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See detailGeriatric day hospital: opportunity or threat? A qualitative exploratory study of the referral behaviour of Belgian general practitioners.
Vanden Bussche, Piet; Desmyter, Fien; Duchesnes, Christiane ULg et al

in BMC Health Services Research (2010), 10

BACKGROUND: In order to address the challenges of an ageing population the Belgian government decided to allocate resources to the creation of geriatric day hospitals (GDHs). Although GDHs are meant to be ... [more ▼]

BACKGROUND: In order to address the challenges of an ageing population the Belgian government decided to allocate resources to the creation of geriatric day hospitals (GDHs). Although GDHs are meant to be a strategy to support general practitioners (GPs) caring for the frail elderly, few Belgian GPs seem to refer to a GDH. This study aims to explore the barriers and facilitating factors of GPs' referral to GDHs. METHODS: A qualitative study using focus group discussions (FGDs) was conducted. Fifteen FGDs were organized in the different Belgian regions (Flanders, Wallonia, Brussels). RESULTS: Contextual factors such as the unsatisfactory cooperation between hospital and GPs and organizational barriers such as the lack of communication on referral procedures between hospital and primary health care (PHC) were identified. Lack of basic knowledge about the concept or the local organization of GDH seemed to be a problem. Unclear task descriptions, responsibilities and activities of a GDH formed prominent points of discussion in all FGDs. Nevertheless a lot of possible advantages and disadvantages of GDHs for the patient and for the GP were mentioned. CONCLUSIONS: In the case of poor referral to GDHs, focusing on improving overall collaboration between primary and secondary health care is essential. This can be achieved by actively delivering adequate information, permanent communication and more involvement of PHC in the organization and functioning of GDHs. The absence of a transparent health care system with delineated role definitions, seems to hinder the integration of new initiatives like GDHs in the care process. Strategies to enhance referral to GDHs should use a comprehensive approach. [less ▲]

Detailed reference viewed: 53 (19 ULg)
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 ▲]

Detailed reference viewed: 124 (16 ULg)