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26 Hospital Accreditation KCE reports 70 Whenever relevant the literature sources are mentioned, the other data used originate from the survey. 5.1.2 Qualitative analysis of the literature study results and the survey answers 5.1.2.1 Programme status % of countries The status of the 27 European Union countries’ programmes is detailed in the table below. It shows that 52% of these countries have 1 or more accreditation programmes on their territory, that 7% are currently developing a programme, that 7% are at the discussion stage and that 30% have no programme at all. Information is lacking for Romania. Table 7 : Countries programme status Number of countries Number of programmes Programme status Countries 52% 14 28 Programme Bulgaria Czech Republic Finland France Germany Ireland Italy (5) Latvia Luxemburg (2) Netherlands Poland Portugal Scotland Spain (7) UK (3) 7% 2 2 In development Denmark Lithuania 7% 2 0 Under discussion Hungary Slovakia 30% 8 0 No programme Austria Belgium Cyprus Estonia Greece Malta Slovenia Sweden 4% 1 0 No information Romania 100% 27 25 In the following analysis, only the programmes for which the completed survey was received and which appear as established or in an advanced phase of development will be considered. These 19 programmes are Bulgaria, Czech Republic, Denmark, Finland, France, Ireland, Italy - Marche, Latvia, Luxemburg - Autorisation d’exploitation, Luxemburg - Incitants qualité, The Netherlands, Poland, Portugal, Spain - FADA-JCI, Spain - Andalusia, Spain - Valencia, UK - Healthcare Commission, UK - HAQU and
KCE Reports 70 Hospital Accreditation 27 5.1.2.2 Policy Scotland. Besides, it was agreed that percentages used for the results’ description would be calculated on the basis of the number of programmes for which information was available, what means that the analysis’ coverage does not always include all these 19 programmes. PROGRAMME INTENTIONS As far as the purpose of the accreditation programme is concerned, only 7 out of 19 programmes (37%) responded and for all of them quality improvement is the main goal. Of those from the remaining programmes, no information was received on the purpose. It is beyond doubt that the implicit goal for a vast majority of the programmes is indeed quality improvement. 10 out of 19 programmes (53%) are based on a voluntary application, 8 (42%) are mandatory x and 1 combines both systems. Indeed, the participation to Andalusia’s accreditation programme is voluntary for the private health care centres and compulsory for the public ones. In addition, 54% of the programmes (7 out of 13) assess hospitals against their capability to ‘come close to’ the defined standards. 31% (4 out of 13) mix them with target standards whilst 2 countries apply minimal standards only, namely Bulgaria and Latvia. These minimum criteria are used to ensure essential requirements while target criteria are implemented to support moving towards excellence. If both characteristics are combined, it appears that a majority of the programmes (54% - 7 out of 13) proposes a voluntary system which includes target standards. A minority (31% - 4 out of 13) is mandatory but comprises at least developmental criteria. The Bulgarian and the Latvian programmes are the only programmes that are mandatory with minimal standards alone. PROGRAMME SUPPORTIVE STRUCTURE Most of the programmes (94% - 16 out of 17) are authorized by law and/or written into a government policy on quality and/or have the composition of their accreditation organization’s governing body determined by an enabling legislation, while 1 has none of these characteristics, i.e. the UK - HAQU programme. Besides, 13 out of 19 programmes (68%) have a link with the government as they are managed within the Ministry of Health, by a separate government agency or by an independent agency with governmental representation, when the 6 left are totally independent of the government. In parallel, the legal status of the accreditation organization is a government agency for 47% of the programmes (8 out of 17), a notfor-profit organization for 35% (6 out of 17) of them and a commercial entity for the last 18%. It then appears that programmes related to the government have an accreditation organization that is a government agency or a not-for-profit organization while independent programmes have a commercial entity or a not-for-profit organisation. If these characteristics are considered from a global point of view, a significant majority of the programmes (76% - 13 out of 17) are officialised by laws or government quality policy and are linked to the government. 18%, that is the Dutch, the Luxemburg - Incitants qualité and the Spain - FADA-JCI programmes, are embedded in a law or fit within a larger quality policy but are independent from the government. Only the UK - HAQU programme is not included in a law or in a governmental quality policy and is independent from the government. x A mandatory programme is a programme whose participation is required by a law or a decree
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Wettelijk depot : D/2008/10.273/01
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38. Baarmoederhalskankerscreening e
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