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Organisation of paediatric hospital care in Belgium: current situation and options for reform / Mélanie Lefevre / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2022)
Organisation of paediatric hospital care in Belgium: current situation and options for reform ; - Short report [printed text] / Mélanie Lefevre , Author ; Nicolas Bouckaert, Author ; Jens Detollenaere , Author ; Joan Vlayen , Author ; Llenalia García Fernández, Author ; Hilde Pincé, Author ; Koen Van Den Heede , Author ; Renate Zeevaert, Author ; Carine Van de Voorde, Author . - Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre, 2022 . - 81 : ill., ; A4. - (KCE Reports. Health Services Research (HSR); 358CS) .
ISSN : D/2022/10.273/47 : € 0,00
Languages : English (eng)
Descriptors: Indexation
2019-50-02 ; Child, Hospitalized ; Continuity of Patient Care ; Health Care Reform ; Home Care Services, Hospital-Based ; Hospital Bed Capacity ; R358
Classification
WX 100 Hospitals and Other Health Facilities -- General worksContents note: FOREWORD 1 -- SHORT REPORT 2 -- 1. INTRODUCTION 5 -- 1.1. THE CHANGING ROLE OF HOSPITAL CARE FOR CHILDREN 5 -- 1.2. OBJECTIVE AND SCOPE OF THE REPORT 6 -- 1.3. METHODS 7 -- 2. CURRENT ORGANISATION AND ACTIVITY PROFILE OF PAEDIATRIC SERVICES IN BELGIAN -- HOSPITALS 8 -- 2.1. THE LEGAL FRAMEWORK OF PAEDIATRIC HOSPITAL CARE 8 -- 2.1.1. Paediatric service 8 -- 2.1.2. Care programme for children 9 -- 2.2. CURRENT LANDSCAPE OF PAEDIATRIC SERVICES IN BELGIAN HOSPITALS 10 -- 2.3. ACTIVITY PROFILE OF HOSPITAL SERVICES PROVIDING CARE FOR CHILDREN 11 -- 2.3.1. Regional differences in activity profile 12 -- 2.3.2. Age and clinical profile of patients 13 -- 2.3.3. Length of stay and readmissions 14 -- 3. HOW DO HOSPITALS RESPOND TO VARIABILITY IN BED DEMAND? 16 -- 3.1. NUMBER OF HOSPITAL BEDS OCCUPIED BY CHILDREN AT THE NATIONAL LEVEL 18 -- 3.2. BED OCCUPANCY RATE AT THE HOSPITAL SITE LEVEL 19 -- 3.3. CHALLENGES OF AND SOLUTIONS FOR SEASONAL PRESSURES ON HOSPITAL RESOURCES 21 -- 3.3.1. Shortage of beds and nursing staff are the main culprits 21 -- 3.3.2. How do hospitals deal with seasonal peaks in hospital admissions? 22 -- 3.3.3. Which policy measures could help hospitals to deal with seasonal peaks? 22 -- 3.4. OPPORTUNITIES AND LIMITS OF HOSPITAL NETWORKS FOR MANAGING SEASONAL DEMAND PRESSURES 25 -- 3.4.1. The introduction of loco-regional networks to get competing hospitals to collaborate 25 -- 3.4.2. Mixed picture among hospitals of the potential impact of hospital networks 25 -- 3.4.3. Collaboration within and between networks to absorb peaks in bed demand 26 -- 4. TRANSMURAL CARE FOR CHILDREN: LESSONS FROM INTERNATIONAL EXPERIENCE 28 -- 4.1.1. A shift from pilot projects for adults to everyday practice for adults and children 28 -- 4.1.2. A broad range of programmes and structures to provide transmural care for children 29 -- 4.1.3. Key features of a paediatric transmural care episode 30 -- 4.1.4. Range of services provided in transmural care programmes 32 -- 4.1.5. Range of clinical conditions treated in transmural care programmes 33 -- 4.1.6. Exclusion criteria for providing transmural paediatric care 34 -- 4.1.7. Workforce requirements 34 -- 4.1.8. Funding systems for transmural paediatric care 36 -- 4.1.9. Public reporting of quality indicators and financial incentives to promote the quality of care 39 -- 5. EFFECTIVENESS AND SAFETY OF HOME-BASED CARE FOR CHILDREN 40 -- 6. TRANSMURAL CARE FOR CHILDREN IN BELGIUM 42 -- 6.1. TRANSMURAL CARE PROVIDED AND SUPPORTED BY THE PAEDIATRIC LIAISON TEAMS 42 -- 6.1.1. How does a paediatric liaison team work? 42 -- 6.1.2. Licensing standards define staff numbers and qualifications 43 -- 6.1.3. Profile of children cared for by the paediatric liaison teams 44 -- 6.1.4. Paediatric liaison teams provide a broad range of support and care 44 -- 6.1.5. Obstacles in daily practice and barriers to growth 47 -- 6.2. THE VIEWS OF BELGIAN STAKEHOLDERS ON THE (FURTHER) DEVELOPMENT OF TRANSMURAL CARE FOR CHILDREN 48 -- 6.2.1. General opinions and attitudes towards transmural paediatric care 48 -- 6.2.2. Preconditions for a further development of transmural care for children in Belgium 50 -- 6.2.3. Key lessons on the organisation of transmural care from pilot projects in Belgium 53 -- 6.2.4. Preconditions for the design and evaluation of pilot projects 55 -- 7. KEY ELEMENTS FOR A NEW BALANCE BETWEEN CURRENT AND NEW MODELS OF CARE FOR CHILDREN IN BELGIUM 56 -- 7.1. NUMBER AND SIZE OF PAEDIATRIC SERVICES 57 -- 7.2. LEVELS OF PAEDIATRIC HOSPITAL CARE 57 -- 7.3. MANAGEMENT OF SEASONAL PEAKS AT THE LEVEL OF THE LOCO-REGIONAL NETWORKS 58 -- 7.4. WHY SHOULD WE (OR NOT) DEVELOP TRANSMURAL CARE FOR CHILDREN IN BELGIUM? 59 -- 7.5. TOO MANY UNANSWERED QUESTIONS TO CHOOSE BETWEEN TRANSMURAL CARE MODELS 59 -- RECOMMENDATIONS 61 -- REFERENCES 66 Link for e-copy: http://doi.org/10.57598/R358CS Format of e-copy: PDF (2,6 MB) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=4857 Organisation des soins hospitaliers pédiatriques en Belgique : situation actuelle et possibilités de réforme / Mélanie Lefevre / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2022)
Organisation des soins hospitaliers pédiatriques en Belgique : situation actuelle et possibilités de réforme : Synthèse [printed text] / Mélanie Lefevre , Author ; Nicolas Bouckaert, Author ; Jens Detollenaere , Author ; Joan Vlayen , Author ; Llenalia García Fernández, Author ; Hilde Pincé, Author ; Koen Van Den Heede , Author ; Renate Zeevaert, Author ; Carine Van de Voorde, Author . - Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre, 2022 . - 52 p. : ill., ; A4. - (KCE Reports B. Health Services Research (HSR); 358BS) .
€ 0,00
Languages : French (fre)
Descriptors: Indexation
2019-50-02 ; Child, Hospitalized ; Continuity of Patient Care ; Health Care Reform ; Home Care Services, Hospital-Based ; Hospital Bed Capacity ; R358
Classification
WX 100 Hospitals and Other Health Facilities -- General worksAbstract: La place d’un enfant malade est-elle vraiment à l’hôpital ? D’autres pays que le nôtre ont mis en place des soins pédiatriques « transmuraux », qui permettent de prendre en charge à domicile des enfants qui auraient normalement été traités à l’hôpital. Il a été demandé au Centre fédéral d’Expertise des Soins de Santé (KCE) d’analyser la manière dont la pédiatrie est organisée et financée au sein des hôpitaux belges et d’examiner dans quelle mesure et selon quelles modalités les soins transmuraux pourraient – en partie – éviter des séjours à l’hôpital ou les raccourcir. Contents note: PRÉFACE 1 -- MESSAGES CLÉS 2 -- SYNTHÈSE 5 -- 1. INTRODUCTION 7 -- 1.1. VERS DE NOUVEAUX MODELES DE SOINS EN PEDIATRIE ? 7 -- 1.2. À PROPOS DE CETTE ETUDE DU KCE : OBJECTIFS ET METHODES 8 -- 2. LES SOINS HOSPITALIERS PÉDIATRIQUES EN BELGIQUE 10 -- 2.1. LE PROGRAMME DE SOINS POUR ENFANTS – CADRE LEGISLATIF 10 -- 2.2. DE NOMBREUX SERVICES, LA PLUPART DE PETITE TAILLE 11 -- 2.3. PROFIL D’ACTIVITE DES SERVICES DE PEDIATRIE 12 -- 2.3.1. L’hôpital de jour 12 -- 2.3.2. Hospitalisations classiques avec séjour 12 -- 2.3.3. Taux d’occupation national – d’importantes variations saisonnières 13 -- 2.3.4. Taux d’occupation local – d’importantes variations d’un hôpital à l’autre 13 -- 2.4. GERER LES PICS SAISONNIERS 15 -- 2.4.1. Un manque de lits, d’infirmiers et parfois de pédiatres 15 -- 2.4.2. Comment les hôpitaux gèrent les pics 15 -- 2.4.3. Mesures politiques possibles pour une meilleure gestion des pics saisonniers 16 -- 2.4.4. Quel rôle pour les réseaux hospitaliers ? 16 -- 3. LES SOINS PÉDIATRIQUES TRANSMURAUX 19 -- 3.1. LES SOINS TRANSMURAUX (POUR ENFANTS) EN BELGIQUE 19 -- 3.1.1. Les équipes de liaison pédiatriques 19 -- 3.1.2. Projets pilotes d’hospitalisation à domicile chez l’adulte 20 -- 3.1.3. Onco@Home 21 -- 3.2. QUELQUES EXEMPLES EN FRANCE, AUX PAYS-BAS ET EN AUSTRALIE 21 -- 3.2.1. Beaucoup de points communs… 21 -- 3.2.2. … mais aussi des différences majeures 22 -- 3.3. LES SOINS TRANSMURAUX POUR ENFANTS SONT-ILS SURS ET EFFICACES ? QUE DIT LA LITTERATURE ? 27 -- 3.4. LEÇONS TIREES DES MODELES INTERNATIONAUX ET NATIONAUX, DES INTERVIEWS AVEC LES ACTEURS CONCERNES ET DE LA LITTERATURE SCIENTIFIQUE 27 -- 3.4.1. Soins pédiatriques transmuraux : pour qui, dans quels contextes et avec quels effets ? 28 -- 3.4.2. Points d’attention pour le déploiement plus large des soins pédiatriques transmuraux 29 -- 3.4.3. Conditions pour la mise en place et l’évaluation de projets pilotes 32 -- 4. CLÉS POUR UN NOUVEL ÉQUILIBRE ENTRE SOINS PÉDIATRIQUES À L’HOSPITAL ET À DOMICILE 34 -- 4.1. OPTIMISER L’ORGANISATION DES SERVICES DE PEDIATRIE 34 -- 4.1.1. Nombre et taille des services de pédiatrie 34 -- 4.1.2. Niveaux de soins hospitaliers pédiatriques 34 -- 4.1.3. Gestion des pics saisonniers 35 -- 4.2. DEVELOPPER LES SOINS TRANSMURAUX POUR ENFANTS EN BELGIQUE 36 -- 4.2.1. Les soins transmuraux peuvent permettre d’éviter que des enfants ne restent (trop) longtemps à l’hôpital, mais ils ne conviennent pas pour tous les patients 36 -- 4.2.2. Les hôpitaux sont divisés sur la question des soins transmuraux pour enfants 36 -- 4.2.3. Trop de questions sans réponse pour privilégier un modèle spécifique 36 -- RECOMMANDATIONS 39 -- RÉFÉRENCES 44 Link for e-copy: http://doi.org/10.57598/R358BS Format of e-copy: PDF (2 MB) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=4859 Relationship between volume and quality of health care / York [U.K.] : The University of York (1995)
Relationship between volume and quality of health care : a review of the literature [printed text] . - York [U.K.] : The University of York, 1995 . - 34 p.. - (CRD report; 2) .
£ 5,00
Languages : English (eng)
Descriptors: Classification
W 84 Health services. Quality of health care (General)
Indexation
Health Facility Size ; Hospital Bed Capacity ; Outcome Assessment (Health Care)Abstract: Authors' objectives To review the evidence for a relationship between the volume of activity of a hospital and patient outcomes in a range of procedures and to examine in detail this relationship for coronary artery bypass surgery.
Type of intervention Organisation, management
Study design Systematic review
Sources searched The electronic databases MEDLINE and the Science Citation Index were searched.
Was any cost information reported? No cost information is provided in this report.
Authors' conclusions The validity of some of the research findings of a positive relationship between volume and outcome of care is suspect because of problems of adjusting for patient-mix. In addition there is a paucity of information as to why high volume might be associated with better outcomes. Policy makers should be cautious when invoking the assumed improvements in outcome by volume as a key argument in the centralisation of services.Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=850 Hold
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Barcode Call number Media type Location Section Status 10273-00959 W 84/REL Report KCE Library (10.124) Available Readers who borrowed this document also borrowed:
SAS survival analysis techniques for medical research Cantor, Alan Hospital volume, physician volume, and patient outcomes Luft, Harold S. Missing data Allison, Paul David Interrupted Time Series Analysis McDowall, David Models for discrete data Zelterman, Daniel Survival Analysis Using SAS Allison, Paul David Categorical data analysis Agresti, Alan Sampling Thompson, Steven K. A visual guide to stata graphics Mitchel, Michael N. Cochrane Handbook for Systematic Reviews of Interventions Higgins, Julian PT Werken aan kwaliteit Bouckaert, G. Required hospital capacity in 2025 and criteria for rationalisation of complex cancer surgery, radiotherapy and maternity services / Carine Van de Voorde / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2017)
Required hospital capacity in 2025 and criteria for rationalisation of complex cancer surgery, radiotherapy and maternity services [printed text] / Carine Van de Voorde, Author ; Koen Van Den Heede , Author ; Claire Beguin, Author ; Nicolas Bouckaert, Author ; Cécile Camberlin , Author ; Piet De Bekker, Author ; Noémie Defourny, Author ; Harlinde De Schutter, Author ; Carl Devos , Author ; Sophie Gerkens , Author ; Patrick Jeurissen, Author ; Florien Margareth Kruse, Author ; Mélanie Lefevre , Author ; Yolande Lievens, Author ; Patriek Mistiaen , Author ; Aude Vaandering, Author ; E. Van Eycken, Author ; Ewout van Ginneken, Author . - Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre, 2017 . - 544 p. : ill., ; A4. - (KCE Reports. Health Services Research (HSR); 289C) .
ISSN : D/2017/10.273/45 : € 0,00
Languages : English (eng)
Descriptors: Indexation
2015-11 ; Health Care Reform ; Hospital Bed Capacity ; Hospital Planning ; R289
Classification
WX 100 Hospitals and Other Health Facilities -- General worksContents note: SCIENTIFIC REPORT 33 -- INTRODUCTION AND BACKGROUND 33 -- 1 PROJECTED FUTURE TRENDS OF HOSPITAL USE IN BELGIUM 35 -- 1.1 INTRODUCTION 35 -- 1.2 TREND ANALYSIS 36 -- 1.3 DATA 37 -- 1.3.1 Population data 37 -- 1.3.2 Hospital data 39 -- 1.4 EVALUATION OF THE REPORT CANNOODT 40 -- 1.4.1 Projection model 41 -- 1.4.2 Comments on the research methodology 45 -- 1.4.3 Evaluation of the projection outcomes 46 -- 1.5 PROJECTION MODEL DEVELOPED FOR THE CURRENT STUDY 59 -- 1.5.1 Defining scope and concepts 61 -- 1.5.2 Rationale for statistical trend analysis 68 -- 1.5.3 Statistical trend model 70 -- 1.5.4 Projection outcomes 78 -- 1.6 INTRODUCTION RESULTS 80 -- 1.7 BASELINE FORECAST RESULTS OF THE PROJECTION MODEL 81 -- 1.7.1 Future need for hospital inpatient care 81 -- 1.7.2 Future need for hospital day care 104 -- 1.7.3 Capacity requirements for isolated categorical hospitals and foreign patients 112 -- 1.7.4 Summary of baseline forecast results 116 -- 1.8 PROJECTION RESULTS SCENARIO WITH ACCELERATED SUBSTITUTION TO DAY CARE 124 -- 1.8.1 Methodology 125 -- 1.8.2 Results 130 -- 1.9 PROJECTION RESULTS SCENARIO WITH ACCELERATED POPULATION AGEING 135 -- 1.9.1 Methodology 135 -- 1.9.2 Results 137 -- 2 HOSPITAL USE BY PATIENTS WITH DEMENTIA 145 -- 2.1 BACKGROUND AND AIM OF THE STUDY 145 -- 2.2 METHOD 147 -- 2.2.1 Literature review 147 -- 2.2.2 Analysis of Belgian hospital registry data 148 -- 2.3 RESULTS ON EPIDEMIOLOGICAL DATA 150 -- 2.3.1 Incidence/prevalence of dementia 150 -- 2.3.2 Hospital use by dementia patients 154 -- 2.4 RESULTS ON INTERVENTIONS TO REDUCE HOSPITAL USE BY DEMENTIA PATIENTS 162 -- 2.4.1 Strategies outside the hospital with an impact on hospital use 162 -- 2.4.2 Strategies in the hospital 164 -- 2.4.3 Strategies with regard to fall prevention 166 -- 2.5 DISCUSSION AND CONCLUSION 166 -- 3 ENGLAND 169 -- 3.1 BACKGROUND 169 -- 3.1.1 Country context 169 -- 3.1.2 Hospital classification 170 -- 3.1.3 Hospital capacity and use 170 -- 3.1.4 English hospitals underwent several changes in service reconfiguration 171 -- 3.1.5 Financial sustainability NHS hospitals 172 -- 3.2 PROXIMITY SERVICES AND SMALL HOSPITALS 172 -- 3.3 CONCENTRATION OF SPECIALISED SERVICES 175 -- 3.3.1 Specialised services are commissioned by NHS England 175 -- 3.4 THE ROLE OF ACUTE CARE HOSPITALS IN INTEGRATED CARE 179 -- 3.5 COLLABORATION FORMS BETWEEN HOSPITALS 179 -- 3.5.1 Mergers: the dominant form of structural collaboration form between English hospitals 179 -- 3.5.2 Collaborative organisation forms 182 -- 3.5.3 Contractual collaboration forms 183 -- 3.5.4 Consolidated collaboration forms 185 -- 3.5.5 Adopt collaboration forms that suit local circumstances 186 -- 3.6 VISION ON THE FUTURE 188 -- 3.6.1 Five Year Forward View 188 -- 3.6.2 From vision towards implementation 190 -- 3.6.3 The envisaged benefits of the reforms plans are overestimated 191 -- 4 FRANCE 193 -- 4.1 BACKGROUND 193 -- 4.1.1 Healthcare regionalisation 193 -- 4.1.2 Health areas 196 -- 4.1.3 Hospital and medical equipment planning 198 -- 4.1.4 Hospital landscape and trends 203 -- 4.2 CONCENTRATION OF COMPLEX SERVICES 206 -- 4.3 SPECIALISATION 209 -- 4.4 PROXIMITY SERVICES AND SMALL HOSPITALS 210 -- 4.5 INTEGRATION OF SERVICES 213 -- 4.6 COLLABORATION FORMS BETWEEN HOSPITALS 215 -- 4.6.1 Hospitals groups 215 -- 4.6.2 Networks 216 -- 4.7 VISION ON THE FUTURE 219 -- 5 THE NETHERLANDS 220 -- 5.1 INTRODUCTION 220 -- 5.2 HOSPITALS IN THE NETHERLANDS 221 -- 5.2.1 The Dutch healthcare system 221 -- 5.2.2 Market reform’ of the healthcare sector 224 -- 5.2.3 Hospital classification, levels and types 226 -- 5.2.4 Hospital capacity: centralised planning and decentralised influences 230 -- 5.3 CONCENTRATION OF SPECIALISED AND HIGHLY SPECIALISED SERVICES 233 -- 5.3.1 Introduction 233 -- 5.3.2 Organisation: dispersion and concentration 233 -- 5.3.3 Planning of specific procedures 234 -- 5.3.4 Contracting specialised services 235 -- 5.4 DISTRIBUTION OF SERVICES 236 -- 5.4.1 Shifts in provision 236 -- 5.5 EFFORTS TO INTEGRATE CARE 237 -- 5.6 CONCLUSIONS AND FUTURE CHALLENGES. 238 -- 5.6.1 Conclusions 238 -- 5.6.2 Future challenges 239 -- 6 COMPLEX SURGERY FOR CANCER OF THE PANCREAS, OESOPHAGUS AND LUNG 240 -- 6.1 INTRODUCTION 240 -- 6.1.1 Background 240 -- 6.1.2 Organisation of care for adults with rare and complex cancers in reference centres 241 -- 6.1.3 Rare and complex cancers: definition and incidence in Belgium 242 -- 6.1.4 Study objectives and research questions 242 -- 6.1.5 Data sources and methods 243 -- 6.2 BRIEF VIEW ON THE ORGANISATION OF ONCOLOGICAL CARE IN BELGIUM AND IN A SELECTION OF COUNTRIES 245 -- 6.2.1 Introduction 245 -- 6.2.2 Belgium 245 -- 6.2.3 France 245 -- 6.2.4 England 252 -- 6.2.5 The Netherlands 254 -- 6.2.6 Denmark 256 -- 6.2.7 A focus on implementation modalities of reference centres or specialised services. 258 -- 6.3 CANCER OF THE PANCREAS 259 -- 6.3.1 Description of the pathology 259 -- 6.3.2 Burden of pancreatic cancer in Belgium 260 -- 6.3.3 Current practice in Belgium 263 -- 6.3.4 International standards for pancreatic resections 269 -- 6.3.5 What is the required number of reference centres in Belgium in 2017? 272 -- 6.3.6 What is the future number of reference centres required (horizon 2025)? 278 -- 6.4 OESOPHAGEAL CANCER 280 -- 6.4.1 Description of the pathology 280 -- 6.4.2 Burden of oesophageal cancer in Belgium 281 -- 6.4.3 Current practice in Belgium 282 -- 6.4.4 International standards for oesophageal resections 289 -- 6.4.5 What is the required number of reference centres in 2017? 292 -- 6.4.6 What is the future number of required reference centres (horizon 2025)? 297 -- 6.5 LUNG CANCER 298 -- 6.5.1 Description of the pathology 298 -- 6.5.2 Burden of lung cancer in Belgium 300 -- 6.5.3 Current practice in Belgium 303 -- 6.5.4 International standards for lung resections 306 -- 6.5.5 What is the required number of reference centres in 2017? 309 -- 6.5.6 What is the future number of required reference centres (horizon 2025)? 314 -- 7 RADIOTHERAPY SERVICES 316 -- 7.1 INTRODUCTION 316 -- 7.2 AVAILABILITY – CURRENT SITUATION IN BELGIUM 317 -- 7.2.1 Programming and licensing rules for radiotherapy departments 317 -- 7.2.2 Current legislation concerning reimbursement 319 -- 7.2.3 Radiotherapy infrastructure in Belgium 319 -- 7.2.4 Activity profile of radiotherapy centres and satellites 329 -- 7.3 NEEDS – CURRENT AND FUTURE SITUATION IN BELGIUM 333 -- 7.3.1 Introduction 333 -- 7.3.2 Methodology 334 -- 7.3.3 Results 356 -- 7.4 HOW ARE RADIOTHERAPY SERVICES ORGANISED IN A SELECTION OF COUNTRIES? 367 -- 7.4.1 Introduction 367 -- 7.4.2 England 372 -- 7.4.3 France 373 -- 7.4.4 Ireland 375 -- 7.4.5 The Netherlands 376 -- 7.4.6 Denmark 378 -- 7.4.7 Summary and conclusion 379 -- 8 MATERNITY SERVICES 379 -- 8.1 INTRODUCTION 379 -- 8.2 ORGANISATION OF MATERNITY SERVICES IN BELGIUM 380 -- 8.2.1 Current organisation and legislation 380 -- 8.2.2 Maternity services activity profile 390 -- 8.2.3 Geographic distribution 410 -- 8.3 ESTIMATION OF (FUTURE) NEEDS 417 -- 8.3.1 Current situation 417 -- 8.3.2 Baseline forecast 417 -- 8.3.3 Alternative scenario 420 -- 8.3.4 Update of programming criteria 424 -- 8.4 ORGANISATION OF MATERNITY SERVICES IN A SELECTION OF COUNTRIES 425 -- 8.4.1 International overview 425 -- 8.4.2 France 430 -- 8.4.3 England 436 -- 8.4.4 Sweden 441 -- 8.5 CRITERIA FOR CONCENTRATION OF CARE 445 -- 8.5.1 Introduction 445 -- 8.5.2 Costs savings 445 -- 8.5.3 Occupancy rate 448 -- 8.5.4 Volume and outcome 448 -- 8.5.5 Access / Distance 449 -- DISCUSSION AND CONCLUSION 450 -- APPENDICES 451 -- REFERENCES 503 Link for e-copy: https://doi.org/10.57598/R289C Format of e-copy: PDF (26 Mb) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=4191 Required hospital capacity in 2025 and criteria for rationalisation of complex cancer surgery, radiotherapy and maternity services / Carine Van de Voorde / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2017)
Required hospital capacity in 2025 and criteria for rationalisation of complex cancer surgery, radiotherapy and maternity services : Short Report [printed text] / Carine Van de Voorde, Author ; Koen Van Den Heede , Author ; Claire Beguin, Author ; Nicolas Bouckaert, Author ; Cécile Camberlin , Author ; Piet De Bekker, Author ; Noémie Defourny, Author ; Harlinde De Schutter, Author ; Carl Devos , Author ; Sophie Gerkens , Author ; Patrick Jeurissen, Author ; Florien Margareth Kruse, Author ; Mélanie Lefevre , Author ; Yolande Lievens, Author ; Patriek Mistiaen , Author ; Aude Vaandering, Author ; E. Van Eycken, Author ; Ewout van Ginneken, Author . - Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre, 2017 . - 103 p. : ill., ; A4. - (KCE Reports. Health Services Research (HSR); 289CS) .
ISSN : D/2017/10.273/44 : € 0,00
Languages : English (eng)
Descriptors: Indexation
2015-11 ; Health Care Reform ; Hospital Bed Capacity ; Hospital Planning ; R289
Classification
WX 100 Hospitals and Other Health Facilities -- General worksContents note: FOREWORD 1 -- SHORT REPORT 2 -- 1. BACKGROUND 7 -- 1.1. DIAGNOSIS OF THE BELGIAN HEALTHCARE LANDSCAPE 7 -- 1.2. REDESIGN OF SERVICE DELIVERY 8 -- 1.3. OBJECTIVE OF THE REPORT: HOSPITAL CAPACITY PLANNING 10 -- 1.4. METHODS 10 -- 2. HOSPITAL CAPACITY PLANNING WITH HORIZON 2025 10 -- 2.1. RATIONALE BEHIND HOSPITAL CAPACITY PLANNING 10 -- 2.2. DESIGN OF A TREND ANALYSIS MODEL 12 -- 2.2.1. Trend analysis method 12 -- 2.2.2. Selection of stays 13 -- 2.2.3. What data are used? 13 -- 2.2.4. The importance of sociodemographic characteristics and pathology groups in capacity planning 14 -- 2.2.5. Model specification 15 -- 2.3. HOW MANY HOSPITAL BEDS ARE NEEDED IN 2025? BASELINE MODEL 16 -- 2.3.1. Almost 12% increase in inpatient stays with population growth and ageing as the main drivers 16 -- 2.3.2. Average length of stay will continue to decrease in the next decade 18 -- 2.3.3. A 5% decrease in the number of nursing days with a shift from acute to chronic care 21 -- 2.3.4. Shift towards day care continues in the years to come 25 -- 2.3.5. Demographic differences between regions result in different resource needs 26 -- 2.3.6. Required bed capacity in 2025 29 -- 2.4. ACCELERATED SUBSTITUTION FROM INPATIENT TO DAY CARE 33 -- 2.5. ACCELERATED AGEING FROM 2030 ONWARDS 34 -- 2.6. THE CAPACITY OF GERIATRIC HOSPITAL BEDS: THE CASE OF DEMENTIA 36 -- 2.6.1. Capacity needs will intensify in the future 36 -- 2.6.2. A plethora of interventions to reduce hospital use are described and tested: but do they work? 39 -- 2.7. DISCUSSION 40 -- 2.7.1. Future capacity needs dominated by ageing population and chronic conditions 40 -- 2.7.2. Some lessons learned from international experience 41 -- 2.7.3. The importance of good quality data and regular updates of the forecasting model 42 -- 3. THE ROLE OF EVIDENCE-INFORMED PROGRAMMING 43 -- 3.1. TYPOLOGY OF HOSPITAL SERVICES 43 -- 3.2. THE CONCEPT OF EVIDENCE-INFORMED PROGRAMMING 44 -- 3.2.1. Information used to build policy decisions: evidence on a par with expert opinion? 45 -- 3.2.2. The process of evidence-informed decision making 45 -- 3.3. COMPLEX SURGERY FOR CANCER OF THE PANCREAS, OESOPHAGUS AND LUNG 47 -- 3.3.1. Scope and research objective 48 -- 3.3.2. Research evidence 48 -- 3.3.3. Pancreatic cancer 48 -- 3.3.4. Oesophageal cancer 53 -- 3.3.5. Lung cancer 57 -- 3.3.6. Quality demands concentration, but concentration must not lead to waiting lists 61 -- 3.4. RADIOTHERAPY 62 -- 3.4.1. The legal framework is outdated 62 -- 3.4.2. Scope and methods 63 -- 3.4.3. Availability of radiotherapy infrastructure in Belgium 63 -- 3.4.4. Cancer incidence and radiotherapy treatment 66 -- 3.4.5. Calculation of required number of devices based on available guidelines: the importance to account for underuse, retreatments and complexity 68 -- 3.4.6. Reforming radiotherapy capacity: lessons learned 70 -- 3.5. MATERNITY SERVICES 73 -- 3.5.1. Scope and methods 73 -- 3.5.2. Availability of maternity services in Belgium 74 -- 3.5.3. Capacity problems for maternity services: national overcapacity — regional imbalances — -- fragmentation of available resources 77 -- 3.5.4. Overcapacity will intensify in the future when length of stay further decreases 79 -- 3.5.5. Policy actions to better match demand and supply 80 -- 3.6. THE CHANGING ROLE OF HOSPITALS 84 -- 4. EVIDENCE-INFORMED PLANNING AND PROGRAMMING: NEXT STEPS 87 -- RECOMMENDATIONS 89 -- REFERENCES 95 Link for e-copy: https://doi.org/10.57598/R289CS Format of e-copy: PDF (2,8 Mb) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=4192 Required hospital capacity in 2025 and criteria for rationalisation of complex cancer surgery, radiotherapy and maternity services / Carine Van de Voorde / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2017)
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