Dominique Paulus Luc Seuntjens

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Dominique Paulus Luc Seuntjens
Belgian
health system
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• Welcome in Belgium
• Health organisation and actors
• Contacts with the GP Health interview survey
• Quality activities in family practice
• Are the patients happy ?

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Welcome in Belgium
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• Population 10.263.414 inhabitants (315/km²,
  2001)
• 32.545 km2 (max 280 kms between 2 points)
• King Albert II
• National languages Dutch, French and German
• Estimated NBP 270 milliards
• Working population 
• Agriculture 73000
• Industry 1 075 000
• Services 2 950 000
• Peak le Signal de Botrange (694 m)
• Mean temperature 11º Celsius (2000)

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Gilles de Binche
La blouse et la pantalon Les deux éléments sont
faits de toile de jute où on a cousu des motifs
de lions et des bandes noires, rouges et jaunes.
Les côtés de la blouse et du pantalon ont
plusieurs mètres de ruban froncé comme la
collerette posant sur les épaules du Gille. De
150 à 200m de ruban sont nécessaires pour leur
confection. La blouse du Gille a été modifiée
plusieurs fois, principalement au 19 siècle.
Les sabots Le sabot est creusé soit dans le
peuplier, soit dans le saule par des machines
dans les Ardennes. Il ne reste plus quà lui
donner sa couleur et il passera 7 à 8 heures dans
un fumoir. A lavant, on cloue le ruban plissé et
on ajoute une talonnette en demi-cercle et une
bride.
                                                
                                       
Illustrations fournies par l'office de tourisme
de Binche Consultez le site Binche.com
Retour               
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2. Health organisation and actors
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Sickness funds INAMI - RIZIV

• Roles
• National health insurance system (covers all
  medical fees)
• Sickness indemnity
• Central control caregivers, patients eligible
  for indemnities, health insurers
• Concertation between the different health actors
• Annual budget 15 000 000 euros

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Health insurances

• Between the INAMI/RIZIV and the patient
• reimbursement, documents core services for all
  patients
• Optional complementary insurance
  hospitalisation, health assistance
  abroad,children holidays
• Information and help social and law support

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Official Caregivers (INAMI/RIZIV status)

• Physicians (42 000)
• 22 000 non specialists, whose 14 000  GPs 
• 20 000 specialists
• Chemists (11 000)
• Dentists (8600)
• Nurses (60 200)
• Midwives (5 000)
• Physiotherapists (28000)

• Speech therapists
• Bandagists
• Opticians
• Dieticians
• Audicians
• chiropodists

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Hospitals
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3. Contacts with the GP

• Health interview survey

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General practice in Belgium

• Fee-for-service system
• /- 75 solo practices, 15 duo and 5 group
  practices (mainly in big cities, 10)
• 94 of the population have a regular GP
• Mean 6.5 contacts per year
• 1/3 home visits (inversely proportional to SES)
• No SES barrier similar pattern between SES
  groups (low SES patients consult even more,
  although poor health status)

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80 of the population had at least one contact
during the last year

• 45 illness or symptom
• lt 15 years respiratory (gt50)
• 15- 64 years osteoarticular (gt 20) and
  respiratory (gt 20)
• gt 64 years cardiovascular (gt 40)
• 6 accident
• 38 control and prevention
• 8 prescription
• 3 others

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Half of the population took a medicine
(prescription) during the last 15 days

• lt 15 years cough, cold, sore throat
• Men 15-64 years cardiovascular (hypertension),
  analgesic
• Women 15-64 years contraception and substitution
  hormonal therapy
• gt 64 years analgesics and sleeping drugs

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4. Main quality initiativesin family practice
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4. Main quality initiativesin family practice

• Peer review circles
• Guidelines
• Scientific societies for GP
• Ministry of PH antibiotics
• Feedbacks about prescriptions
• Antibiotics
• Hypertension

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5. Are the patients happy ?(at least as happy
as NHS patients ? )
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Patient satisfaction ?

• Health interview survey five items from the
  Europep questionnaire
• Listening to the patient (communication)
• Rapid treatment of symptoms (care)
• Patient information
• Information about referral (continuity)
• Waiting time (accessibility)
• General practice specialist
• AND

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Do not forget to taste

• Before going back,

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 French  fries ?

• Coming from regions near the Meuse fried chips
  replaced by fried fishes (small sticks) when the
  river froze
• 1861 Mr FRITS sold this product
• World war American soldiers tasted it with
  French-speaking Belgian soldiers

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But also

• Beers
• Speculoos
• Chocolates
• Caricoles
• Mussels
• Chicons
• Babelutten
• Waterzooi

• Eel in chervil
• Rabbit with beer
• Couques de Dinant
• Beers

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Thanks
for
your attention