Some thoughts on health and healthcare

 Inleiding Deze cheat sheet 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 controles en valid...

Introduction Patient-based costing seeks to measure the cost of care at the level of the individual patient rather than by broad departmental or specialty averages. In methodological terms, activity-based costing (ABC) assigns costs to activities and then to cost objects through cost drivers, whereas time-driven activity-based costing (TDABC) simplifies this logic by combining two core parameters: the cost of supplying resource capacity and the time required to perform the activities in the care process. In healthcare, TDABC has become especially relevant because it is explicitly tied to process mapping and the measurement of real care delivery across pathways. For Belgian hospitals, the policy relevance of patient-level costing is unusually high. Belgium still allocates a major part of hospital financing through an APR-DRG/SOI-based budget allocation whose weights are based on average length of stay (LOS) rather than cost weights. The Belgian Health Care Knowledge Centre (KCE) has...

Introduction In Belgium, hospital financing reform should start from the target state to be achieved rather than from the inherited institutional configuration to be incrementally adjusted. That is especially important because the Belgian health system is structurally path-dependent: it combines near-universal compulsory insurance with direct access, predominantly fee-for-service remuneration, and a division of responsibilities between the federal state and the federated entities that was deepened by the sixth State reform. In hospital financing, Belgium already uses All Patient Refined Diagnosis Related Groups (APR-DRG)/Severity of Illness (SOI) information for budget allocation, but not as a true case-based payment system with national cost weights; the current B2 logic of the Budget of Financial Means (BFM) uses national average length of stay by APR-DRG/SOI as a proxy for resource use. At the same time, Belgium has two mandatory hospital datasets with major strategic value: Minima...