Proposition de modernisation de la tarification des actes d'anesthésiologie réalisés au bloc opératoire en Belgique

A reform of the Belgian nomenclature for medical procedures is desirable. This will have to be based on sufficiently transparent criteria accepted by the majority of doctors. Our study, even though addressing one field only (anaesthesiology), shows that inspiration can be found in foreign examples likely to encourage discussion and promote the implementation of useful simulations. In the light of recent developments, it seems that the Belgian political authorities and professional organisations have perhaps become aware of the need to seek, in a concerted manner, the methodological foundations that will allow in-depth restructuring of the classification and pricing of medical acts. Using a representative sample of anaesthesiology procedures carried out in the operating facilities of 13 hospitals (representing ± 10% of the national costs reimbursed in anaesthesiology), it has been possible to calculate a score for each procedure selected, based on one objective parameter (the duration of the anaesthesia), and one more subjective factor (the inherent difficulty of the act of anaesthesia), estimated by a consensus of experts. The experts also had to choose and justify the importance to be given to each of these two parameters (duration and difficulty).