Vergelijkende studie van ... - KCE

28 Hospital Accreditation KCE reports 70
PROGRAMME INCENTIVES
The desire for improvement is the most cited incentive for the hospitals’ participation
to the programme (used by 63% of the programmes – 12 out of 19). It is followed by
the statutory requirement (used by 47% - 9 out of 19), the marketing (used by 32% - 6
out of 19), the contractual requirement by purchasers (used by 26% - 5 out of 19), the
additional funding (used by 21% - 4 out of 19), the academic recognition for training
(used by 11% - 2 out of 19) and the staff recruitment (used by 5% - 1 out of 19).
These motivators can be filed in 4 categories: desire for improvement; statutory and
contractual requirements; marketing, academic recognition for training and staff
recruitment and additional funding.
It appears then that different mixes of incentives are put in place by each programme.
Indeed, some programmes (37% - 7 out of 19) use only 1 kind of incentive, so Ireland,
Spain - FADA-JCI and UK - HAQU use only the desire for improvement, Latvia,
Luxemburg - Autorisation d’exploitation and UK - Healthcare Commission use only the
statutory and/or contractual requirements and Czech Republic uses only marketing.
Others (42% - 8 out of 19) combine 2 kinds of motivators and few (21%) mixes 3 types
of drivers. Denmark, Finland, France and Poland are part of this last category, using
desire for improvement and statutory and/or contractual requirements with marketing,
academic recognition training and staff recruitment or additional funding incentives.
PROGRAMME COVERAGE
16 out of 19 programmes (84%) include public and private facilities while the 3 left, that
is the Bulgarian, Irish and Portuguese programmes, are limited to the public hospitals.
Besides, most of the programmes (11 out of 13 - 85%) cover the entire hospital and the
2 left relate to different services of the hospitals. So, Valencian and Scottish
programmes have different programmes for each medical specialty.
Finally, 74% of the programmes (14 out of 19) concern the entire country’s territory
while 26% are regional, that is Italy - Marche, Spain - Andalusia, Spain - Valencia, UK -
Healthcare Commission and Scottish programmes.
If these dimensions are aggregated, 7 out of 13 programmes (54%) are global as they
apply to both types of hospitals, to the entire hospital and to the entire country. The
countries which have regional programmes are UK, Spain and Italy.
5.1.2.3 Governance
BODY STAKEHOLDERS’ PARTICIPATION
The clinical professionals are the most represented in the accreditation organization’s
governing bodies (represented in 68% of the programmes – 13 out of 19). They are
followed by the hospital owners (represented in 37% - 7 out of 19), the regulators
(represented in 37% - 7 out of 19), the users (represented in 32% - 6 out of 19), the
academic/training institutions (represented in 26% - 5 out of 19) and the health care
insurers (represented in 16% - 3 out of 19). The Latvian programme has no external
representatives in its body for the moment but there are discussions for changes.
Various combinations of stakeholders appear in respective governing bodies having
external representatives. Indeed, a minority of the accreditation organizations (28% - 5
out of 18) has only 1 category represented, so Bulgaria and Czech Republic have
hospital owners only, Italy - Marche and Luxemburg – Autorisation d’exploitation have
regulators only and Portugal has clinical professionals only. A majority (61% - 11 out of
18) has 2 or 3 categories represented and a significant minority (12%) has 4 or 5
categories represented. The Irish and French programmes are thus the most diversified
in terms of stakeholders’ representatives with clinical professionals, hospital owners and
users, plus academic/training institutions for Ireland, and regulators and health care
insurers for France.