A healthcare system accessible for all
A healthcare system accessible for all
The performance of the healthcare system must be regularly evaluated to ensure its effectiveness.
In Belgium the healthcare system is accessible to the majority of the population. In conjunction with the Federal Centre of Expertise in Healthcare (KCE) and the National Institute for Health and Disability Insurance (INAMI), we oversee its smooth running.
The evaluation is performed using indicators that touch, among others, on the health status of the population, accessibility and quality of care. The information compiled through these indicators for Belgium are reported to the World Health Organization (WHO), the European Commission and the Organisation for Economic Cooperation and Development (OECD) for Europe-wide use.
Our national health survey also gives us first class indications, since it allows us to estimate the prevalence and distribution of health indicators and analyse social inequalities in access to care.
Sciensano takes part in a series of initiatives set up to assess the quality of patient care:
- Our experts coordinate registers, that is to say national databases, devoted to patients suffering, for example, from cystic fibrosis, neuromuscular disorders, or to drug addicts.
- We assess care strategies implemented by doctors for people with type 2 diabetes or kidney failure.
- In another area, our researchers assess the policy on cancer in Belgium and formulate new measures.
- Our researchers are also involved in the field of rare diseases and orphan drugs. They participate, in particular, in a web platform project that, in the long-term, will bring together information on more than 6000 rare diseases, for citizens, specialists and doctors.
- Healthcare monitoring also covers medicinal treatments: Sciensano studies the effect of antibiotic resistance on human and veterinary health.
- The quality of healthcare is also observed via patient perception: perception of their health status and their experience of care or health services.
- Sciensano monitors healthcare associated infections and has the status of reference for certain types of diagnostics.
- With Healthdata.be, Sciensano has created an IT platform designed to centralise data from health research.
SOME EXAMPLES OF OUR ACTIONS
The status of chronically ill patient finally recognised
Chronic diseases (strokes, cancers, chronic respiratory diseases, diabetes, etc.) are long-term conditions that generally evolve slowly. Chronic diseases are one of the main causes of mortality world-wide. The Federal Public Service (FPS) Public Health, Safety of the Food Chain and Environment has obtained official government recognition of the status of “chronic patient”, allowing people with chronic disease to receive better reimbursement of medical care. In May 2012, the authorities inaugurated as such an “Observatory of chronic diseases” within the Scientific Council of the healthcare department of the INAMI. This observatory is in charge of examining scientific aspects related to healthcare and quality of care. Sciensano takes part in the project for specific diseases. For patients suffering from a neuromuscular disease for example, an INAMI agreement has enabled the creation of six neuromuscular reference centres in Belgium. These centres have been accompanied by the establishment of a national registry of neuromuscular patients, the Belgian Neuromuscular Disease Registry (BNMDR). Sciensano manages this registry, whose main objective is to improve the quality of care at reference centres.
A cancer plan to better structure care pathways
As part of the national cancer plan developed by the FPS Public Health, Food Chain Safety and Environment, Sciensano has been chosen to host the Belgian Cancer Centre. Active since 2008, the Cancer Centre takes on 3 main tasks: monitoring and evaluating cancer policy in Belgium, formulating new measures to fight against cancer and, finally, making proposals for future action earmarked at Ministers, with the aim of optimising the fight against cancer in Belgium.
The Cancer Centre examines new customised treatment options offered by “Next Generation Sequencing” (NGS), a DNA test which analyses several genes simultaneously. The introduction of this technology in (haematology)-oncology within our healthcare system is an important step. . Its development is ensured in Belgium, by a national pilot project deployed over 5 years and coordinated by Sciensano since January 2016.
A comprehensive platform on orphan diseases
Rare diseases, also known as orphan diseases, are diseases that affect fewer than one person in every 2000, although the majority even affects less than one in 100,000. Rare diseases are often life-threatening or lead to difficult living conditions. Half of them occur during childhood and up to 30% of patients die before the age of 5. Most of these diseases have a genetic origin, and they occur in all branches of medicine. Well-known examples are cystic fibrosis, which is relatively common, or the very rare disease progeria, which is characterised by premature ageing. Rare diseases pose special problems precisely because of their rarity. So few people are affected by these diseases that pharmaceutical companies do not consider it profitable to develop the necessary medicines, also known as orphan medicines. Patients have difficulty finding their way through the maze of often scarce and scattered information around the world. To address this problem, Sciensano is involved in a major web platform project, dubbed “Orphanet”, dedicated to rare diseases and orphan medicines. It contains information on more than 6,000 rare diseases. This platform aims to provide concerned citizens with answers to their questions. It is also earmarked for specialists and doctors for whom it is a source of reliable information. Sciensano is responsible for developing the national component of Orphanet, in close collaboration with the FPS Public Health, Food Chain Safety and Environment. Moreover, and more specifically, we coordinate the Belgian Registry of Cystic Fibrosis, the Registry of neuromuscular diseases and are responsible for processing the collected data, namely demographic and clinical data from medical records of patients with rare diseases.
Healthdata.be: a new web platform to centralise health data
In Belgium the healthcare sector has many players, and each one has its own working methods for the collection and recording of health data.
This means that the data collected remain heterogeneous, both from a quantitative and qualitative standpoint. Developed by Sciensano and the INAMI, since 2015, the Healthdata.be platform makes it possible to standardise and homogenise the recording and storage of health data, while ensuring absolute confidentiality. By offering a practical solution to the problem of scattered data, the Healthdata.be project also improves the quality of health research.
Monitoring treatment of drug addicts
Healthcare monitoring also touches on the care provided to addicts. We thus chair the TDI register ( 'Treatment Demand Indicator'). This register can record applications for the treatment of a problem of abuse or addiction to an illegal drug or to alcohol. This system was created as part of the Drug Action Plan of the European Union, of which Belgium is a signatory. Registration is done via a technical platform, and the information gathered is compared at European level to better understand the problems of drugs and be able to come up with a better response.
You are in good hands!
The problem of infections related to hand hygiene during hospital care is a top priority for the federal authorities. Good hand hygiene leads to a decrease in the number of hospital infections. Since 2005, and every 2 years, the FPS Public Health, Food Chain Safety and Environment and the Federal Platform for Hospital Hygiene organise national “You are in good hands” campaigns. In collaboration with Sciensano, the campaign aims to promote hand hygiene in all health institutions. Hospital participation is completely voluntary and the campaign is widely followed each time.
For example, in 2014-2015, compliance with instructions related to hand hygiene has increased markedly, from an average of 69.1% before the national campaign to 77.7% after the campaign, compared to 2010-2011 when the figures were 62.3% and 72.9% respectively.