Quelles solutions pour la garde en médecine générale? - KCE

KCE Reports 1771
between € 14 inn
the Netherlandss,
€ 7 in UK and € 6 in France. Thiss
statistic
is dependent onn
the sum allocateed
by the country to implement afteer-
hours
services.
Third, the available
data from ddifferent
countries s (Switzerland, Denmark,
Belgium) illustrrate
that the modde
of contact gre eatly influence the
costs:
home visits aree
more expensivee
than consultatio ons. Phone advicce
is the
least expensivee
.
Last but not leaast,
the report froom
the National Audit A Office indicaates
that
rurality is an immportant
cost drivver
and that the organization/financing
of
ODCs need to be tailored to thee
type of area. Th his result is interesting
for
the Belgian conntext
characterizedd
by urban and “e experimental” postts.
6.2. Organized
duty centre
The initiative financed
by the N
Insurance (NIHDI)
is extensively
6.2.1. Budgeet
allocated to th
Since 2003, thhe
subventions a
maximum available
budget of €
2008 (20 ODCs)
estimated at € 1
• € 3.6 Millio
• € 3.7 Millio
• € 3 Million
The global budg
• A budget
inscribed
•
implementa
A percenta
National C
Million and
Recent NIHDI e
107 es in Belgium
National Institute for Health and DDisability
described in chap pter 2.4.
he organized duty
centres
allocated by the NIHDI increased from a
1.232 Million (2 ODCs) to € 4.2 MMillion
in
.The last figgures
released by y the NIHDI for 22011
are
10.3 Million for 299
ODCs :
on for the experimeental
ODCs,
on for the urban ODCs,
for the extension of the project.
get is a mix of 2 eelements:
:
approved for thee
ODCs within th he experimental projects
in article 56 (budget release ed by NIHDI for the
ation of pilot projeects),
age of the annuual
GP budget proposed yearly by the
Commission of GPP’s
and Sickness Funds. (article 556:
€ 7.3
GP budget : € 3 Million).
estimations for 2012
are € 11 Million
for 30 ODCs.
Affter-Hours
Primaary
Care
66.2.2.
Financinng
Process
66.2.2.1.
Principple
In
2010, the Natioonal
Commission oof
GP’s and Sicknness
Funds put ann
end
too
this experimenttal
project. From tthat
moment, a paart
of the GP budget
is
aallocated
yearly too
the ODCs, nextt
to the financial mmeans
from articlle
56.
WWith
this new meeasure,
the budgget
increased fromm
€ 6 Million to € 10
MMillion.
AAt
the beginning, the budget was aallocated
for a peeriod
of three yeaars.
In
22011,
this period wwas
reduced to six
months, exceptt
for the new initiaatives
wwhich
can count on a two yearss
budget. The exxisting
ODCs havve
to
inntroduce
a renewwal,
examined bby
the Health care
Department oof
the
NNIHDI
and approvved
by the Members
of the Insurrance
Committee.
The
yyear
2011 markss
a new impulsion
in this projeect
with an expected
immplication
of the National Commiission
of GP’s annd
Sickness Funnds.
It
eexplains
why the budget for existing
project was reeduced
to six moonths.
FFor
2012, the periood
applicable to thhe
contracts is still
unknown.
66.2.2.2.
Budgeet
of an ODC
In
order to beneefit
from a finanncing,
each ODCC
has to introduuce
a
mmotivated
requestt
with information on its activities (mmentioning
the opening
aand
closing hours)
and a detaiiled
financial repport.
This requeest
is
eexamined
by the Health care Deppartment
of the NIHDI which cann
ask
ccomplementary
innformation.
Each project is presennted
for approbatiion
to
the
Members of thhe
Insurance Commmittee.
AAt
the beginning oof
the project, thee
budget was alloocated
for three yyears.
DDuring
the year 22011,
the existingg
projects could ccount
on a six months
bbudget
with renewwals
and the neww
ODCs received a first financing pperiod
oof
two years.
66.2.2.3.
Calcullation
of the globbal
budget allocaated
to organizeed
duty ccentres
by the Naational
Institute for Health and
Disability
Insurance
TThe
financial meaans
allocated each
year to this prooject
are based oon
the
laast
budget approoved
by the Meembers
of Insuraance
Committee. It is
inncreased
by the estimation of thee
financial means coming from diffferent
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