Hyperbare Zuurstoftherapie: Rapid Assessment - KCE

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60 Hyperbaric Oxygenation Therapy <strong>KCE</strong> Reports 74 Table 13. Overview of Belgian centres with (a) hyperbaric chamber(s) Hospital Chamber type Number of patients OLV Ziekenhuis – Aalst 1 ZNA Stuivenberg Antwerpen 1 UZ Antwerpen – Edegem 1 Cliniques du Sud Luxembourg Arlon AZ Sint Jan – Brugge 1 Hôpital Universitaire St.Pierre Bruxelles CHU de Charleroi Hôpital Vésale, Montigny-le-Tilleul Ziekenhuis Oost Limburg (ZOL) Genk 1 Multiplace 10 sitting or 2 lying Multiplace 5 sitting or 1 lying Multiplace 12 sitting or 2 lying Monoplace 1 lying Multiplace 7 sitting or 2 lying Monoplace 1 lying Multiplace 12 sitting or 2 lying Multiplace 12 sitting or 4 lying CHR La Citadelle – Liege 1 Multiplace 6 sitting or 2 lying CHU Sart Tilman – Liege Monoplace 1 lying Military Hospital Brussels 2 x Multiplace 20 sitting or 5 lying Marine basis Zeebrugge 2 x Multiplace 18 sitting or 2 lying 1 These six hospitals have a recognized diabetic foot clinic. According to RIZIV/INAMI data from 1989 to 2005, 65c Belgian hospitals have invoiced HBOT codes. Since the majority of these hospitals do not have a hyperbaric chamber, they transfer their patients to a nearby hospital for provision of this therapy. Currently, there is no apparent capacity problem and geographic distribution seems sufficient. 5.7 CURRENT PRACTICE BY INDICATION 5.7.1 Results from questionnaire to hyperbaric centres We asked the 12 centres in Belgium to voluntarily report their activities using a questionnaire. An example of this questionnaire is included in appendix. For each of the centres, the person responsible for the hyperbaric chamber was contacted by phone and a questionnaire was then distributed by e-mail. Non-responders received a reminder three weeks after the first mailing by phone and e-mail. Eventually, 11 centres responded leading to a slight underestimation of numbers. The results of this survey are presented in this chapter. Overview by indication Based on the data received form those eleven HBOT centres, a total of 1 980 patients were treated in 2006, which accounted for 16 402 sessions. The hyperbaric chamber is most often used for the following two indications: hearing disorders (32% of all reported treatment sessions, 26% of all reported patients), and post-radiotherapy tissue damage (30% of sessions, 10% of patients). However, CO-intoxication provided the largest amount of patients for a single indication (40% of patients) (see Figure 26). c Hospitals that have merged during this period were only counted once.
<strong>KCE</strong> Reports 74 Hyperbaric Oxygenation Therapy 61 Figure 26. National use of HBOT in 2006: overview by indication (in number of patients and sessions) Sudden Deafness Post-radiotherapy tissue damage Diabetic Ischemic Injuries Osteomyelitis Delayed wound healing CO intoxication Acute soft tissue ischemia Anaerobic or mixed anaero-aerobic bacterial infections Decompression illness Burns Gas embolism Other CO intoxication Sudden Deafness Post-radiotherapy tissue damage Diabetic Ischemic Injuries Anaerobic or mixed anaero-aerobic bacterial infections Decompression illness Delayed wound healing Osteomyelitis Acute soft tissue ischemia Gas embolism Burns Other Number of sessions 0 1000 2000 3000 4000 5000 6000 Number of patients 0 100 200 300 400 500 600 700 800 900 Source: data from questionnaire. For one hospital, only the total number of sessions for the full year was available. For our estimates, we combined these aggregated data with the average number of sessions by indication from the other hospitals. Patient mix variations between the centres The data from the questionnaire reveal a large variation in chamber utilization from centre to centre. Three of the centres use their chamber predominantly for postradiotherapy tissue damage, i.e. for 66%, 48%, and 40% of their sessions, whereas at three other centres this indication accounts for only 0%, 8% and 9% of the total sessions respectively. One centre uses its chamber mostly for CO intoxication patients (50%). At the other centres, this treatment accounts for only 1 to 18% of all sessions. At three centres the chamber is frequently used for sudden deafness (66%, 39% and 33%), whereas at four other centres this patient group accounts for only 0%, 0%, 2% and 6% of the sessions. All treatments for decompression illness occurred in five centres. The following three figures show that there is a difference in indications being treated according to type of chamber and to whether or not there is a diabetic foot clinic. In hospitals with a multiplace chamber, sudden deafness is treated more often in comparison to hospitals with monoplace chambers (Figure 27 versus Figure 28 and
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