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Organising and running a Hospital Under DRG Financing: Efficiency, Safety, Co-Governance, and the Quintuple Aim

Introduction Organizing and running a hospital under Diagnosis-Related Group (DRG) financing requires an intricate balance of clinical excellence, streamlined operational logistics, financial sustainability, and patient-centric governance. Successfully steering a medical facility under these conditions demands blending top-tier patient care with complex legal and administrative frameworks to maintain patient safety, regulatory compliance, and a resilient workforce. Diagnosis-Related Group (DRG) financing changes the managerial problem of the acute hospital. Instead of being reimbursed primarily for every input consumed, the hospital is paid, wholly or partly, according to case-mix groups that are intended to reflect clinically meaningful and resource-homogeneous episodes of care. In principle, this improves transparency, allows comparison of hospital activity, and creates incentives to reduce unnecessary length of stay, avoid inefficient resource use, and improve throughput (Busse et a...
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Shift-Left EHR Data Quality as a Patient-Safety Strategy in European Acute Hospitals

Introduction A “shift-left” data quality strategy in an Electronic Health Record (EHR) means that data are validated, standardized, governed, and made clinically usable at the point where they are created, rather than corrected later in a data warehouse, registry, audit process, medical coding or AI pipeline. In a European acute hospital, this is not merely an informatics improvement. It is a patient-safety intervention, a clinical governance obligation, and a regulatory compliance strategy under the General Data Protection Regulation (GDPR), the European Health Data Space Regulation (EHDS), and the Artificial Intelligence Act when EHR data feed AI-enabled clinical decision support systems. The central argument of my essay is that a shift-left EHR data quality strategy should be implemented as a risk-based clinical safety programme, not as a purely technical data-cleaning project. It should prioritize data elements that directly affect diagnosis, medication safety, care escalation, han...
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Cheat sheet medische dossiervoering, MZG-codering en BFM-impact - voor artsen in Belgische acute ziekenhuizen

 Inleiding Deze cheat sheet (spiekbriefje) is geschreven als intern ziekenhuisdocument, voornamelijk voor Belgische artsen in een niet-psychiatrisch ziekenhuis. De belangrijkste bron voor deze cheat sheet is MZG , een verplicht registratiesysteem voor Belgische niet-psychiatrische ziekenhuizen. MZG ondersteunt onder meer organisatie en financiering van de gezondheidszorg (BFM); de registratie gebeurt via Portahealth (PH).  Het Belgisch ziekenhuisdossier moet minimaal diagnoses, onderzoeken, adviezen, behandeling, evolutie, operatie-/anesthesieprotocol en ontslagverslag bevatten; het ontslagverslag moet de continuïteit waarborgen en het dossier moet de diagnostische en therapeutische aanpak getrouw weergeven.  Voor MZG worden administratieve en medische gegevens continu geregistreerd binnen semestriële registratieperiodes; overdracht aan de FOD Volksgezondheid gebeurt uiterlijk vijf maanden na het einde van de registratieperiode, na uitgebreide interne en externe con...
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