Quelles solutions pour la garde en médecine générale? - KCE

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4 Affter-Hours Primaary Care KCE Reportss 171 5.5.2. Immpact of the new models on GPs, ppatients and HC ssystem use .......... ............................ .... 51 5.5.3. SSuggestions to impprove organizationn of after-hours caare ...................... ............................ .... 52 6. ECONOMIC ANALYSIS: DDATA FROM BELGIUM AND OTHEER COUNTRIES ............................ .... 53 6. 1. FINANCINNG OF AFTER-HOOURS CARE IN OOTHER COUNTRRIES ..................... ............................ .... 53 6.1.1. Innformation on cossts of after-hours ccare ..................... ............................ ............................ .... 54 6.1.2. DDiscussion ............ ............................ ............................ ............................ ............................ .... 56 6. 2. ORGANIZZED DUTY CENTRRES IN BELGIUMM .......................... ............................ ............................ .... 57 6.2.1. BBudget allocated too the organized duty centres .......... ............................ ............................ .... 57 6.2.2. FFinancing Processs ........................... ............................ ............................ ............................ .... 57 6.2.3. EEconomic descripttion ...................... ............................ ............................ ............................ .... 58 6.2.4. EExpenses and reveenues of the ODCCs ......................... ............................ ............................ .... 58 6.2.5. AActivities of the ODDCs ..................... ............................ ............................ ............................ .... 59 6. 3. UNIQUE CCALL NUMBER WWITH TRIAGE (PRROJECT “1733”) . ............................ ............................ .... 63 6.3.1. BBudget 2011 and pplanning budget 22012 to cover the ccountry ............... ............................ .... 63 6.3.2. AActivities of the 1733 ....................... ............................ ............................ ............................ .... 63 6. 4. DISCUSSION ..................... ............................ ............................ ............................ ............................ .... 64 6.4.1. WWhat we have learrnt from the Belgiaan experiences .... ............................ ............................ .... 64 6.4.2. LLimitations of the OODC description .. ............................ ............................ ............................ .... 65 6.4.3. WWays for the futuree .......................... ............................ ............................ ............................ .... 65 7. CONCLUSSION .................... ............................ ............................ ............................ ............................ .... 66 8. APPENDICES .................... ............................ ............................ ............................ ............................ .... 67 8. 1. RESEARCCH ON AFTER-HOOURS IN BELGIUUM ....................... ............................ ............................ .... 67 8.1.1. WWho consult the GGP or emergency ddepartments durinng after-hours perriods?................... .... 67 8.1.2. EEvaluation tools foor activities during after-hours periodds ....................... ............................ .... 68 8.1.3. SStudy about security of self-employeed professionals .. ............................ ............................ .... 69 8.1.4. SState and prospects of general pracctice organization in the province off Luxembourg ...... .... 69 8.1.5. WWork during “deepp nights” ............... ............................ ............................ ............................ .... 69 8.1.6. PPerceptions of GPs of after-hours wwork ...................... ............................ ............................ .... 70 8.1.7. SSearch for optimal solutions in two pprovinces (Instituuut voor Mobiliteit) ............................ .... 71 8.1.8. SSummary of the reesearch findings .. ............................ ............................ ............................ .... 71
KCE Reports 171 Affter-Hours Primaary Care 8. 2. APPENDICCES: STATEMENNTS OF PROFESSSIONAL ASSOCIATIONS ............. ............................ .... 72 8.2.1. SSynthesis note of tthe working groupp “after-hours” (Feederal GP Circles Council) .............. .... 72 8.2.2. SStatements from aassociations of youung general practtitioners (Jong Domus and SSM-J) . .... 73 8.2.3. AAfter-hours care: oon the agenda of tthe unions ............ ............................ ............................ .... 75 8.2.4. AAfter-hours in geneeral practice : alsoo an issue in the ssurroundings of Brussels ................ .... 76 8.2.5. SSummary: statemeents of the associaations .................. ............................ ............................ .... 76 8. 3. APPENDICCES: CASE REPORTS OF BELGIAN INITIATIVES . ............................ ............................ .... 76 8.3.1. SSOS Médecins ..... ............................ ............................ ............................ ............................ .... 76 8.3.2. UUnique call numbeer and organized DDuty Centre in Chharleroi ................ ............................ .... 78 8.3.3. OODC post Meuse eet Samson .......... ............................ ............................ ............................ .... 83 8.3.4. OODC post Deurne . ............................ ............................ ............................ ............................ .... 86 8.3.5. OODC Oudenaarde: future integrationn of an ODC in thee hospital ............ ............................ .... 88 8.3.6. AAgreement with loccal emergency deepartments: the caase of Gouvy ....... ............................ .... 89 8.3.7. PPilot projects 17333 ........................... ............................ ............................ ............................ .... 90 8. 4. APPENDICCES: MODELS INN FIVE OTHER CCOUNTRIES: DETTAILS BY COUNTTRY ...................... .... 96 8.4.1. AAfter-hours care inn The Netherlandss ........................... ............................ ............................ .... 96 8.4.2. AAfter-hours care inn The United Kingddom ..................... ............................ ............................ .. 104 8.4.3. AAfter-hours care inn Denmark ........... ............................ ............................ ............................ .. 115 8.4.4. AAfter-hours care inn France .............. ............................ ............................ ............................ .. 120 8.4.5. AAfter-hours care inn Italy ................... ............................ ............................ ............................ .. 125 8.4.6. Illustration of an indicator in different countries ........... ............................ ............................ .. 128 8. 5. APPENDICCES : BELGIAN LLEGISLATION .... ............................ ............................ ............................ .. 128 8.5.1. MMethodology ......... ............................ ............................ ............................ ............................ .. 128 8.5.2. DDescription of the ccurrent legislationn ........................... ............................ ............................ .. 128 8.5.3. FFour alternative sccenarios for after-hhours care : legal considerations ... ............................ .. 154 8.5.4. SScenario 1: Projecct 1733 ................. ............................ ............................ ............................ .. 155 8.5.5. SScenario 2: referennce to a close hosspital during the deep nights .......... ............................ .. 163 8.5.6. SScenario 3: Phonee consultation ...... ............................ ............................ ............................ .. 167 8.5.7. SScenario 4: Consuultation by specificcally trained nursees ......................... ............................ .. 172 8. 6. APPENDICCES: DATA ANALLYSIS ................. ............................ ............................ ............................ .. 174 5
Page 1 and 2: KCE REPORTS 2011 171B QUELLLES SOOL
Page 3: Contrôle Direction Contact Comm mi
Page 6 and 7: COLOPHOON Titre : Auteurs : Experts
Page 9 and 10: KCE Reports 1771B PRÉFFACE Il y a
Page 11 and 12: KCE Reports 1771B Obstacles liéés
Page 13 and 14: KCE Reports 1771B Autres alternnati
Page 15 and 16: KCE Reports 1771B Garddes en médec
Page 17 and 18: KCE Reports 1771B SYNTTHÈSE Garde
Page 19 and 20: KCE Reports 1771B 1.3.2. Chargees d
Page 21 and 22: KCE Reports 1771B La plupart des é
Page 23 and 24: KCE Reports 1771B n'est pas le cass
Page 25 and 26: KCE Reports 1771B PROCESSUS PROCÉD
Page 27 and 28: KCE Reports 1771 SCIENTIFIC RREPOR
Page 29: KCE Reports 171 Affter-Hours Primaa
Page 33 and 34: KCE Reports 1771 LIST OF FFIGURES L
Page 35 and 36: KCE Reports 1771 LIST OF AABBREVIAT
Page 37 and 38: KCE Reports 1771 Affter-Hours Prima
Page 39 and 40: KCE Reports 1771 1.1.3. Initial The
Page 41 and 42: KCE Reports 1771 below. 15 The eeva
Page 43 and 44: KCE Reports 1771 2.6. Uniquee call
Page 45 and 46: KCE Reports 1771 • Advising thhe
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Page 49 and 50: KCE Reports 1771 • The GP By join
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Page 53 and 54: KCE Reports 1771 contacts and too s
Page 55 and 56: KCE Reports 1771 Table 3: Numbber o
Page 57 and 58: KCE Reports 1771 4.2.2.3. Limmitati
Page 59 and 60: KCE Reports 1771 When looking at ag
Page 61 and 62: KCE Reports 1771 4.3.2. Type of are
Page 63 and 64: KCE Reports 1771 1.a.Use oof search
Page 65 and 66: KCE Reports 1771 • perceived work
Page 67 and 68: KCE Reports 1771 Continuity of c as
Page 69 and 70: KCE Reports 1771 • The safetyy of
Page 71 and 72: KCE Reports 1771 5.4.4. Financial i
Page 73 and 74: KCE Reports 1771 the ambulance serv
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Page 77 and 78: KCE Reports 1771 the patient’s ne
Page 79 and 80: KCE Reports 1771 • To assesss the
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KCE Reports 1771 6.1.1.1. Thee Neth
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KCE Reports 1771 between € 14 inn
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KCE Reports 1771 Table 16 : Disstri
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KCE Reports 1771 The NIHDI tablees
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KCE Reports 1771 Some demograaphic
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KCE Reports 1771 In the same wway,
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KCE Reports 1771 8. APPEENDICES 8.1
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KCE Reports 1771 • A logistic o c
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KCE Reports 1771 • The after-hhou
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KCE Reports 1771 o Decreaase of GP
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KCE Reports 1771 o en terrme de san
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KCE Reports 1771 Place, Populattion
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KCE Reports 1771 • Eviter les pat
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KCE Reports 1771 Nombre de vissites
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KCE Reports 1771 • Prévoir dees
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KCE Reports 1771 appelss, délais e
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KCE Reports 1771 8.3.4.4. Othhers T
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KCE Reports 1771 • One difficuult
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KCE Reports 1771 personnes (réggio
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KCE Reports 1771 • Réponse à un
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KCE Reports 1771 overchargee of som
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KCE Reports 1771 Items System refor
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KCE Reports 1771 Items Who does the
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KCE Reports 1771 8.4.1.1. Weebsites
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KCE Reports 1771 study of twwo inte
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KCE Reports 1771 Items Main drivers
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KCE Reports 1771 Items Affter-Hours
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KCE Reports 1771 Items Critical suc
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KCE Reports 1771 Items Suggestions
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KCE Reports 1771 10. Dale J, Croouc
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KCE Reports 1771 8.4.3. After-hhour
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KCE Reports 1771 Items Number of ac
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KCE Reports 1771 8.4.5. After-hhour
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KCE Reports 1771 INAMI/RIZIV/NIHDI
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KCE Reports 1771 o Avec l Il y a de
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KCE Reports 1771 compléter les sse
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KCE Reports 1771 des accords de soi
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KCE Reports 1771 qui seerait de gar
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KCE Reports 1771 8.5.2.2. Norrmes e
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KCE Reports 1771 • Les norme Deux
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KCE Reports 1771 S’il ne particip
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KCE Reports 1771 Des deux dispoosit
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KCE Reports 1771 L’article 9, §
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KCE Reports 1771 o En ou grave. A c
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KCE Reports 1771 L’on envisage s
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KCE Reports 1771 Si le conseil nnat
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KCE Reports 1771 Affter-Hours Prima
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KCE Reports 1771 patiënten. Zoa hi
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KCE Reports 1771 o De aaangestelde
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KCE Reports 1771 De standaardlijs b
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KCE Reports 1771 de 1733-centrrales
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KCE Reports 1771 worden in een ziek
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KCE Reports 1771 waarvan de veerant
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KCE Reports 1771 Affter-Hours Prima
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KCE Reports 1771 De arts die dooor
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KCE Reports 1771 rétablissemment d
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KCE Reports 1771 peuplée et une zo
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KCE Reports 1771 Code de nomenclatu
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KCE Reports 1771 8.6.3.2. Nummber o
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KCE Reports 1771 Number of outt-of-
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KCE Reports 1771 8.7. Appenddices:
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KCE Reports 1771 8.7.2.2. Thirrd ye
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KCE Reports 1771 9. REFEERENCES 1.
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KCE Reports 1771 38. Pickin DMM, O'
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KCE Reports 1771 79. Thompsoon F, G
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KCE Reports 1771 121. Arrêté roya
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KCE Reports 1771 Tijdschrifft van d
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