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

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78 Maternal Intensive Care in Belgium KCE Reports 94 Key messages • Applying the Delphi method, an expert group listed the clinical conditions which should be treated in MIC-beds. Women identified as suffering from at least one of such conditions in the database were defined as “intermediate care women”. Women without such conditions were labelled “standard care women”. For a number of clinical conditions, no consensus was reached as regards the adequate level of care. Women reported as suffering from such conditions were labelled as “grey zone women”. • The list of conditions was translated into ICD-9 codes. Categorization of women used a data extraction algorithm. 9.6 % and 33.7% of women were classified “intermediate care” and “grey zone”, respectively. Moreover, the correlation between a theoretical and empirical score of MIC orientation by hospital was tested, and found significant. • The expert list was assessed by comparing patient and health service characteristics between the groups. “Intermediate care women” had a lower socio-economic status, a higher c-section rate, a longer hospital stay, more stillborns, more twins, and more preterm deliveries.
KCE Reports 94 Maternal Intensive Care in Belgium 79 6 COMPARATIVE ANALYSIS In this chapter we present the results of the comparison between the care currently delivered in MIC- and non-MIC services and the care theoretically required in these services. Following parameters are shown for women theoretically requiring intermediate care (~intermediate care women): • place of delivery • type of morbidity, • rate of referrals and transfers • proportion of Very Low Birth Weight-infants and premature neonates A logistic regression model was also used to apprehend the factors associated with an admission in a maternity with MIC-beds. 6.1 PLACE OF DELIVERY 6.1.1 Proportion of "intermediate care women” in MIC-services by province Table 39: Per province, proportion of intermediate care women and grey zone women delivering in hospitals with a MIC-service Region Province Proportion of Proportion of Proportion of "Intermediate "Grey zone" Proportion of women who care" women women who maternities with delivered in who delivered in delivered in MIC beds maternities with maternities with maternities with MIC beds MIC beds MIC beds Région Bruxelles-Capitale Brussels Hoofdstedelijk gewest 54.55% 48.03% 62.13% 51.31% Vlaams Antwerpen 15.79% 27.25% 34.81% 33.45% Gewest Vlaams Brabant 16.67% 37.66% 45.73% 40.44% West Vlaanderen 7.14% 10.66% 17.70% 16.59% Oost Vlaanderen 7.14% 10.00% 21.29% 9.51% Limburg 12.50% 26.54% 40.00% 24.05% Région Wallonne Total 11.50% 21.95% 32.57% 24.71% Brabant Wallon 0.00% 45.70% 59.92% 53.08% Hainaut 13.33% 22.11% 31.48% 23.62% Liège 20.00% 51.88% 64.27% 54.12% Luxembourg 0.00% 6.43% 18.09% 9.13% Namur 0.00% 8.75% 15.47% 9.95% Total 11.80% 30.24% 43.00% 33.59% Unknown 0.00% 25.52% 31.11% 28.70% Belgium 16.00% 27.96% 40.47% 31.34% Source: Merged IMA and MKG/RCM Data 01/10/2003 – 30/09/2004 Globally, only 40% of the “intermediate care women” are currently admitted in a maternity with a MIC-service. This proportion goes from a low 15.5% in Namur to 64.1% in Liège.
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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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