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

• Published in: European journal of trauma and emergency surgery (Munich : 2007) Vol. 45; no. 5; pp. 885 - 892
• Main Authors: Van den Heede, Koen, Dubois, Cécile, Mistiaen, Patriek, Stordeur, Sabine, Cordon, Audrey, Farfan-Portet, Marie Isabel
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.10.2019; Springer Nature B.V
• Subjects: Belgium - epidemiology; Critical Care Medicine; Databases, Factual; Delivery of Health Care - organization & administration; Emergency Medicine; Health Care Reform - organization & administration; Health Services Research; Humans; Intensive; Medicine; Medicine & Public Health; Original Article; Practice Guidelines as Topic; Quality Improvement - organization & administration; Sports Medicine; Surgery; Surgical Orthopedics; Trauma care; Trauma Centers; Traumatic Surgery; Wounds and Injuries - epidemiology; Wounds and Injuries - therapy; Belgium; Multiple trauma; Trauma centres; Quality of health care; Health care reform
• ISSN: 1863-9933; 1863-9941
• DOI: 10.1007/s00068-018-0932-9

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.