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

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.

Meaning in life: An important factor for the psychological well-being of chronically ill patients?

“…The RIZIV follows the guidelines of the World Health Organization and describes chronic diseases as diseases of long duration, namely longer than 6 months, and with a slow progression. Most frequent chronic diseases in Belgium are low back pain, arthritis, neck pain, and chronic headaches (Paulus, Van Den Heede, & Mertens, 2012). Because of privacy reasons, researchers were not allowed to have access to diagnosis information.…”

Care Coordination of Multimorbidity: A Scoping Study

“…In relation to the former, the relative structural differentiation of healthcare systems plays a significant role as they have become more complex with the emergence of new sub-disciplines and the availability of new treatments [ 5 , 20 , 50 ]. Organizing care delivery for patients with multimorbidity requires connections among different healthcare services [ 22 , 38 , 44 , 45 , 53 ]. This applies particularly to the coordination between the primary care sector and the secondary hospital sector [ 4 ].…”

Implementing an electronic medication overview in Belgium

“…In accordance with previously published international research [ 6 , 11 ], the Belgian healthcare knowledge center stresses the importance of patient involvement to establish a better communication between healthcare practitioners [ 12 ]. In the research of Blenkinsopp et al patient involvement was also highlighted as they investigated (and confirmed) the use of paper notification cards, distributed by patients to their general practitioner and pharmacists, as a tool to improve communication [ 13 ].…”