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Ben RHM II - LZG.NRW

Ben RHM II - LZG.NRW

Benchmarking Regional Health Management II (Ben RHM II) ___________________________________________________________________________________________________________________________________________________________________ 5.2.2 Belgium (Flemish Community) Which institutions/organisations have the main responsibility for health management at the local, regional and national level? � The Flemish Community is responsible for the prevention in general and the organisa- tion of breast cancer screening in particular. � The federal government is responsible for organising and financing care, and for fi- nancing the mammographys for screening. Which further institutions/organisations are involved and how do they relate to each other? � The five centres for screening are responsible for inviting the women from the target group, the second readings of the mammographies, the quality assurance of the mam- mographic entities and the follow up of women with abnormal screening results. They also form a consortium which is responsible for the registration of all data of the screening programme. � The mammografic entities are radiologists or radiological services which are recog- nised by the Flemish Community. They perform the mammographies and the first reading of these. � The ‘Logo’s’ are a network of locoregional organisations active in prevention that cover the whole Flemish region. They work together with the centres for screening in sensibilisation of the target group at a local level, in order to increase participation. � Also GPs and gynaecologists can recruit women for screening. They are also responsible for follow up of the women with abnormal screening results. � A Flemish Working Group on Breast Cancer screening, involving all actors mentioned above, as well as the mutualities and the Flemish League against Cancer, acts as an advisory organ for the Flemish administration and minister on this matter of breast cancer screening. � The database used to invite women is a database from the federal health insurance institute. - 130 -

Benchmarking Regional Health Management II (Ben RHM II) ___________________________________________________________________________________________________________________________________________________________________ Which laws regulate health management? � Decree of 21 November 2003 concerning preventive health care. � Decision of the Flemish Government of 2 February 2001 concerning the recognition of mammographic entities and regional screening centres for breast cancer screening, adapted on 28 May 2004. � Ministerial decision of 7 March 2001 ratifying the guidelines, cited in article 16, 1° en 3°, of the decision of the Flemish Government of 2 February 2001 concerning the rec- ognition of mammographic entities and regional screening centres for breast cancer screening. Who is responsible for the surveillance and how is it conducted? The Flemish administration of Health Care is responsible for the surveillance of the pro- gramme. This is performed using the evaluation of the data set delivered by the centres, through the consortium. The European guidelines for quality assurance in mammography screening are followed as much as possible. The quality control of the mammographic entities is done by the screening centres on the basis of registration of data and evaluation of the screening mammographies. In future, the screening centres themselves will be evaluated by an independent international organisation (e.g. the European reference centre EUREF in Nijmegen, the Netherlands). At the same time, the data development in the Flemish Cancer Registration Network is followed up. The Federal government has commissioned the Scientific Institute for Public Health to evaluate the programme for breast cancer screening in the different communities. Do registries exist? If so, how do they work? For the purpose of the breast cancer screening, the Flemish administration of Health Care selects the women in the target population from the general population database; this selected data set is then provided to the screening centres. The process of screening and follow up in case of an abnormal screening result is registered for each woman, as well as the data of the next screenings. The screening centres register this through web-based application (Heracles), which is managed by the consortium. The data are delivered to the Flemish administration of Health Care after coding by the consortium. In future, these coded data will be linked to the data in the cancer register. - 131 -

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Part II
IB417 - IIS RU