AB380         THE IMPLEMENTATION AND EVALUATION OF THE SYSTEM OF THE THIRD PARTY PAYMENT IN PRIMARY HEALTH CARE IN THE CITY OF GHENT

Author(s): 
De Maeseneer J, Willems S, De Roo L
Ghent University, GHENT, BELGIUM
Text: 
Background:
In the fee-for-service system in Belgium, the patients are reimbursed for the fee paid to the doctor from their health insurance company except for the 33% cost-share. Further reimbursement system of the health insurance companies has changed from a direct payment at the office-desk to a monthly bank transfer on the account of the patient. As a result more patients are unable to pay the fee for the general practitioner.
Aim: To improve the accessibility of the primary health care in the city of Ghent by implementing and improving the system of the third party payment in primary health care (ie. that the GP sends the bill directly to the insurance company).
Methods: Based on focus group interviews and multidisciplinary meetings with GPs and collaborators of the mean health insurance companies, a procedure to implement the system of the third party payment was designed and executed. A quantitative analysis of the implementation was done by analysing the data files of the insurance companies. Finally limiting and enabling factors to use this system were identified using focus group interviews with participating and non-participating GPs.
Results: Four groups of factors were identified as being limiting or enabling to use the system of third party payment nl. administrative, ethical, financial and practical factors. The system is, 6 months after the introduction, used by 13% of the GPs in Ghent representing 60% of the GPs in the most deprived areas.
Conclusions:
Based on this result the system is permanently adjusted and more GPs engage themselves to use the system. Further research on the impact of this system on the use of primary care and emergency services will be carried out. Results of this research will be also available at the conference.