Development of a national position paper for chronic care: Example of Belgium

• Published in: Health policy (Amsterdam) Vol. 111; no. 2; pp. 105 - 109
• Main Authors: Paulus, Dominique, Van den Heede, Koen, Gerkens, Sophie, Desomer, Anja, Mertens, Raf
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ireland Ltd 01.07.2013; Elsevier
• Subjects: Belgians; Belgium; Biological and medical sciences; Cancer; Caregivers; Carers; Chronic disease; Chronic Disease - therapy; Chronically ill; Consensus; Dementia; Diseases; Health administration; Health care; Health care reform; Health management; Health Policy; Humans; Interdisciplinary team work; Internal Medicine; Investments; Long-term care; Management; Medical sciences; Medical service; Miscellaneous; Organisation and administration; Patients; Payment; Payments; Policy Making; Public health. Hygiene; Public health. Hygiene-occupational medicine; Quality of care; Reform; Reforms; Western countries; Belgium; Europe; Organisation and administration; Chronic disease; Long-term care; Health care reform; Chronic; Position; Political aspect; Paper; Reform; Public health; Care; Long term care
• ISSN: 0168-8510; 1872-6054
• DOI: 10.1016/j.healthpol.2013.04.010

Abstract The management of chronic diseases is a prime challenge of most 21st century health care systems. Many Western countries have invested heavily in care plans oriented towards specific conditions and diseases, such as dementia and cancer. The major downside of this narrowly focused approach is that treatment of multimorbidity is ignored. This paper describes the development and main stance of a national position that proposes streamlined reforms of the Belgian health care system to improve care for patients with multiple chronic diseases. We used a combination of methods to develop this stance: literature review and stakeholders’ consultation. The latter identified areas for improvement: efficiency of the health care system, coordination of care, investments in human care resources, informal caregivers’ support, better accessibility, and changes in the financial payment system. The position paper list 20 recommendations that are translated into about 50 action points to reform the health care system. Chronic care tailored to the patient's needs, including implementation of multidisciplinary teamwork, new functions, task delegation in primary care, and empowerment of the patient and informal caregivers are some major areas discussed. In addition, improved support, revised payment mechanisms, and setting up a quality system, along with the tailoring of patient care, can all facilitate delivery of high quality care in patients with chronic comorbidities.