Original Paper: Home visits in Belgium: a multivariate analysis

Abstract

Background: In Belgium 46% of the GP-patient encounters are home visits. This is the highest percentage in the world. Objective: To analyse ‘system characteristics’ and ‘patient characteristics’ that may contribute to the explanation of the proportion of home visits. Methods: Historical trend analysis and multivariate analysis of healthcare utilisation data. We analysed the change over time of the proportion of home visits in relation to the increase in the number of GPs and the increase of the co-payment in the fee-for-service system. Moreover, a random sample of members of the two largest health insurance companies in two major regions (Aalst and Liège) were interviewed on morbidity, socio-economical data, attitudes and functional status. We used a multivariate linear regression analysis with the percentage of home visits (recorded during two years) as the dependent variable and data from the interview as explaining variables. Results: Historical trend analysis showed almost no change over time of the percentage of home visits. The most important patient characteristics in relation to the percentage of home visits were age, sex, morbidity and region. Conclusion: Patient characteristics only partially explain the percentage of home visits. The Belgian ‘world record’ is probably related to characteristics of the healthcare system: fee-for-service, absence of patient list system and gate keeping.