Hospital care at home (HAD) is an approach which still requires work in Belgium but most definitely fulfils certain patients’ medical and social needs. It was the object of a recent research project by the Belgian Health Care Knowledge Centre (KCE), which, based on practice abroad, made a series of recommendations in view of implementing a Belgian model. However, a similar model already exists in the Brussels region. The NGO Aremis, founded in 1988, is a trendsetter in this field. The KCE study highlights the fact that defining hospital care at home is complicated as it can apply to many different pathologies and call for different types of care and technologies. The concept is still limited in Belgium – Aremis and its 28 years of experience are almost the sole reference, not counting certain paediatric projects elsewhere in the country – and according to KCE, it is “better not to roll out the system on a large scale for now.”
KCE recommends a clear delineation of who is responsible for patient care at home, and prefers a multi-disciplinary approach to the care needed by patients. It will also be necessary to assess the social and family environment of the patient in order to decide whether hospital care at home is a suitable option for the patient. A network ensuring continuity of care from the hospital to primary care at home must be a priority, said KCE.
The idea of hospital care at home also requires a legal framework, a point on which Brussels Minister of the Economy and Employment, Didier Gosuin, and Brussels Secretary of State in charge of emergency care, are in total agreement. “I will request this issue be on the agenda of the inter-ministerial health conference,” adds Mrs. Jodogne. The KCE research also dwells on the need for very specific and technical training for staff working in this field.
There is also still the prickly issue of financing to be resolved. An NGO such as Aremis, approved by Cocof (French community commission) and financed by the same, has unfunded running costs to deal with. “We pay for almost 200 patients a year, adults and children alike. Almost 80% come from hospitals,” points out Marion Faingnaert, co-founder of Aremis. “The care we offer is very technical; our nurses in fact often come from a hospital environment.”
Lars Andersen (Source: Belga)