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Title: Nursing and midwifery in the Belgian health care system


1
Nursing and midwifery in the Belgian health care
system
European Doctoral Nursing Programme, Manchester
  • Tom Braes
  • Centre for Health Services and Nursing Research
  • Katholieke Universiteit Leuven

2
Introduction (1)
  • BELGIUM IN FIGURES
  • ?population 10,364,388
  • ?life expectancy at birth total 78.62 years
    male 75.44 years female 81.94
    years
  • ? age structure 0-14 years 16.9
    15-64 years 65.7 65 years 17.4
  • ? health expenditure/GDP 9.1
  • ? number of nurses 60.142
  • ? number of midwives 4912

Source NIS, OECD, CIA World Fact Book
3
Introduction (2)
72 sites ? 15.000 beds
34 sites ? 3.000 beds
221 sites ? 53.000 beds
Source FOD http//www.health.fgov.be - 2001
4
Introduction (3) Belgian
nursing workforce
Source Stordeur et al., 2004
5
?activity rates of nurses by age group
Introduction (4) Belgian
nursing workforce

median age Belgian nursing workforce
Source Manpower Planning SESA UCL - 2003
6
Belimage - study
  • ?87.1 is proud being a nurse
  • ?84.2 is satisfied to very satisfied with the
    current work
  • ?68.6 experience the context of care as
    stressful
  • ?54.7 would discourage family or friends from
    studying nursing
  • ?39.2 wouldnt choose nursing again as a career
  • ? 8.5 intend to leave their job within 1 year

7
Professional plans for the future
  • ? 8.5 intend to leave their job within 1 year
  • Canada 16.6
  • Germany 16.7
  • US 22.7
  • Scotland 30.3
  • UK 38.9
  • (Aiken et al., Health Affairs, 2001)

8
Introduction (4) nurse staffing
-2
1 to 10
Source FOD http//www.health.fgov.be
9
?percentage BSN to total staff (A1)
Introduction (5)qualification level
8
28
32
19
27
Source FOD http//www.health.fgov.be
10
?trends in some nursing activities 1988 - 1998
Introduction (6)nursing care
13
19
39
37
37
47
Source FOD http//www.health.fgov.be
11
THUS
  • ?high increase in nursing intensity
  • ?small increase in nurse staffing levels
  • ?high increase in qualification levels

12
Source of funding global
  • ?compulsory health care system
  • employers and employees are obliged to contribute
    to social security
  • state subsidies (25 for hospital charges
  • ? each citizen must choose his own insurance
    company
  • ? social security reimburses charges to insurance
    companies
  • ? free access to health services
  • ? free choice in health care provider
  • ? out of pocket costs limited

13
Source of funding primary care
  • ?primary health care
  • GPs
  • pharmacists
  • dentists
  • physiotherapists
  • nurses independent / nursing care services
  • ?all are paid on a fee-for-service basis
    (revised regularly)
  • ?number of pharmacists and physiotherapists is
    limited.

mostly independent
14
Source of funding hospital care
  • ?hospital care
  • both private and public hospitals (mostly
    private)
  • ? physicians are paid on a fee-for-service
    basis
  • ? nursing / material / hospital stay paid by a
    fixed amount/patient day
  • this amount may vary between hospitals, and
    between nursing units, and is revised annually

15
Educational programmes
  • ?Bologna declaration since 2005

Master in Nursing/Midwifery Major nursing

Major midwifery
Switch-programme (schakelprogramma) 1 year
Bachelor in nursing (3 years)
Bachelor in midwifery (3 years)
16
Status of academic nurses
  • ?active in various roles functions
  • research associate
  • clinical nurse specialist advanced nurse
    practitioner
  • head nurse
  • nurse
  • case manager
  • consultancy
  • management
  • gt hospital care versus home care

17
Status of nursing research
  • ?research at universities, offering a Masters
    degree
  • ?research at colleges, offering a Bachelors
    degree
  • ?research by (university) hospitals
  • ?research by other health care organizations
  • ?research supported by federal or Flemish
    government
  • collaboration
  • aim / purpose differs
  • quality differs
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