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Evolution of the number of stays / contacts

In 2008, the total number of hospital stays (which includes classic or day hospital stays and ambulatory contacts with emergency departments) was 5,138,177. This number increased to 6,214,325 in 2017.

To accurately compare this evolution over time, it is necessary to look at the number of stays /contacts per 100,000 inhabitants. From 2008 to 2017, this number increased by 13.9%. This is mainly due to a higher number of day hospitalisations (+29%) and ambulatory contacts with emergency departments (+15.5%). Another lesson is that from 2013 onwards, day hospital stays exceed those of classic hospitalisation.

Number of hospital stays / contacts according to region²

In 2017, the total number of stays per 100,000 inhabitants in Flanders was 50,862 (+14.4% since 2008), 58,495 in Brussels (+9.4% since 2008) and 58,023 in Wallonia (+14.4% since 2008).

A closer look at the 3 regions reveals several differences between them.

In general, the rate of hospital care use is lower in Flanders than in the other two regions. The use of day hospitalisation is significantly higher and the use of ambulatory contacts with the emergency departments lower. The rate of use of ambulatory emergency services is twice as high between the Flemish region and the Brussels-Capital Region. In all three regions, the classic hospitalisation is comparable per 100,000 inhabitants, although remains a little less frequent in the Brussels-Capital Region.

[2] Region of origin of the patient.

New hospital stays during the week

16.947 stays per day

For the year 2017, the average number of new hospital stays and contacts with the emergency department per day was 16,947. However, this average number varies according to the day of the week. The ambulatory contacts with emergency department remain fairly stable, but stays in classic hospitals gradually decrease from Monday to Saturday and increase again from Sunday onwards. This slight increase on Sundays is due to stays for surgical procedures scheduled for the following morning.

The number of weekday day hospital stays is higher than other types of stays and is almost non-existent during the weekend.

Age and gender of the patient

About one-fifth of hospital service users are between 55 and 70 years of age. There is also a peak for children aged 1 to 5 years, mainly due to higher use of ambulatory emergencies. After age 80, women have a higher total number of hospital stays due to longer life expectancy. The higher use of hospital care by women aged 20 to 40 compared to men in this age group is mainly related to childbirth.

Average length of stay in classic hospitalisation

For several years, health care policies have encouraged a reduction in the length of stay in order to ensure efficiency and appropriate use of hospital infrastructure without compromising the quality of care and taking into account the specific situation of patients. We examine here, firstly, the evolution of the length of stay starting in an acute department (whereas stays started at the maternity are excluded)1 and, secondly, the length of stays starting at the maternity department. Between 2008 and 2017, the average length of stay in these services decreased by one day.2

 

A closer analysis of the number of days spent in hospital for acute care and maternity shows that just over half of acute care stays do not exceed 2 days of hospitalisation, and that the average length of stay for acute care is 4.6 days.

In maternity, in 55% of cases, the duration does not exceed 3 days and 80% of stays do not exceed 4 days.3

[1] Average length of stay in classic hospitalization: voetnoot dient toegevoegd te worden: Stays that start in a service for surgery (index C), internal medicine (index D), pediatry (index E) and  care for newborns (index NIC) are taken into account.

[2] It is the case that 81% of classic hospital stays correspond to acute care (excluding stays starting in maternity departments), which represented nearly 1.5 million hospitalisations in 2017. Maternity stays represent 7.6% of stays.

[3] Psychiatric and chronic stays are not included in these graphs. Stays longer than 10 days (9% of acute stays, 2% of maternity stays) are not shown in this graph for the sake of readability.

 

Emergency admission

The following graphs describe hospitalisations following an emergency department visit, as regards the ambulatory contacts with the emergency department (without hospitalisation).

BREAKDOWN ACCORDING TO AGE

With children, youth and young adults an ambulatory use of emergency departments results rarely in hospitalisation. While among the elderly, hospitalisations following a visit to the emergency department are more frequent. After the age of 70, a contact with the emergency department is followed in more than half of the cases by classic hospitalisation. Rarely consulting the emergency department is followed by a day hospitalisation.

BREAKDOWN ACCORDING TO REGION

Almost 45% of contacts with a hospital in the Flemish region start with a visit to the emergency department, compared to just over 60% in the Brussels-Capital Region and the Walloon Region, which is related to the breakdown, according to regions, of the types of stays per 100,000 inhabitants mentioned below.

In Flanders, the emergency services are proportionally less used, per 100,000 inhabitants, and one third of emergency visits continue with hospitalisation. This proportion is higher than in the other 2 regions. In Wallonia and Brussels, four out of five patients return home after their visit to the emergency department. These results reflect different uses of emergencies.

Remark: The stays in the day hospitalisation are less than 1% and therefore not taken into account in the figure.

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