Abstract
The Phd project will focus on the organization and cost-effectiveness of out-of-hours and withinhospital care. For out-of-hours care, patients can choose in Belgium between general practitioner (GP) services and the hospital's emergency department (ED) without former contact or referral. Every ED in Belgium needs to give appropriate care to anyone entering the service and overuse of ED is of concern. The organization of out-of-hours care within GP cooperatives has improved accessibility, sustainability and safety of primary care as trustworthy alternative for EDs. An important difference for the patient is that there is no direct payment at the ED as compared to GP services. Although medical care is largely reimbursed by medical insurance in Belgium, out of pocket payment accounts for approximately 25% of health expenses. In 2014, a database infrastructure iCAREdata was established to link data from GP Cooperatives, ERs and pharmacies during out-of-hours care. Within the doctoral project, the aim is to extent iCAREdata with costing data and extend this valuable initiative with health economic opportunities. Nursing shortage is one of the greatest challenges in global health care. Nurses from the baby boom generation will soon leave the labor market and many younger nurses consider leaving the occupation. In addition, the need for individualized care is increasing and requires additional qualifications of the nursing staff. The computerized decision support instrument "BNuT" aims to support nursing team management based on hard and soft data on nursing teams and patient care. The aim within this Phd project is to evaluate the cost-effectiveness of nursing team interventions in terms of staff numbers, qualifications, competencies, and demographics. The PhD candidate will contribute to the BNuT project by the introduction of cost data. There is already hospital data available from the prototype, though more data will become available soon with the valorization process of the tool.
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