preventive and curative measures, and dealing with emergencies as appropriate.” In this report we use ‘community care’ as a general term for care at home. We distinguish home nursing, home care and home helping. All those services can be considered as a continuum 10 . Key points • The Belgian public financing of home nursing seems not to be fully adapted to demographic and health care system evolutions and challenges. • Three main profiles of patient groups home care were identified. The most common profile concerns people of an average age of 60 who are in need of home nursing for about one month following a hospital stay. The second profile is composed with younger patients who need homecare for less than a month. The third most common profile concerns dependent people after the age of 75 who require chronic care. • The scope of this study is limited to homecare nursing that is currently reimbursed at the Belgian federal level through the public payer NIHDI. It focuses on nursing activities. • The main objective of this study is to assess whether the financing of professional homecare nursing services can be adapted whilst taking into account the relative patient case-mix. 2.4 THE ORGANISATION OF HOME NURSING IN BELGIUM 2.4.1 Self-employed or employee nurses Home nursing in Belgium is organised in two ways: via employee-nurses and via selfemployed nurses. Employee-nurses in home care are employed by private not-for-profit organisations with a specific focus on home nursing. A small proportion of employeenurses is employed by the local public centres for social welfare and by self-employed nurses. For most self-employed nurses, delivering nursing care at the patient’s home is their main and sole professional activity. Other self-employed nurses are working under a mixed professional statutory: on the one hand they are employee-nurses in a hospital, a nursing home or a medical practice (a general practice or a medical specialist’s practice) and on the other hand, beyond their working hours, they may develop selfemployed professional activity in delivering nursing care at home. Currently, there is no federal register for nurses in Belgium. Consequently, exact numbers of self-employed nurses and employee-nurses are not known. In 2002, the proportion of employee-nurses was estimated to be 42% to 43% of all home nurses in Belgium, which is the most recently public available estimation 2 .
Page 1 and 2: Le financement des soins infirmiers
Page 3 and 4: Le financement des soins infirmiers
Page 5 and 6: KCE Reports 122B Financement des so
Page 13: KCE Reports 122B Financement des so
Page 16 and 17: 2 Financing of Home Nursing KCE rep
Page 26 and 27: 12 Financing of Home Nursing KCE re
Page 74 and 75:
60 Financing of Home Nursing KCE re
Page 76 and 77:
Page 78 and 79:
Page 80 and 81:
Page 82 and 83:
Page 84 and 85:
Page 86 and 87:
Page 88 and 89:
Page 90 and 91:
Page 92 and 93:
Page 94 and 95:
Page 96 and 97:
Page 98 and 99:
Page 100 and 101:
Page 102 and 103:
Page 104 and 105:
Page 106 and 107:
Page 108 and 109:
Page 110 and 111:
Page 112 and 113:
Page 114 and 115:
100 Financing of Home Nursing KCE r
Page 116 and 117:
Page 118 and 119:
Page 120 and 121:
Page 122 and 123:
Page 124 and 125:
Page 126 and 127:
Page 128 and 129:
Page 130 and 131:
Page 132 and 133:
Page 134 and 135:
Page 137 and 138:
This page is left intentionally bla
Page 139 and 140:
KCE reports 1. Efficacité et renta
Page 141 and 142:
73. Financement du programme de soi
show all

Le financement des soins infirmiers à domicile en Belgique - KCE

Create successful ePaper yourself

Delete template?

Save as template?