References of "Heyrman, Jan"
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See detailAdvantages, disadvantages and feasibility of Pay-for-Quality programs in Belgium
Van Herck, Pieter; Sermeus, Walter; Annemans, Lieven et al

in BMC Health Services Research (2010, October), 10

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See detailAvantages, désavantages et faisabilité de l’introduction de programmes “P4Q” en Belgique
Annemans, Lieven; Boeckxstaens, Pauline; Borgermans, Liesbeth et al

Report (2009)

This study is a logical follow up of previous KCE reports about quality of care, namely report 41 about clinical quality indicators in hospitals and report 76 about quality promotion in general practice ... [more ▼]

This study is a logical follow up of previous KCE reports about quality of care, namely report 41 about clinical quality indicators in hospitals and report 76 about quality promotion in general practice. Pay for Performance (P4P) or Pay for Quality initiatives (P4Q), who concentrate exclusively on the quality constituent of performance, establishes a direct correlation between the payment and the outcomes, assessed by structure, process and\or outcome indicators). P4Q initiative arouses an increasing interest, abroad as in our own country. However, the future Belgian initiatives will be able to reach their objective if they are based on what can be learned from experiences led abroad and on a theoretical frame fitting to the Belgian context. Accordingly, the present report will answer the following research questions: 1. What can be learned from the international P4Q models about: • Assessment: what are the benefits and the unintended consequences of the P4Q programs? • The concept and the implementation: which theoretical framework can be applied to the Belgian health care system; how should be conceived the financial incentives; what are the determining success factors? 2. What are the essential conditions required to apply the international P4Q models or add a P4Q constituent to the Belgian quality experiences? • What are the current initiatives in Belgium? Are there proofs of their impact on quality of care? • To what extent are financial planning, databases and other current tools (recommendations of good practice, quality indicators) adequate to implement a P4Q program in the Belgian context of health care? What are the determining factors for success or failure in the implementation of these programs? [less ▲]

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See detailObjective: remission of depression in primary care The Oreon Study.
Ansseau, Marc ULg; Demyttenaere, Koen; Heyrman, Jan et al

in European Neuropsychopharmacology (2009), 19(3), 169-76

OBJECTIVE: Treatment of depression should result in the absence of symptoms, i.e. remission, in order to restore the functional status of the patient and reduce the risk for relapse. The study assessed ... [more ▼]

OBJECTIVE: Treatment of depression should result in the absence of symptoms, i.e. remission, in order to restore the functional status of the patient and reduce the risk for relapse. The study assessed the current remission rates in primary care and determined the influencing factors. METHODS: 10 consecutive depressive patients treated by antidepressants for at least 3 months and not more than 12 months were screened by each investigator. Remission rates were defined using the Hamilton-Depression scale 7 items (score of 3 or less) as well as the Carroll self rating scale (score of 7 or less). In addition, patients completed the Sheehan Disability Scale (SDS). Initial severity of depression, type of treatment and socio-economic factors were collected. RESULTS: 292 general practitioners screened a total of 2630 patients. Results indicated low remission rates: 28.3% according to the clinician and 17.1% according to the patient. Absence of remission was associated with higher impairment in work, social and family life. The most frequently reported residual symptoms in nonremitters were general somatic symptoms (92%), depressed mood (92%), psychic anxiety (91%) and impaired work and activities (89%). No differences were observed in remission rates between men and women. Remission rates were significantly lower in patients living alone as compared to those living in couple or family (25.1% vs 30.2%, p=0.03), in patients with lower education (21.3% vs 32.3%, p<0.001), in patients speaking French as compared to Dutch (24.0% vs 34.0% p<0.001), and unemployed patients compared to patients having an occupation (17.1% vs 39.0%, p<0.001). Higher initial severity and number of previous episodes decreased remission rates (p<0.001). CONCLUSION: This study shows low remission rates in depressed patients treated in general practice. The absence of remission is associated with impairment in work, social and family life. Special attention should be given to identify patients who do not reach remission. [less ▲]

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