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IHF University Hospital Chapter May 16th, 2001 - 14:00 - 15:30 Hong Kong

IHF University Hospital Chapter May 16th, 2001 - 14:00 - 15:30 Hong Kong. “ View on the situation of the university hospitals ”. Presentation by Prof. Eric ENGELBRECHT Chief Executive Officer Ghent University Hospital.

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IHF University Hospital Chapter May 16th, 2001 - 14:00 - 15:30 Hong Kong

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  1. IHF University Hospital ChapterMay 16th, 2001 - 14:00 - 15:30Hong Kong “ View on the situation of the university hospitals ” Presentation by Prof. Eric ENGELBRECHT Chief Executive Officer Ghent University Hospital

  2. 1. MY ENVIRONMENT2. COMPARATIVE STUDY UNIVERSITY HOSPITALS IN 5 EUROPEAN COUNTRIES3. PROPOSAL FOR THE FUTURE4. THEMES FOR THIS AFTERNOON SESSION

  3. 1. GHENT UNIVERSITY HOSPITAL

  4. Mission of a University Hospital Providing high quality : 1. Health care 2. Education & Training 3. Scientific research 4. Service

  5. 1.059 beds (35 wards) Budget 01 : 270 million $ Number of employees : 3.212,47 BFTE 4.101 people Number of buildings : 16 (288.000m2) Medical equipment : 3 CT scans 4 CAT labs 2 angiography-rooms 1 MRI (1.5 tesla) & 1 MRI (1 tesla) 3 linear accelerators 1 PET 1 cyclotron Main figures : input

  6. Medical department :48 medical services in the following disciplines • Internal medicine : endocrinology, gastro-enterology, haematology, geriatrics, cardiovascular diseases, medical oncology, pneumology, enz • Surgery : general thoracal & cardiovascular surgery, cardial surgery, urology, neurosurgery, ophtalmology, otorhinolaryngology, plastic surgery • Pediatrics • Dental surgery : fixed protheses & paradontology, preserving dental surgery & orthodontics, mouth - teeth & jaw diseases • Radiotherapy & nuclear medicine • Psychiatry

  7. Medical department :48 medical services in the following disciplines (continuation) : • Medical logistical services: clinical biology lab UZ Gent, anaesthetics, radiography & radiology • Maternity & women diseases • Emergency unit • Intensive care • Special services : burns unit, medical genetics, neonatal intensive care, fertility unit, ...

  8. Psychiatry Surgery Medicine Pediatrics Geriatrics Maternity Neonatal IC Total beds = 86 428 380 72 30 31 32 1.059 Number of beds

  9. Staff • Number of functionary doctors 180 • Number of employee doctors 80 • Number of junior doctors 330 Total medical staff 590 • Number of nurses 1.750 • Other personnel 1.760 Total staff 4. 100

  10. Main figures (output) • Hospitalisation in 2000 • admissions 32.000 • average bed occupation rate 82% • inpatient days 300.000 • operations 18.000 • Outpatient activities in 2000 • consultations 172.000 • day case admissions 42.000 • outpatient attendances 400.000

  11. Main figures ‘92-’00

  12. Length of stay ‘75-’00

  13. Transplantation services

  14. Organisation chart

  15. 2. COMPARATIVE STUDY CONCERNING UNIVERSITY HOSPITALS IN 5 EUROPEAN COUNTRIES

  16. Comparative study : framework • Sept 1998 : Foundation of the Council of University hospitals in Belgium • Jan 2000 : paper : “Which future for the University Hospitals?” • Study ordered by the government :  analysis of the problems  structural solutions • May 2000 : presentation first draft of the report to the belgian Minister of Social Affairs

  17. Comparative study : contents • 5countries : France Netherlands United Kingdom Germany Belgium

  18. Comparative study : contents • 4fields : • Mission and Legislation • Patient care • Education and training • Clinical research

  19. Comparative study : main figures F N UK G B Hospital beds (H) 734 305 420 658 560 /100.000 inhabitants “University” beds (U)142 49 ? 57 72 /100.000 inhabitants Percentage (U/H ) 19% 16% ? 9 % 13%

  20. Comparative study : findings F N UK G B Mission and + + + + + legislation + + - + + Mission : F : education and training, research N: health care, scientific medical education, research G: health care, education and research B: health care, education and scientific research Legal frame : F : since 1958 - public sector N: in 1994 - positionning towards university G: in 1999 - gaining of independence - public character B: in 1978 - recognition - not applied

  21. Comparative study : findings F N UK G B Primary care - - - - - Secundary care ++ + ++ ++ ++ Tertiary care + ++ + + + Specialised services = Referral from an external specialist to our medical staff

  22. Comparative study : findings F N UK G B Doctors revenu salary + + + + + fee for service - - - - -

  23. Comparative study : findings F N UK G B Education and training Excess funding 13% 23% 20% 25% 3.55% Clinical research funding public + + + + + private + + + + +

  24. Comparative study : health care expenditure F N UK G B Health care in GNP 9.9 8.5 6.7 10.5 7.6 % Hospitals in Health45 52 42 35 41 care cost (%) expenditure hospital440450 250 390 340 care per inhabitant ($)

  25. 3. PROPOSAL FOR THE UNIVERSITY HOSPITALSIN BELGIUM

  26. Proposal • Towards programming & concentration • A clear legal definition on • the legal frame • the mission for the university hospitals

  27. Proposal • Global budget no longer acceptable : • Patient care : funding related to care programs • Training & research : funding in relation to a patient related assignment

  28. Proposal : programming • financing of patient care related to care programs : • special care programs such as pediatric oncology, burns unit, neonatal care • incentive for integration of physicians in hospital structures (multidisciplinary) • sufficient exta funding for • patient care • complexity of care • severity (APR DRG, SAPI) • second opinion and revisions

  29. Proposal : concentration • patient related mission financing for teaching and research • excess % on the budget (European comparison) • evaluation by objective criteria

  30. Proposal : concentration • evaluation by objective criteria : • education : • number of students, • number of junior doctors • number of trainers • research : • publications • citations • impact factors cfr. NHS R&D budget (1 % of NHS global budget) AME proposal

  31. Conclusion Donna Shalala, Ph.D. on the AMC in the U.S. Secretary of Health & Human Services, Washington DC “If we lose our academic health centers we won’t just be cutting costs, we’ll be cutting our best chance for a healthier America” (Acad. Med. 74,8; Aug 1999)

  32. 4. THEMES FOR THIS AFTERNOON SESSION

  33. 4. Program 14.15 Sten Lindahl - Prof. Karolinska Hospital “How to integrate Health Care, research and teaching in a learning organisation?” 14.30 Lauri Laitinen - CEO University Hospital Helsinki “Rebirth of University Hospitals. Finnish strategies” 14.45 M. Jacques Grisoni - Deputy Chief Executive Teaching hospital group of Lyon “Organisation of research activities” 15.00 Hendrik Borchgrevink - Management consultant Norway “From performance to transformance (transforming)”

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