Patient blood management (PBM) becomes increasingly important for hospitals, as policies and guidelines are developed. The European Commission recently published a practical implementation guide for hospitals and authorities for supporting PBM in the EU. One of our customers was interested in exploring PBM for the Belgian context. This included identifying the current PBM perception in hospitals and the financial structure and incentives for PBM.
The approach consisted of three main steps:
Phase 1 - Theoretical financing structure of blood transfusions and IV iron in Belgium
In the first phase, in-depth desk research was performed to determine the financing flows of blood transfusions and IV iron administrations in Belgium. Both in the in- and outpatient setting, to understand the cost and reimbursement of IV iron administration and blood transfusions (theoretical context).
The desk research included literature, analysis of databases such as NomenSoft (RIZIV/INAMI), and the analysis of hospital invoices from two different hospitals.
Phase 2 - Development of a conceptual BIM
The objective of the second phase was to
To identify all the parameters which are influenced by PBM a phased approach was used including a high-level desk research, workshop with the client, and in-depth literature search.
The financial flow of these parameters was elaborated on to create insight on the possible financial impact of implementing PBM.
In order to develop a BIM concept, a thorough literature search was performed to collect evidence on all identified parameters. At first a broad literature search was performed to identify all available evidence. Subsequently, an extended literature search was performed for a specific target population.
Based on the identified parameters and the available evidence, a conceptual model was developed. In total, three concrete concepts were developed by Hict and validated by Prof. Lieven Annemans.
Phase 3 - Clinical practice in Belgium
To validate the theoretical financial incentives for blood transfusion and IV iron, interviews were performed with different hospitals across Belgium.
The interviews were also used to collect additional information on the clinical practice in Belgium concerning PBM. This included, but was not limited to: