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

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64 Maternal Intensive Care in Belgium KCE Reports 94 This list wants to group theoretically ideal levels of care needed by women (and their foetuses) suffering from a pathology (pregnancy of not-pregnancy related). In other words, this list of indications gives an overview of the required levels of care in an ideal world. It is important to keep in mind that we created the list based on our definition of intermediate care: ‘a woman requiring more than standard care could benefit from intermediate care’. This does not mean that these women with a pathology grouped in the intermediate care category should also be admitted to an intermediate care unit. We only created theoretical risk profiles that indicate that woman could benefit from ‘more-than-standard-care’. Due to the fact that not much evidence was found on the topic, most of the recommended levels of care are based on the expert opinions of the members of the MIC research group. It is evident that the few indications wherefore sufficient evidence was found, were also included. In addition to the theoretical work on the list and the approval process, monthly reunions of an ad hoc working group tested the clinical relevance of the admission criteria. This working group of the Gent University Hospital enclosed two obstetricians, the head midwife, a MKG codification specialist and a MIC researcher. All patients admitted to the MIC-service were individually screened, the diagnosis was compared to the list of indications. In case the pathology was listed as standard care, the patient was considered as a maternity patient. If the pathology was listed as intermediate care, the patient was considered as a MIC-patient. If the pathology was not on the list, it was discussed (cf. supra) and if relevant, added to the list. Patients, from whom the situation was not clear, were extensively discussed by and decided to group into the grey zone or intermediate care. These valuable monthly exercises (from February 2007 to March 2008) tested the list of admission criteria for clinical relevance and the potential implementation within the daily practice. The relevant conclusions of these discussions where systematically included into the list of admission criteria. 5.3 SCHEMATIC OVERVIEW CONSTRUCTION THEORETICAL MODEL A complete version of the list of indications is included in the annexes
KCE Reports 94 Maternal Intensive Care in Belgium 65 Systematic literature review 171 → 13 Poor results Dutch guidelines: CBO, Nederlands Huisartsengenootschap, Richtlijnen Kenniscentrum (KCE), RIZIV richtlijnen and WVVH Domus Medica CEBAM- search PICO (keywords: : obstetric (intermediate) care, peripartal care, pregnancy care and high risk, maternity services (and high risk), maternity care, disease and pregnancy, high dependency unit • Low risk • Specific complication & pregnancy • No MIC guidelines Clinical list UZ Gent: • Pregnancy related • Not-pregnancy related Systematic implementation found guidelines per pathology DELPHI (4x) Simultaneously with MKG-list Final list of indications for standard, recommended intermediate, indispensable intermediate and intensive care Anglo-Saxon guidelines: Guideline Finder UK, National Guideline Clearinghouse, New Zealand Guidelines Group, Prodigy Guidelines and WHO written oral adaptations
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Dépôt légal : D/2008/10.273/78
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35. Etude relative aux coûts poten
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Soins maternels intensifs (Maternal Intensive Care) en Belgique - KCE

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