KCE Reports 302 (2018)
Hospital financial reform stipulates that hospital stays be divided into three “clusters” based on the variability of care, with each cluster benefiting from a different form of financing. For the “high variability” cluster – which groups together hospitalisation admissions for which needs are difficult to standardise and thus not predictable– the principle is that care is provided according to patients’ progress and that hospitals are reimbursed after the fact, based on the care actually provided.
We analysed the way in which other countries finance high-variability healthcare to ascertain the extent to which their methods can be applied here. We concluded from this that it is desirable to begin with a “proof of concept” study of a system of financing for an organisational model already in place, such as that for the management of CVAs. Other areas could then be added gradually, each time with a careful evaluation of the impact of each step on overall hospital budgets.
We also recommended several measures which are crucial for the implementation of such financing in the Belgian system, such as strengthening the collection, analysis, and control of hospital data. Essentially, at present, Belgian hospitals are not required to calculate the costs of each individual patient.