Vergelijkende studie van ... - KCE

36 Hospital Accreditation KCE reports 70
o Different levels, namely in 55% of the programmes (6 out of
11)
• The validity term of an accreditation ‘award’ tends to be 3 years (53%
- 9 out of 17)
o In all the responding programmes apart for Bulgaria (95% - 18
out of 19), there is a defined mechanism for hospitals to
appeal the accreditation decision
o There is a visible trend regarding the publication of this
decision: more and more programmes (5 out of 14 in 2004’s
survey – 9 out of 14 at present) make the hospitals’ results
available to the public
Funding mechanism & sources
• Apart from The Netherlands, which was created by a professional
association, and Spain - FADA-JCI and UK - HAQU which were
launched by the voluntary sector, all the responding programmes (82%
- 14 out of 17) have initially been funded by governments or
international aid
• A focus on 4 countries (France, Ireland, Luxemburg and UK Health
Care Commission) shows that the costs for running the accreditation
programme are significant i.e. between 3,5 mn. € (Ireland) and 60
mn.€ (UK Health Care Commission)
• There is a clear pattern in 79% of the programmes (15 out of 19) to
charge services to the hospitals either by means of fees or by means of
an annual subscription system. Yet, the amount of these fees varies
heavily, ranging from 450 to over 10.000 EUR. Logically this also
depends on the services included e.g. facilitation and preparation, selfassessment
documentation, induction of hospital staff, accreditation
decision and award, etc.
• For most of those who apply charges to the hospitals (67% - 6 out of
9), in 2006, over 50% of the total income was generated by the
hospitals
• From a cost perspective the amounts involved and their nature differ
to an extent that conclusions can not be drawn
As France, The Netherlands and UK are the countries for which there is the largest
amount of information, a specific analysis regarding the main elements of the Common
Framework has been developed.
Policy
• France applies a compulsory system while The Netherlands leaves the
choice to participate to the hospitals. In UK, disparities appear
between the 2 programmes in place: UK - Healthcare Commission is
mandatory but UK - HAQU is voluntary. According to Pomey et al. 19
the fact that accreditation is mandatory lends itself to ambiguity and
likens the process to an inspection. The consequence could be that
establishments reduce quality processes to nothing more than the
completion of accreditation and to focus efforts on standardizing
practices and resolving safety issues to the detriment of organisational
development. The fact that in countries where accreditation is not
mandatory, the majority of the healthcare organisations subscribe to it
spontaneously, questions all the more the relevance of a mandatory
system.