Quelles solutions pour la garde en médecine générale? - KCE

56
Table 13 : GP ffees
(€ by hour) in the UK (2006)
GP pay rates
per hour
Average rate
Maximum
Minimum
Source: The Natiional
audit Office, TThe
provision of Afte er-hours Care in Enggland.
6.1.1.4. Fra
A report 105 co
organization an
organized by
“Permanence d
be € 370 Million
No further info
official GP fee
“Ameli” 106 ance
ommissioned by
nd future of after-h
the French GP
des soins ambulat
n in 2006 (excludi
ormation on fees
s displayed in th
(“Asssurance-Maladie
e
There is a diffeerence
between t
from the Frencch
health care ins
the visit for an
elderly patient
supplement is reimbursed ; the
not reimbursed.
Table 14: GP feees
in France 106
y the Ministry of o Heath preseents
the
hours care in Fra ance. After-hours services
Ps are official since s 2003 and named
toires”. Their glob bal cost was estimmated
to
ng costs of transp port).
per hour could be obtained, exccept
the
he table below, found f on the weebsite
of
en ligne”).
the official tariffs and the reimburssements
surance. For the justified home vissits
(like
t or someone who w can not movve),
the
supplement for the t not justified vvisits
are
GP consult
Home visit
Weekday Weekkday
Week-end
evening overnnight
67 844
80
124 1332
163
47 222
57
Supplement for juustified
home visit : 220
PM to 0 AM and 6 AM to 8 AM
Supplement for juustified
home visit : 0 AM to 6 AM
Supplement for juustified
home visit Suunday
and Public Ho oliday
Supplement for noot
justified home visit
: 20 PM to 0 AM and a 6 AM to 8 AM
Supplement for noot
justified home visit
: 0 AM to 6 AM
Week-end
overnight
92
163
22
Supplement for noot
justified home visit
Sunday and Public c Holiday*
Affter-Hours
Primaary
Care
Public
holidays
119
191
57
GP fees
( (2011, in
23
23
38.5
43.5
22.6
35
40
19.06
A supplement is aalso
applicable foor
the consultatioons
of the GP onn
duty
dduring
week-ends and public holidaays.
66.1.1.5.
Switzeerland
A recent cost desscription
study co
bbased
on the perspective
of the S
( payers). The coonclusions
point
immportant
determinant
of the costs
ccontacts,
the mean
total cost
HHowever,
costs a
ppractice
contact a
mmode
of contact,
ccontacts
(25%) an
OOne
interesting r
International
Class
the
cost pattern. T
trriage:
the patient
GGP
on duty and a
hhigh
proportion of
ppatients
who are d
TThe
authors conc
aafter-hours
service
66.1.2.
Discussi
TThe
after-hours
ccommon
patterns.
FFirst,
the cost is l
rreferral
to the mos
SSecond,
putting t
immplies
a release
aamount
spent by
aafter-hours
service
a onducted in Zuric
Swiss health care
out that the mo
s
for on
are respectively €
and telephone co
is also the most
nd telephone conta
result is that the
sification of Prima
This finding shows
ts who call the em
an ambulance is s
f home visits is ex
dissatisfied when t
clude that GPs m
e with little diagno
ion
systems differ b
ower in countries
st appropriate solu
the reform of aft
of financial mean
three countries
es gives informat
101 . Based on a
ne patient contact
€ 158, € 90 and
ontact. Home visi
common (61%),
acts (14%).
medical problem
ary Care - has no
s the importance o
mergency aid serv
sent in case of se
xplained by the u
they receive telep
manage most em
ostic testing b ch (data from 20009)
is
insurance comppanies
ode of contact is an
sample of 685 patient
t is estimated at € 144.
d € 48 for home visit,
t, the most expeensive
compared to praactice
m – according too
the
o relevant influencce
on
of the quality of thhe
GP
vice are connectedd
to a
erious emergencyy.
The
usual preference oof
the
phone advice onlyy.
mergency demands
in
and bbasic
care.
between the fivee
countries but show
s with a unique ccall
number, triagee
and
ution (including phhone
consultation) ).
ter-hours care onn
the political aggenda
s to implement thhe
services. The gglobal
(The Netherlandss,
UK and France)
on
tion on the cost pper
inhabitant. It vvaries
a
b
KCE Reportss
171
Total cost: basic
cost + individuual
cost. Basic costt
: charges for timee
units
and emergeency
surcharge. IIndividual
cost: ccounseling,
travellinng
(if
applicable), ddiagnostic,
treatmennt
procedures.
Diagnostics : laboratory tests, X-ray,
ECG, Ultrasouund,
Other diagnostics