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Sub-series Health Services Research (HSR)
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Assessing the sustainability of the Belgian health system using projections / Mélanie Lefevre / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2021)
Assessing the sustainability of the Belgian health system using projections : Add-on to “Performance of the Belgian health system – report 2019” Supplement: technical sheets for indicators [printed text] / Mélanie Lefevre , Author ; Sophie Gerkens , Author . - Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre, 2021 . - 32 p. : ill., ; A4. - (KCE Reports. Health Services Research (HSR); 341S) .
ISSN : D/2021/10.273/15 : € 0,00
Languages : English (eng)
Descriptors: Classification
W 84 Health services. Quality of health care (General)
Indexation
2019-19 ; Delivery of Health Care ; Forecasting ; Health Expenditures ; Health Workforce ; R341Abstract: This report is an add-on to a previous KCE report published in 2019 that assessed the performance of the Belgian health system (KCE Report 313).
This add-on discusses the opportunity to include projection based indicators, in addition to those based on historic data, to better assess the sustainability of the health system.
A conceptual framework is used to select relevant indicators in this context. Then projection-based indicators related to workforce and financing are analysed to complement the assessment of the performance of the health system. These indicators are aimed to provide warning signals of a future imbalance between demand and supply within the Belgian healthcare system.Contents note: 1. SUSTAINABILITY: PROJECTION-BASED INDICATORS 3 -- 1.1. PHYSICIAN WORKFORCE DEMAND (S-18) 3 -- 1.1.1. Documentation sheet 3 -- 1.1.2. Results 6 -- 1.2. PHYSICIAN WORKFORCE SUPPLY (S-19) 14 -- 1.2.1. Documentation sheet 14 -- 1.2.2. Results 19 -- 1.3. PUBLIC EXPENDITURE ON HEALTH (S-20) 24 -- 1.3.1. Documentation sheet 24 -- 1.3.2. Results 26 Link for e-copy: https://doi.org/10.57598/R341S Format of e-copy: PDF (1,2 MB) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=4740 Assessment and support of decisional capacity in persons with dementia or mental health problems / Imgard Vinck / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2022)
Assessment and support of decisional capacity in persons with dementia or mental health problems [printed text] / Imgard Vinck , Author ; Nadia Benahmed, Author ; Marie Dauvrin , Author ; Anja Desomer, Author ; Justien Cornelis , Author ; Pascale Jonckheer , Author ; Patriek Mistiaen , Author . - Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre, 2022 . - 329 p. : ill., ; A4. - (KCE Reports. Health Services Research (HSR); 349C) .
ISSN : D/2021/10.273/55 : € 0,00
Languages : English (eng)
Descriptors: Classification
W 85 Patients. Attitude and compliance. Satisfaction
Indexation
2018-11 ; Decision Making ; Decision Making, Shared ; Dementia ; Mental Competency ; Patient Rights ; R349Contents note: 1 INTRODUCTION 13 -- 2 SCOPE OF THE STUDY 15 -- 3 RESEARCH QUESTIONS 17 -- 3.1 RESEARCH QUESTION 1: WHAT ARE THE DIFFERENT APPROACHES TOWARDS DECISIONAL CAPACITY, ITS ASSESSMENT AND SUPPORT? 17 -- 3.2 RESEARCH QUESTION 2: HOW DOES BELGIAN LEGISLATION DEAL WITH DECISIONAL CAPACITY AND ITS ASSESSMENT AND SUPPORT? 17 -- 3.3 RESEARCH QUESTION 3: WHAT ARE THE NEEDS OF (HEALTH)CARE PROFESSIONALS (IN THE DOMAIN OF DEMENTIA OR MENTAL HEALTH PROBLEMS) IN THE ASSESSMENT AND SUPPORT OF DECISIONAL CAPACITY? 18 -- 3.4 RESEARCH QUESTION 4: WHAT ARE THE NEEDS OF THE PERSONS WITH MENTAL HEALTH PROBLEMS OR DEMENTIA IN THE ASSESSMENT AND SUPPORT OF DECISIONAL CAPACITY? 18 -- 4 METHODOLOGY 18 -- 5 DECISIONAL CAPACITY IN SCIENTIFIC LITERATURE 19 -- 5.1 OBJECTIVE 19 -- 5.2 METHODOLOGY 19 -- 5.2.1 Search strategy 19 -- 5.2.2 Selection criteria for in- or exclusion 19 -- 5.2.3 Data to retrieve / analysis 21 -- 5.3 RESULTS 22 -- 5.3.1 Description of the included articles. 22 -- 5.3.2 Presentation of the findings 22 -- 5.4 PART 1 - TERMINOLOGY 22 -- 5.4.1 Decision-making : a complex phenomenon 22 -- 5.4.2 Decision-making in the medical context 23 -- 5.4.3 Different wordings and four elements 23 -- 5.4.4 Decisional capacity: decision and time specific 30 -- 5.5 PART 2 - PATHOLOGIES AS SOURCE OF DECISIONAL CAPACITY IMPAIRMENT 32 -- 5.5.1 Dementia 33 -- 5.5.2 Brain tumors and other neurological cancers 33 -- 5.5.3 Schizophrenia spectrum and other psychotic disorders 34 -- 5.5.4 Bipolar and related disorders 35 -- 5.5.5 Depression 35 -- 5.5.6 Autism spectrum disorders 36 -- 5.6 PART 3 - ASSESSING DECISIONAL CAPACITY 37 -- 5.6.1 When is a formal assessment needed? 37 -- 5.6.2 How can an assessment be performed? 41 -- 5.6.3 Who should be designed to be assessor? 51 -- 5.6.4 Which barriers are linked to this assessment? 52 -- 5.6.5 Which facilitators are linked to this assessment? 57 -- 5.6.6 Which recommendations have already been formulated regarding decisional capacity assessment? 65 -- 5.7 PART 4 – IMPACT OF DECISIONAL INCAPACITY: AN ETHICAL QUESTION 69 -- 5.7.1 Discrimination and preconceptions 70 -- 5.7.2 Autonomy versus Paternalism 71 -- 5.7.3 Strategies for improving or maintaining the “decisional capacity” 72 -- 5.8 PART 5 – SUPPORTED DECISION-MAKING PATHWAY 73 -- 5.8.1 Concept 74 -- 5.8.2 When has a supported decision-making pathway to be proposed ? 74 -- 5.8.3 How can a supported decision-making pathway be organized? 75 -- 5.8.4 Who has to be involved in a supported decision-making pathway? 78 -- 5.8.5 Which benefits are described with a supported decision-making pathway? 79 -- 5.8.6 Which barriers are linked to the supported decision-making pathway? 79 -- 5.8.7 Which facilitators are linked to the supported decision-making pathway 82 -- 5.8.8 Which recommendations have already been formulated regarding supported decisionmaking pathway? 84 -- 5.9 PART 6 – ADVANCE DECISION 89 -- 5.9.1 Concepts 89 -- 5.9.2 When should advance decision be proposed? 90 -- 5.9.3 How is advance decision elaborated? 92 -- 5.9.4 Who has to be involved in advance decision pathway? 93 -- 5.9.5 Which benefits are described with advance decision? 95 -- 5.9.6 Which barriers are linked to the advance decision pathway? 97 -- 5.9.7 Which facilitators are linked to the advance decision pathway? 103 -- 5.9.8 Which recommendations have already been formulated regarding advance decision? 107 -- 5.10 PART 7 – SURROGATE DECISION-MAKING PATHWAY: SUBSTITUTED JUDGEMENT AND BEST-INTEREST APPROACH 111 -- 5.10.1 Concepts 111 -- 5.10.2 When a surrogate decision-making pathway should be proposed? 112 -- 5.10.3 How is a surrogate decision-making pathway organized? 113 -- 5.10.4 Who has to be involved in the surrogate decision-making pathway? 116 -- 5.10.5 Which barriers are linked to the surrogate decision-making pathway?. 117 -- 5.10.6 Which facilitators are linked to the surrogate decision-making pathway? 122 -- 5.10.7 Which recommendations have already been formulated regarding surrogate decisionmaking pathway. 125 -- 5.11 LIMITATIONS OF THIS LITERATURE REVIEW 129 -- 5.12 FUTURE RESEARCH 130 -- 5.12.1 Assessment 130 -- 5.12.2 Supported decision-making 131 -- 5.12.3 Advance decision 131 -- 5.12.4 Surrogate decision-making 131 -- 5.12.5 HCPs Training and support 131 -- 6 DECISIONAL CAPACITY AND THE LAW 132 -- 6.1 OBJECTIVE 132 -- 6.2 METHODOLOGY 132 -- 6.3 PART 1 - DECISIONAL CAPACITY: TERMINOLOGY, INTERPRETATION AND ASSESSMENT 133 -- 6.3.1 Terminology 133 -- 6.3.2 The capabilities required to have decisional capacity 134 -- 6.3.3 The assessment of decisional capacity 138 -- 6.4 PART 2 - CONSEQUENCES OF DECISIONAL INCAPACITY: SUBSTITUTE DECISIONMAKING IN THE EXERCISE OF PATIENT’S RIGHTS 149 -- 6.4.1 Who is the substitute decision-maker in charge of exercising patient’s rights? 150 -- 6.4.2 How should a substitute decision-maker decide when exercising patient’s rights? 155 -- 6.4.3 The value of action through which an incapacitated patient appears to oppose treatment. 156 -- 6.4.4 Support in case of reduced decisional capacity? 157 -- 6.5 PART 3 –DECISIONAL CAPACITY IN SPECIFIC LEGISLATION: THE EXAMPLES OF EUTHANASIA, ORGAN DONATION AND MEDICAL EXPERIMENTS 160 -- 6.5.1 Decisional capacity and euthanasia 161 -- 6.5.2 Decisional capacity and experiments on human beings 166 -- 6.5.3 Decisional capacity and organ donation 168 -- 6.6 PART 4 - ADVANCE CARE PLANNING 171 -- 6.6.1 Types of written advance directives 172 -- 6.6.2 Crisis planning for patients with a psychiatric disorder 176 -- 6.7 PART 5 - ADMISSION OF A CARE USER IN A RESIDENTIAL CARE SETTING 178 -- 6.7.1 Admission to a residential care centre (or home replacement environment) 178 -- 6.7.2 Admission in a psychiatric facility 179 -- 6.7.3 Decisional incapacity and day-to-day decisions in a residential care context 183 -- 6.8 PART 6 - THE ROLE OF THE UNITED NATIONS CONVENTION ON THE RIGHTS OF PERSONS WITH DISABILITIES 185 -- 6.9 LIMITATIONS 194 -- 7 PROFESSIONALS’ PERCEPTIONS RELATED TO DECISIONAL CAPACITY 195 -- 7.1 OBJECTIVE 195 -- 7.2 METHODOLOGY 195 -- 7.2.1 Participants 195 -- 7.2.2 Data collection 196 -- 7.2.3 Data analysis 198 -- 7.3 PART 1 -TERMINOLOGY USED BY PROFESSIONALS AROUND DECISIONAL CAPACITY 199 -- 7.3.1 Many synonyms/terms are used 199 -- 7.4 PART 2 - CONTENT AND CHARACTERISTICS OF DECISIONAL CAPACITY 201 -- 7.4.1 Composing elements of decisional capacity 201 -- 7.4.2 Decisional capacity, a ‘relative’ concept 202 -- 7.4.3 Decisional capacity is task/context-specific 202 -- 7.5 PART 3 - ASSESSMENT OF DECISIONAL CAPACITY: CHARACTERISTICS, BARRIERS AND FACILITATORS, METHODS AND CONTEXT 203 -- 7.5.1 Focus on the decision-making process, not on the ultimate decision 203 -- 7.5.2 Standards and modalities for assessment depend on the severity of the pathology and the consequences of the decision for the patient’s health 207 -- 7.5.3 Methods for assessing the decisional capacity 207 -- 7.5.4 When (explicitly) evaluating decisional capacity? 210 -- 7.5.5 Particularities to certain types of mental health problems 210 -- 7.5.6 The impact of the personality and the social context of the patient 211 -- 7.5.7 The (possible) balance of power between the patient and physicians 212 -- 7.5.8 Place of the changing identity/values/preferences 212 -- 7.6 PART 4 - SUPPORTING THE PATIENTS IN THEIR DECISIONAL CAPACITY 214 -- 7.7 PART 5 - NEED FOR GUIDANCE FOR PROFESSIONALS 215 -- 7.8 PART 6 - NEED FOR FEEDBACK TO THE PATIENT 216 -- 7.9 PART 7 - ADVANCE CARE PLANNING 217 -- 7.9.1 Opportunities and limits of advance care planning 217 -- 7.9.2 When initiating advance care planning? 218 -- 7.9.3 Who should initiate/be involved in the process? 219 -- 7.10 PART 8 - CRISIS PLANNING FOR PERSONS WITH PSYCHIATRIC PROBLEMS 221 -- 7.11 LIMITATIONS 221 -- 8 PATIENTS’ PERSPECTIVES ON DECISIONAL CAPACITY 222 -- 8.1 OBJECTIVE 222 -- 8.2 METHODOLOGY 222 -- 8.2.2 Data analysis 225 -- 8.2.3 Ethical aspects 225 -- 8.3 RESULTS 226 -- 8.3.1 Presentation of the participants 226 -- 8.3.2 Presentation of the findings 227 -- 8.4 PART 1 - DECISIONAL CAPACITY AND DECISIONS ABOUT HEALTH CARE 228 -- 8.4.1 Definition/characteristics of the decisional capacity 228 -- 8.4.2 Factors influencing decisional capacity related to health care 229 -- 8.4.3 Patient reported experiences of exerting their decisional capacity 239 -- 8.5 PART 2 - EVALUATION OF THE (IN)CAPACITY 245 -- 8.5.1 Methods to assess the capacity of the patients 245 -- 8.5.2 When should the decisional capacity be assessed? 246 -- 8.5.3 Actors of the evaluation 248 -- 8.5.4 Communication of the results of the evaluation 249 -- 8.5.5 Consequences of the evaluation 249 -- 8.6 PART 3 - SOLUTIONS TO RESTORE AND MAINTAIN DECISIONAL CAPACITY 250 -- 8.6.1 At patient level 250 -- 8.6.2 At institutional level 255 -- 8.6.3 At political level 256 -- 8.7 LIMITATIONS OF THE ANALYSIS AND POTENTIAL BIAS 258 -- 9 DISCUSSION AND CONCLUSIONS 260 -- 9.1 NO CLARITY IN TERMINOLOGY AND DEFINITION OF DECISIONAL CAPACITY 260 -- 9.2 SHIFT FROM SUBSTITUTED-DECISION MAKING TO SUPPORTED-DECISION MAKING? 262 -- 9.3 TOWARDS A MORE PROMINENT ROLE FOR SUPPORTED DECISION-MAKING IN BELGIUM? 264 -- 9.4 ELEMENTS TO STRENGTHEN SUPPORTED DECISION – MAKING 265 -- 9.4.1 Foresee more (types of) support 265 -- 9.4.2 Provide training for patients and support persons 267 -- 9.4.3 Provide training for professionals 268 -- 9.4.4 Manage medical barriers for decisional capacity 268 -- 9.4.5 Facilitate advance care planning 269 -- 9.5 ELEMENTS TO FACILITATE DECISIONAL CAPACITY ASSESSMENTS 272 -- 9.5.1 Guidance on how to deal with decisional capacity (assessments) for healthcare professionals 273 -- 9.5.2 Provide support in the assessment process 275 -- 9.5.3 Provide training, intervision and supervision for professionals 275 -- 9.6 ORGANISING SUBSTITUTE DECISION-MAKING OF PATIENTS IN A COHERENT WAY 276 -- 9.7 FORESEE GUARANTEES RELATED TO COERCION AND OPPOSITION OF PATIENTS 277 -- 9.8 OVERALL NEED FOR SUPPORT MEASURES EMBEDDED IN AN ORGANIZATIONAL AND LEGAL FRAMEWORK TO OPTIMIZE THE PROCESS OF ASSESSING, SUPPORTING AND RESTORING DECISIONAL CAPACITY 278 -- APPENDICES 279 -- APPENDIX 1. LITERATURE SEARCH STRATEGIES 279 -- APPENDIX 1.1. SEARCH STRATEGY 279 -- APPENDIX 1.2. REASONS OF EXCLUSION OF 13 ARTICLES 281 -- APPENDIX 1.3. SUCCINCT DESCRIPTION OF THE 76 INCLUDED ARTICLES 283 -- APPENDIX 1.4. INSTRUMENTS FOR DECISION-MAKING ASSESSMENT. 294 -- APPENDIX 2. STATEMENTS AND CASES OF THE PROFESSIONAL FORUM 300 -- APPENDIX 3. INTERVIEW GUIDE 308 -- APPENDIX 3.1. INTRODUCTION 308 -- APPENDIX 3.2. QUESTIONNAIRE IN FRENCH 309 -- APPENDIX 3.3. TOPIC GUIDE IN DUTCH 315 -- REFERENCES 324 Link for e-copy: https://doi.org/10.57598/R349C Format of e-copy: PDF (4,04 MB) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=4811 Asylum seekers in Belgium / Marie Dauvrin / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2019)
Asylum seekers in Belgium : options for a more equitable access to health care. A stakeholder consultation [printed text] / Marie Dauvrin , Author ; Jens Detollenaere , Author ; Chris De Laet , Author ; Dominique Roberfroid , Author ; Imgard Vinck , Author . - Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre, 2019 . - 135 p. : ill., ; A4. - (KCE Reports. Health Services Research (HSR); 319C) .
ISSN : D/2019/10.273/53 : € 0,00
Languages : English (eng)
Descriptors: Indexation
2017-10 ; Delivery of Health Care ; Economics ; Health Policy ; Health Services Administration ; R319 ; Refugees
Classification
WA 300 Health issues of special population groupsContents note: 1 INTRODUCTION .12 -- 2 SCOPE AND RESEARCH QUESTIONS 14 -- 3 METHODS 16 -- 4 CONTEXT OF INTERNATIONAL PROTECTION AND HEALTH CARE FOR ASYLUM SEEKERS IN BELGIUM .19 -- 4.1 INTERNATIONAL PROTECTION FOR ASYLUM SEEKERS .19 -- 4.1.1 Procedure for international protection: legal and administrative aspects 20 -- 4.1.2 Number of asylum seekers in Belgium .21 -- 4.1.3 Material assistance during the procedure for international protection 22 -- 4.2 HEALTH PROBLEMS, HEALTH CARE UTILISATION AND COSTS AMONG ASYLUM SEEKERS.26 -- 4.2.1 Health problems 26 -- 4.2.2 Health care utilisation and costs 26 -- 4.3 CURRENT ORGANISATION AND ACCESS TO HEALTH CARE FOR ASYLUM SEEKERS 27 -- 4.3.1 Legal framework 27 -- 4.3.2 Summary of the key organisational elements 33 -- 5 DESCRIPTION OF THE PROBLEMS .37 -- 5.1 PROBLEMS AT THE MACRO-LEVEL .37 -- 5.1.1 Lack of coordination 37 -- 5.1.2 Regional differences regarding health care for asylum seekers 37 -- 5.1.3 Lack of monitoring of health care use and health care costs 37 -- 5.1.4 Lack of transparency about health care expenses .38 -- 5.1.5 Lack of administrative support and of qualified personnel to manage administrative tasks 38 -- 5.2 PROBLEMS AT THE MESO-LEVEL .39 -- 5.2.1 Unclear administrative system for health care professionals 39 -- 5.2.2 Differences in health care system depending on place of stay 39 -- 5.2.3 Lack of health care professionals qualified to interact in health care for asylum seekers 40 -- 5.2.4 High turnover of health care professionals in reception centres 40 -- 5.2.5 Reluctance and/or overburdening of (some) health care professionals 40 -- 5.2.6 Poor and/or unclear collaboration between the different actors involved in health care for asylum seekers .41 -- 5.2.7 Tension regarding patient confidentiality .41 -- 5.2.8 Lack of appropriate health information for asylum seekers 41 -- 5.3 PROBLEMS AT THE MICRO-LEVEL 41 -- 5.3.1 Inequity in access .41 -- 5.3.2 Inequity in treatment 43 -- 5.3.3 Inequity in outcomes 44 -- 5.4 SPECIFIC PROBLEMS FOR HEALTH CARE WITH UNACCOMPANIED MINORS 45 -- 5.4.1 Lack of coverage through insurance funds for unaccompanied minors 45 -- 5.4.2 Difficulties to comply with the conditions to access the compulsory health insurance .45 -- 5.4.3 Shortage of guardians 45 -- 5.4 OTHER ISSUES 45 -- 6 OPTIONS TO IMPROVE EQUITABLE ACCESS TO HEALTH CARE FOR ASYLUM SEEKERS: RESULTS OF THE STAKEHOLDER CONSULTATION 48 -- 6.1 FUNDAMENTAL TRANSVERSAL PRINCIPLES TO IMPROVE EQUITABLE ACCESS .48 -- 6.2 DISTRIBUTION OF FUNDING OF HEALTH CARE FOR ASYLUM SEEKERS .49 -- 6.2.1 Option 1: Sickness funds acts as distributor of funding – integration of asylum seekers in compulsory Belgian health care insurance .49 -- 6.2.2 Option 2: Fedasil acts as distributor of funding .59 -- 6.2.3 Option 3: actual actors distribute the funding, administration by MedPrima for all asylum seekers and access to health care covered by health insurance 63 -- 6.3 FUTURE GOVERNANCE OF HEALTH CARE FOR ASYLUM SEEKERS 65 -- 6.4 IMPROVEMENTS TO THE CURRENT SYSTEM (QUICK WINS) 70 -- 6.4.1 Quick wins across organisations 70 -- 6.4.2 Quick wins on the level of the CPAS – OCMW 71 -- 6.4.3 Quick wins on the level of Fedasil 72 -- 7 CONCLUSION .72 -- 7.1 PREREQUISITES 72 -- 7.2 ESTIMATED EFFECT OF OPTIONS ON THE DESCRIBED PROBLEMS 73 -- 7.3 LIMITATIONS 76 Link for e-copy: https://doi.org/10.57598/R319C Format of e-copy: PDF (3 MB) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=4610 Copies(0)
Status No copy Bariatric surgery in Belgium: organisation and payment of care before and after surgery / Koen Van Den Heede / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2020)
Bariatric surgery in Belgium: organisation and payment of care before and after surgery [printed text] / Koen Van Den Heede , Author ; Belinda ten Geuzendam, Author ; Dorien Dossche, Author ; Sabine Janssens, Author ; Peter Louwagie, Author ; Kirsten Vanderplanken, Author ; Pascale Jonckheer , Author . - Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre, 2020 . - 249 p. : ill., ; A4. - (KCE Reports. Health Services Research (HSR); 329C) .
ISSN : D/2020/10.273/06 : € 0,00
Languages : English (eng)
Descriptors: Indexation
2018-07 ; Bariatric Surgery ; Health Services Research ; Organizational Policy ; R329
Classification
WI 980 Digestive system surgical proceduresContents note: SCIENTIFIC REPORT 11 -- 1 INTRODUCTION 11 -- 1.1 EPIDEMIOLOGY OF OVERWEIGHT AND OBESITY 11 -- 1.2 MANAGEMENT OF OBESITY 12 -- 1.2.1 Introduction 12 -- 1.2.2 Effectiveness of bariatric surgery 16 -- 1.3 SCOPE AND RESEARCH OBJECTIVES 18 -- 1.4 KEY POINTS 19 -- 2 BARIATRIC SURGERY IN BELGIUM: ANALYSIS OF THE CURRENT BELGIAN SITUATION 20 -- 2.1 BELGIAN CRITERIA FOR REIMBURSEMENT 20 -- 2.2 EPIDEMIOLOGY OF BARIATRIC SURGERY IN BELGIUM 21 -- 2.2.1 IMA-AIM data 21 -- 2.2.2 Evolution in the number of (first) bariatric surgery procedures 21 -- 2.2.3 Demographic information about bariatric surgery patients 24 -- 2.2.4 Prevalence of bariatric surgery since start nomenclature 24 -- 2.3 ORGANIZATION OF BARIATRIC SURGERY 28 -- 2.3.1 Pre-surgery care 28 -- 2.3.2 Distribution of bariatric surgery patients by hospitals and surgeons 28 -- 2.3.3 Follow-up by Bariatric surgery centres 33 -- 2.3.4 Role of General practitioners 34 -- 2.3.5 Pregnancy after bariatric surgery 44 -- 2.3.6 Accountability patients 45 -- 2.3.7 Registries 45 -- 2.4 KEY POINTS 45 -- 3 A QUALITATIVE ANALYSIS OF PATIENTS AND HEALTHCARE PROFESSIONALS VIEWS 47 -- 3.1 PATIENT VIEWS: BEST-PRACTICES AND UNMET NEEDS 47 -- 3.1.1 Objective 47 -- 3.1.2 Methods: interviews with Belgian patients 47 -- 3.1.3 Description of the patient sample 48 -- 3.1.4 Patients’ decision for surgery 49 -- 3.1.5 Preparation during the pre-surgery phase 51 -- 3.1.6 Post-operative follow-up 60 -- 3.2 A QUALITATIVE ANALYSIS OF HEALTHCARE PROFESSIONALS VIEWS 84 -- 3.2.1 Objective 84 -- 3.2.2 Methods 84 -- 3.2.3 Description of the nominal groups 85 -- 3.2.4 Results 86 -- 3.3 KEY POINTS 100 -- 4 LITERATURE REVIEW GUIDELINES AND PATHWAYS 104 -- 4.1 OBJECTIVE 104 -- 4.2 METHODS 104 -- 4.3 RESULTS: GENERAL CONSIDERATIONS 105 -- 4.4 PRE-OPERATIVE PERIOD 105 -- 4.4.1 Pre-operative assessment 105 -- 4.4.2 Pre-operative preparation programme 117 -- 4.4.3 Composition of the team and duration of the pre-operative period 121 -- 4.5 DECISION MAKING 122 -- 4.6 POST-OPERATIVE FOLLOW-UP DURING THE FIRST 2 YEARS 125 -- 4.6.1 Post-operative monitoring 125 -- 4.6.2 Post-operative management programme 138 -- 4.6.3 Composition of the team and time points of the post-operative period 155 -- 4.7 LONG TERM FOLLOW-UP 158 -- 4.7.1 Long term follow-up monitoring 160 -- 4.7.2 Long term follow-up management 161 -- 4.8 PREGNANCY 163 -- 4.9 ORGANIZATIONAL LEVEL 165 -- 4.10 KEY POINTS 172 -- 5 INTERNATIONAL DESCRIPTION OF ORGANISATION AND PAYMENT 179 -- 5.1 INTRODUCTION AND STUDY APPROACH 179 -- 5.2 THE NETHERLANDS 180 -- 5.2.1 Criteria for reimbursement bariatric surgery and utilization rates 180 -- 5.2.2 The role of bariatric surgery centres 181 -- 5.2.3 Role of GP’s 183 -- 5.2.4 Registry 184 -- 5.2.5 Body contouring surgery 186 -- 5.3 ENGLAND 187 -- 5.3.1 Criteria for reimbursement bariatric surgery and utilization rates 187 -- 5.3.2 The role of (bariatric surgery) centres 189 -- 5.3.3 Role of GPs 190 -- 5.3.4 Registry 191 -- 5.3.5 Body contouring surgery 193 -- 5.4 FRANCE 193 -- 5.4.1 Criteria for reimbursement of bariatric surgery and utilization rates 193 -- 5.4.2 The role of bariatric surgical centres and surgeons 195 -- 5.4.3 Role of GP’s 196 -- 5.4.4 Bariatric surgery registry and other relevant databases. 197 -- 5.4.5 Body contouring surgery 197 -- 5.5 SWEDEN 198 -- 5.5.1 Criteria for reimbursement and bariatric surgery utilization rates 198 -- 5.5.2 The role of bariatric surgery centres 199 -- 5.5.3 The role of the GPs 200 -- 5.5.4 Nationwide registry 200 -- 5.5.5 Body contouring surgery 202 -- 5.6 COMPLIANCE FOLLOW-UP CARE 203 -- 5.7 VOLUME-OUTCOME RELATIONSHIP 205 -- 5.8 KEY POINTS 207 -- 6 SOLUTIONS ELEMENTS FOR THE ORGANISATION AND PAYMENT OF THE CARE OF BARIATRIC SURGERY IN BELGIUM 211 -- 6.1 INTRODUCTION 211 -- 6.2 ACCESS TO BARIATRIC SURGERY 213 -- 6.3 BARIATRIC SURGERY CENTRE 215 -- 6.3.1 Multidisciplinary team Bariatric surgery centre 215 -- 6.3.2 Coordinator 217 -- 6.3.3 Volume-thresholds 219 -- 6.3.4 Identify key-interventions for a care pathway 221 -- 6.4 PRIMARY CARE 223 -- 6.5 PATIENT ENGAGEMENT 227 -- 6.6 PAYMENT SYSTEM 232 -- 6.6.1 Payment for consultations with a psychologist and dietician via the convention 232 -- 6.6.2 Conventions 234 -- 6.6.3 Pilot projects 236 -- 6.7 BARIATRIC SURGERY REGISTRY 237 -- REFERENCES 240 Link for e-copy: https://kce.fgov.be/sites/default/files/2021-11/KCE_329_Bariatric_surgery_in_Bel [...] Format of e-copy: PDF (3.3 Mb) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=4668 Bariatric surgery in Belgium: organisation and payment of care before and after surgery / Koen Van Den Heede / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2020)
Bariatric surgery in Belgium: organisation and payment of care before and after surgery : Supplement [printed text] / Koen Van Den Heede , Author ; Belinda ten Geuzendam, Author ; Dorien Dossche, Author ; Sabine Janssens, Author ; Peter Louwagie, Author ; Kirsten Vanderplanken, Author ; Pascale Jonckheer , Author . - Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre, 2020 . - 72 p. : ill., ; A4. - (KCE Reports. Health Services Research (HSR); 329S) .
€ 0,00
Languages : English (eng)
Descriptors: Indexation
2018-07 ; Bariatric Surgery ; Health Services Research ; Organizational Policy ; R329
Classification
WI 980 Digestive system surgical proceduresContents note: 1. APPENDIX TO CHAPTER 2 5 -- 1.1. TOPIC LIST SITE VISITS 5 -- 1.2. ANALYSES IMA-AMI DATA: SUPPLEMENTARY INFO 7 -- 1.3. EVALUATING THE USE OF DIAGNOSTIC TESTS BEFORE AND AFTER BS IN BELGIUM 19 -- 1.3.1. Method 19 -- 1.3.2. Outcomes for Belgium 19 -- 1.3.3. Number of tests per patient 22 -- 1.3.4. Detailed information 24 -- 2. APPENDICES TO CHAPTER 3 31 -- 2.1. TOESTEMMINGSFORMULIER 31 -- 2.2. INTERVIEW GIDS VOOR PATIËNTEN 34 -- 2.2.1. Openingsvraag 34 -- 2.2.2. Inleidingsvraag: verhaal en achtergrond van de patiënt 34 -- 2.2.3. Sleutelvragen: 35 -- 2.2.4. Uitleiding (globale kijk op) 39 -- 2.2.5. Algemeen afsluitend 39 -- 3. APPENDICES TO CHAPTER 4 40 -- 3.1. SEARCH STRATEGY FOR GUIDELINES IN BARIATRIC SURGERY 40 -- 3.2. SEARCH STRATEGY FOR CARE PATHWAYS 41 -- 3.2.1. OVID MEDLINE 41 -- 3.2.2. EMBASE 43 -- 3.2.3. COCHRANE 45 -- 3.3. FLOWCHART FOR GUIDELINES 47 -- 3.4. FLOWCHART FOR PATHWAYS 48 -- 3.5. QUALITY ASSESSMENT OF GUIDELINES 49 -- 3.6. QUALITY ASSESSMENT OF LITERATURE ON CARE PATHWAY 52 -- 3.7. CRITERIA USED FOR GRADING KEY INTERVENTIONS 54 -- 3.8. CATEGORIZATION USED BY AUTHORS FOR THE LEVEL OF EVIDENCE AND/OR THE STRENGTH OF RECOMMENDATION 54 -- 3.8.1. ASMBS 2016 & AACE/TOS/ASMBS 2013 – Key to evidence statements and grades of recommendations 54 -- 3.8.2. EASO 2017 – Key to evidence statements and grades of recommendations 56 -- 3.8.3. HAS 2009 – Key to evidence statements and grades of recommendations 57 -- 3.8.4. Heber 2011 – Key to evidence statements and grades of recommendations 57 -- 3.8.5. IFSO-EC/EASO 2017 – Levels of evidence 58 -- 3.8.6. SIGN 2010 – Key to evidence statements and grades of recommendations 58 -- 4. APPENDICES TO CHAPTER 5 59 -- 4.1. SEARCH STRATEGIES CONDUCTED FOR THE DISCUSSION – COMPLIANCE AND ADHERENCE 59 -- 4.2. REVIEW ON VOLUME-OUTCOME 60 Link for e-copy: https://doi.org/10.57598/R329S Format of e-copy: PDF (1,2 Mb) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=4669 Barriers and facilitators for eHealth adoption by general practitioners in Belgium / Jens Detollenaere / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2020)
PermalinkBarriers and opportunities for the uptake of biosimilar medicines in Belgium / Isabelle Lepage-Nefkens / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2013)
PermalinkBarriers and opportunities for the uptake of biosimilar medicines in Belgium / Isabelle Lepage-Nefkens / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2013)
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PermalinkBesoins et suivi des patients atteints de COVID long / Diego Castanares-Zapatero / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2021)
Permalink[Burnout among general practitioners: prevention and management] / Pascale Jonckheer / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2011)
PermalinkCardiac rehabilitation / Ilse Van Vlaenderen / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2010)
PermalinkCardiac rehabilitation / Ilse Van Vlaenderen / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2010)
PermalinkCare integration in a vulnerable elderly population in Belgium / Justien Cornelis / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2021)
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