UZ GENT - PowerPoint - PowerPoint

Document Sample
UZ GENT - PowerPoint - PowerPoint Powered By Docstoc
					       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
1.   MY ENVIRONMENT

2.   COMPARATIVE STUDY
     UNIVERSITY HOSPITALS
     IN 5 EUROPEAN COUNTRIES

3.   PROPOSAL FOR THE FUTURE

4.   THEMES FOR THIS AFTERNOON
     SESSION
1. GHENT UNIVERSITY HOSPITAL




DIA 3
Mission of a University Hospital
Providing high quality :
1. Health care

2. Education & Training

3. Scientific research

4. Service

DIA 4
Main figures : input
 1.059 beds
   (35 wards)

 Budget 01 : 270 million $    Medical equipment :
                                  3 CT scans
 Number of employees :           4 CAT labs
  3.212,47 BFTE                   2 angiography-
  4.101 people                     rooms
                                  1 MRI (1.5 tesla) & 1
                                   MRI (1 tesla)
 Number of buildings : 16
  (288.000m2)                     3 linear
                                   accelerators
                                  1 PET
                                  1 cyclotron
DIA 5
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
DIA 6
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, ...
DIA 7
 Number of beds

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

DIA 8
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

DIA 9
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
DIA 10
       outpatient attendances     400.000
            Main figures „92-‟00

                1992     1993     1994     1995     1996      1997     1998     1999     2000

Sales $          148      160      172      181      188       190      205      233      240
(million)

Admissi       26.800    27.700   27.900   28.200   29.000    30.000   30.600   30.900   32.000
ons

Amb.         154.000 155.000 159.000 161.000 162.000        164.000 170.000 173.000 172.000
Cons

Operati       11.500    11.800   12.300   13.900   15.000    15.300   16.200   17.500   18.000
ons *

* general anaesthesia




            DIA 11
Length of stay „75-‟00


17
16
15
14
13                                               Length of stay
12
11
10
  9
75

         78

              81

                   84

                        87

                             90

                                  93

                                       96

                                            99

DIA 12
Transplantation services
         YEAR   KIDNEY   LIVER   PANCREAS   HEART
          91       24      21        0         1
          92       23      34        0         5
          93       25      35        0         7
          94       40      34        1         9
          95       36      36        0        12
          96       39      41        1         7
          97       41      42        2        10
          98       41      28        7        10
          99       62      46       12         8
          00       79      45       12         6


  65
  60
  55
  50
  45
  40                                                Kidney
  35
  30                                                Liver
  25
  20                                                Heart
  15
  10
   5
   0
DIA 13   91 92 93 94 95 96 97 98 99         0
     Organisation chart

                                            BOARD OF DIRECTORS


                                        CHIEF EXECUTIVE OFFICER


                                        MANAGEMENT COMMITTEE


                            GENERAL STAFF                 GENERAL SECRETARIAL
                                                                OFFICES

                           ADVISORY BOARDS                  GENERAL SERVICES


                     BUILDING & TECHNICAL SERVICES           HOTEL SERVICES
                             Support function                 Support function



MEDICAL DEPARTMENT        NURSING DEPARTMENT               PHARMACY & CARE          ADMINISTRATION &
                                                         LOGISTICS DEPARTMENT    FINANCIAL DEPARTMENT




   DIA 14
  2. COMPARATIVE STUDY
       CONCERNING
  UNIVERSITY HOSPITALS
IN 5 EUROPEAN COUNTRIES
    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
Comparative study : contents


    5 countries :
     France
     Netherlands
     United Kingdom
     Germany
     Belgium
Comparative study : contents


    4 fields :

      Mission and Legislation
      Patient care
      Education and training
      Clinical research
     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%
  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
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
  Comparative study : findings
                   F   N   UK   G   B

Doctors revenu
 salary            +   +   +    +   +
 fee for service   -   -   -    -   -
Comparative study : findings

                   F     N    UK   G   B


Education and training
Excess funding      13% 23% 20% 25% 3.55%

Clinical research funding
 public              +    +   +    +   +
 private             +    +   +    +   +
    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 Health   45    52    42    35    41
care cost (%)

expenditure hospital 440    450   250   390   340
care per inhabitant ($)
 3. PROPOSAL FOR THE
UNIVERSITY HOSPITALS
      IN BELGIUM
    Proposal


   Towards programming & concentration

   A clear legal definition on
    the legal frame
    the mission
    for the university hospitals
    Proposal


   Global budget no longer acceptable :

     Patient care :    funding related to
                        care programs

     Training & research : funding in relation
      to a patient related assignment
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
Proposal : concentration

   patient related mission financing for
    teaching and research

    excess% on the budget (European
      comparison)

    evaluation   by objective criteria
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
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)
 4. THEMES FOR THIS
AFTERNOON SESSION
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)”

				
DOCUMENT INFO