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Evaluating the need to reform the organisation of care for major trauma patients in Belgium: an analysis of administrative databases

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Abstract

Purpose

In light of the international evolutions to establish inclusive trauma systems and to concentrate the care for the most severely injured in major trauma centres, we evaluated the degree of dispersion of trauma care in Belgium.

Methods

We used descriptive statistics to illustrate the dispersion of major trauma care in Belgium based on two independent administrative databases: the registry of Mobile Intensive Care Units (2009–2015) and the Belgian Hospital Discharge Dataset (2009–2014).

Results

Patients with a severe trauma (n = 3856 in 2015) were transported towards 145 different hospital sites (on a total of 198 hospital sites) resulting in a median of 17 cases per hospital site (min = 1; P25 = 4; P75 = 30; max = 165). A minority of major trauma patients is after admission transferred to another hospital (8%) with a median of 10 days after admission to the hospital (IQR 3.5–24).

Conclusions

The dispersion of care for major trauma patients in Belgium is so high that a reorganisation of care for severe injured patients in major trauma centres concentrating professional expertise and specialised equipment is recommended to guarantee a high quality of care in a qualitative and sustainable way.

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Fig. 1

Source: Federal Public Service (FPS) Health, Food Chain Safety and Environment: Mobile Intensive Care Units (MICU) Data 2015

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Acknowledgements

This study was funded by the Belgian Health Care Knowledge Centre (KCE). The KCE is a federal institution which is financed by the National Institute for Health and Disability Insurance (NIHDI, RIZIV—INAMI), the Federal Public Service of health, food chain safety and environment, and the Federal Public Service of social security. The development of health services research studies is part of the legal mission of the KCE. Although the development of the studies is paid by the KCE budget, the sole mission of the KCE is providing scientifically valid information.

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Authors and Affiliations

  1. Belgian Healthcare Knowledge Centre, Kruidtuinlaan 55, 1000, Brussels, Belgium

    Koen Van den Heede, Cécile Dubois, Patriek Mistiaen, Sabine Stordeur, Audrey Cordon & Marie Isabel Farfan-Portet

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  1. Koen Van den Heede
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Correspondence to Koen Van den Heede.

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Van den Heede, K., Dubois, C., Mistiaen, P. et al. Evaluating the need to reform the organisation of care for major trauma patients in Belgium: an analysis of administrative databases. Eur J Trauma Emerg Surg 45, 885–892 (2019). https://doi.org/10.1007/s00068-018-0932-9

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