Laasman, 1993, “Dépenses de santé: une analyse empirique des déséquilibres régionaux”, Cahiers Economiques de Bruxelles, Brussels.
Prepared by J. Levy.
See OECD (1992) for a detailed description of the structure of the health care system in Belgium. Part of the material in this note draws from this publication.
If an agreement is rejected by more than 40 percent of practitioners, the government can intervene and impose fees for some or all of the services.
One exception to the general decrease in the number of beds was the region of Brussels, where for a variety of reasons new university hospitals were built.
To date reimbursements are actually based on “inferred” DRG, i.e., actual medical acts (detailed on insurance claims) are matched to the most likely DRG, with final payment set according with the latter.
These guidelines will not be mandatory procedures (e.g., somewhat like the French “références médicales opposables”).
Enforcement of some measures taken in the past has been difficult--in particular in the case of laboratories. In many instances parties have ended up in courts. The government has attempted to strengthen the institutional bodies representing professional groups as a way to reduce such conflicts.
Until fuller integration of data systems yields more detailed information the government is using econometric models (Laasman, 1993 provides an illustration of this class of models). The most important variables considered in these models are the mortality and disability rates, age and sex distributions, and the unemployment rate.