Model for the organization and reimbursement of psychological and orthopedagogical care in Belgium : Summary

38 p.ill.,FOREWORD 1 -- KEY MESSAGES 2 -- OVERVIEW. 4 -- 1. WHY THIS STUDY? 6 -- 1.1. PSYCHOLOGICAL SUFFERING, AN IMPORTANT PROBLEM 6 -- 1.2. A SUBSTANTIAL SOCIAL IMPACT 6 -- 1.3. PSYCHOLOGICAL CARE MUST BE ENHANCED 6 -- 1.4. TOWARD A NEW MODEL FOR THE ORGANISATION AND FINANCING OF PSYCHOLOGICAL -- CARE. 7 -- 2. WHAT IS THE CURRENT SITUATION IN BELGIUM? 9 -- 2.1. CURRENT ORGANISATION OF THE PSYCHOLOGICAL CARE OFFER 9 -- 2.1.1. A first level with direct access: 9 -- 2.1.2. A second level of specialised ambulatory care: 10 -- 2.1.3. A third, more hospital-orientated level: . 10 -- 2.2. THE MOST IMPORTANT IDENTIFIED PROBLEMS . 11 -- 2.2.1. The first contact is difficult. 11 -- 2.2.2. The offer is not transparent enough and offers inadequate guarantees 11 -- 2.2.3. High costs for the patient 11 -- 2.2.4. Long waiting lists 12 -- 2.2.5. Care continuity is not guaranteed . 12 -- 3. ACCESS TO PSYCHOLOGICAL CARE IN OTHER COUNTRIES12 -- 3.1. DIRECT ACCESS TO PSYCHOLOGICAL CARE 13 -- 3.2. ACCESS CONDITIONS FOR SPECIALISED PSYCHOLOGICAL CARE 13 -- 3.2.1. Gatekeeping 13 -- 3.2.2. Indications . 13 -- 3.2.3. Therapeutic methods 13 -- 3.2.4. Number of sessions 14 -- 4. PILOT PROJECTS FOR THE FIRST-LINE PSYCHOLOGICAL FUNCTION IN -- FLANDERS15 -- 4.1. OBJECTIVES 15 -- 4.2. ORGANIZATIONAL ASPECTS 15 -- 4.3. MAJOR RESULTS 15 -- 5. APPROACHES TO THE ORGANISATION OF PSYCHOLOGICAL CARE 16 -- 5.1. A PSYCHOLOGICAL CARE SYSTEM WITH TWO LEVELS.16 -- 5.2. PARTIES INVOLVED: EACH LEVEL HAS ITS CHARACTERISTICS 18 -- 5.2.1. First line: parties with complementary competences 18 -- 5.2.2. Specialised care: authorised and accredited professionals 20 -- 5.3. CARE OFFER: STEPPED CARE AND THERAPEUTIC FREEDOM, BUT LIMITED NUMBER OF -- SESSIONS 21 -- 5.3.1. Stepped Care 21 -- 5.3.2. Types of intervention. 21 -- 5.3.3. No restrictive lists of indications 21 -- 5.3.4. No limitation on the type of treatment 22 -- 5.3.5. Not exclusively face-to-face consultations 22 -- 5.3.6. Limitation of the number of reimbursed sessions .23 -- 5.4. ACCESS: FREE IN FIRST LINE, UNDER CONDITIONS FOR SPECIALISED CARE 24 -- 5.4.1. First line: multiple gateways 24 -- 5.4.2. Specialised care: multidisciplinary gatekeeping 24 -- 5.5. ACTIVE INTEGRATION INTO THE EXISTING NETWORK 25 -- 5.6. LOCATION: VERY FLEXIBLE ACCOMMODATION 26 -- 5.6.1. Regarding the first line of care: . 26 -- 5.6.2. Regarding specialised (ambulatory) care: 26 -- 5.7. QUALITY OF CARE 26 -- 5.8. MIXED FINANCING 27 -- 5.8.1. Financing possibilities for the professionals involved 27 -- 5.8.2. Proposals of the KCE for a mixed model 30 -- 5.8.3. Out-of-pocket payment of the patient 31 -- RECOMMENDATIONS 32 -- REFERENCES 3