Belgium: Geographic variations in health care

Abstract

This chapter looks at variations in medical practice across provinces in Belgium, for hospital medical admissions and a number of diagnostic and surgical procedures, drawing on data from 2009. While variations across provinces are relatively small for hospital admissions and some surgical procedures such as caesarean sections, variations are larger in the use of diagnostic procedures such as knee arthroscopy, cardiac catheterisation, MRI exams and CT exams. In the case of MRI and CT exams, there is strong evidence of a substitution effect in the use of these two diagnostic exams. Furthermore, differences in utilisation rates are due at least partly to a greater number of MRI units in the Flemish provinces. A strategy involving co-operation with stakeholders was developed to reduce exposure to ionising radiation from imaging tests by 25%. Persisting geographic variations in medical practice in Belgium requires a variety of strategies and approaches to engage governments, providers and patients in continuously improving health service delivery.