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The 2016 proposal for the reorganisation of urgent care provision in Belgium: A political struggle to co-locate primary care providers and emergency departments

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  • Van den Heede, Koen
  • Quentin, Wilm
  • Dubois, Cécile
  • Devriese, Stephan
  • Van de Voorde, Carine

Abstract

Internationally the number of emergency department (ED) visits is on the rise while evidence suggests that a substantial proportion of these patients do not require emergency care but primary care. This paper presents the Belgian 2016 proposal for the reorganisation of urgent care provision and places it into its political context. The proposal focused on re-designing patient flow aiming to reduce inappropriate ED visits by improving guidance of patients through the system. Initially policymakers envisaged, as cornerstone of the reform, to roll-out as standard model the co-location of primary care centres and EDs. Yet, this was substantially toned down in the final policy decisions mainly because GPs strongly opposed this model (because of increased workload and loss of autonomy, hospital-centrism, etc.). In fact, the final compromise assures a great degree of autonomy for GPs in organising out-of-hours care. Therefore, improvements will depend on future developments in the field and continuous monitoring of (un-)intended effects is certainly indicated. This policy process makes clear how important it is to involve all relevant stakeholders as early as possible in the development of a reform proposal to take into account their concerns, to illustrate the benefits of the reform and ultimately to gain buy-in for the reform.

Suggested Citation

  • Van den Heede, Koen & Quentin, Wilm & Dubois, Cécile & Devriese, Stephan & Van de Voorde, Carine, 2017. "The 2016 proposal for the reorganisation of urgent care provision in Belgium: A political struggle to co-locate primary care providers and emergency departments," Health Policy, Elsevier, vol. 121(4), pages 339-345.
  • Handle: RePEc:eee:hepoli:v:121:y:2017:i:4:p:339-345
    DOI: 10.1016/j.healthpol.2017.02.006
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    References listed on IDEAS

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    1. Pieter Van Herck & Lieven Annemans & Walter Sermeus & Dirk Ramaekers, 2013. "Evidence-Based Health Care Policy in Reimbursement Decisions: Lessons from a Series of Six Equivocal Case-Studies," PLOS ONE, Public Library of Science, vol. 8(10), pages 1-10, October.
    2. Akhalaia N. & Vasadze M., 2016. "New trends in Hospitality Industry and Georgia," Advances in Management and Applied Economics, SCIENPRESS Ltd, vol. 6(6), pages 1-6.
    3. Caroline Berchet, 2015. "Emergency Care Services: Trends, Drivers and Interventions to Manage the Demand," OECD Health Working Papers 83, OECD Publishing.
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    Cited by:

    1. Baier, Natalie & Geissler, Alexander & Bech, Mickael & Bernstein, David & Cowling, Thomas E. & Jackson, Terri & van Manen, Johan & Rudkjøbing, Andreas & Quentin, Wilm, 2019. "Emergency and urgent care systems in Australia, Denmark, England, France, Germany and the Netherlands – Analyzing organization, payment and reforms," Health Policy, Elsevier, vol. 123(1), pages 1-10.
    2. Polin, Katherine & Hjortland, Maximilien & Maresso, Anna & van Ginneken, Ewout & Busse, Reinhard & Quentin, Wilm, 2021. "“Top-Three” health reforms in 31 high-income countries in 2018 and 2019: an expert informed overview," Health Policy, Elsevier, vol. 125(7), pages 815-832.
    3. Daniel Aiham Ghazali & Arnaud Richard & Arnaud Chaudet & Christophe Choquet & Maximilien Guericolas & Enrique Casalino, 2019. "Profile and Motivation of Patients Consulting in Emergency Departments While not Requiring Such a Level of Care," IJERPH, MDPI, vol. 16(22), pages 1-18, November.

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