Le financement des soins infirmiers à domicile en Belgique - KCE

22 Financing of Home Nursing KCE reports 122
system, which is a huge and growing number. There are no criteria for
defining systematic abuse of the assessment instrument, and it is not clear
which sanctions are to be foreseen and which defence or lawful counsel a
nurse may apply or which are the procedures for appeal.
2.5.3.2 Specific costs for home nursing organisations
Since 2002, specific costs for home nursing organisations are financed (Royal Decree of
16 April 2002, modified by the Royal Decree of 7 June 2004). Specific costs were
defined as costs for organisation, coordination, programming, continuity, quality and
evaluation. The objective of this subsidy was to promote collaboration of home nurses.
In order to receive a subsidy for specific costs, the following criteria have to be met:
• The organisation is under authority and supervision of a nurse who is
responsible for planning, coordination, programming, continuity, quality and
evaluation.
• The organisation is employing a minimum of 7 full-time-equivalent nurses, not
including the supervising nurse.
• The organisation is exclusively employing employee-nurses; there are no selfemployed
nurses.
• The organisation implements permanent education for at least 20 hours per
year per full-time-equivalent nurse.
• The organisation guarantees consultation and peer review for at least 25
hours per year per full-time-equivalent nurse.
• The organisation uses one unique third party payer’s number.
Originally, only organisations working with employee-nurses could receive this subsidy.
Since 1 September 2004, associations of self-employed nurses can receive a subsidy too.
The subsidy is paid every three months and amounts 11 151 euro for 14 full-timeequivalent
nurses, not including the supervising nurse. Services applying for this subsidy
have to document the number of nurses employed by the service and the activities of
the service during the preceding trimesters. The yearly expenditures for these costs
significantly increase from one year to another (Table 7).
Table 7: Yearly expenditures for specific costs of organisations for home
nursing
Year Expenditures Evolution since the year before
2003 11 820 752 euro
2004 12 775 478 euro +8.08%
2005 13 517 473 euro +5.81%
2006 14 424 044 euro +6.71%
2007 15 369 389 euro +6.55%
Source NIHDI: OW 2008/54, November 2008
2.5.3.3 Subsidy for costs relative to the use of a computer software
Since 2006, a yearly financing of € 350 per nurse was introduced for costs relative to
the use of a certified computer software. From 2008, the subsidy is € 800 per nurse.
The introduction of the VINCA standard, which is an experiment in 2008-2009 will
allow easier control of care provision in the future , because for every visit by a home
nurse, the patient’s identity will be checked electronically using the SIS-card or the E-ID
card.