Soins maternels intensifs (Maternal Intensive Care) en Belgique - KCE

KCE Reports 94 Maternal Intensive Care in Belgium 39
• the mother level:
age, socioeconomic characteristics, place of residence, mode of
delivery, length of stay (and number of in-patients stays), frequency
of ICD-9-CM codes (primary and secondary) during
•
hospitalization, transfers, mortality;
the newborn level:
status (stillborn or alive), in-hospital mortality, birth weight,
gestational age, Apgar score, stay in a NIC or N* department.
4.2.8
Subsequently, associations were explored in a bivariate analysis. Finally, a binary logistic
regression model was constructed to identify the parameters associated with admission
to a MIC-service. Goodness-of-fit of the model was assessed through the Hosmer and
Lemeshow test for goodness-of-fit.
Definition of studied indicators
A. Indicators related to patients:
• Age of the women,
• Place of residence identified by INS code 27 : these codes are attributed by the
National Institute of Statistics to each municipality,
• Socioeconomic status established on the basis of IMA/AIM population
information:
• People who have very low earnings 28 benefit from a higher reimbursement of
their medical expenses; they are labelled as “BIM” in our data. People with
low social status and low revenue do not have any co-payment for their
health expenses when they reach some threshold of health care expenses.
These people are called Maf29 in our data;
• Single people are adult people who live alone or alone with children.
B. Indicators related to health care
• Ambulatory care received is identified by nomenclature codes attributed to
each reimbursed medical services; prescribed drugs are identified by CNK
codes30. The drugs are grouped by ATC codes (Anatomical Therapeutic
Classification)31 classification system devised by WHO;
• In-patient care is identified through nomenclature codes, ATC codes and
MKG/RCM data. For each in-patient stay, the hospital attributes an APR-
DRG 32 and a degree of severity, on the basis of clinical diagnoses.
Diagnostics attributed to the in-patient stay are coded by means of ICM-9-
CM codes33. Each woman has only one main diagnosis, but women can have
more than one secondary diagnosis. Several diagnoses may be registered for
one patient in the case of ‘sequential stays’ in various hospital departments,
e.g. if admitted through the emergency room, the main diagnosis for
department 1 is “UUUU” and the secondary diagnosis is “DDDD” and there
will be a ‘second stay’ where an ICD-9-CM code will be attributed;
27 http://www.statbel.fgov.be/figures/d12_fr.asp
28 Conditions to be respected to benefit from a higher reimbursement are detailed at the following address
http://www.inami.fgov.be/secure/fr/medical_cost/general/ceiling/index.htm
29 Conditions to be respected to be in this category are detailed at this address
http://www.inami.fgov.be/secure/fr/medical_cost/general/maf/index.htm
30 http://www.inami.fgov.be/drug/fr/index.htm
31 http://www.whocc.no/atcddd/
32 The procedure of registration is thoroughly described at the following address
https://portal.health.fgov.be/pls/portal/docs/PAGE/INTERNET_PG/HOMEPAGE_MENU/GEZONDHEIDZ
ORG1_MENU/ZORGINSTELLINGEN1_MENU/REGISTRATIESYSTEMEN1_MENU/MKGMINIMALEKLI
NISCHEGEGEVENS1_MENU/RICHTLIJNEN1_HIDE/RICHTLIJNEN1_DOCS/DIRECTIVES%20RCM%20
LAY-OUT%201999%20FR%20OCTOBRE%202003.PDF
33 Definition and more information can be found at the following address
http://www.cdc.gov/nchs/about/otheract/icd9/abticd9.htm