Les bases de données médico-administratives pour étudier les médicaments pendant la grossesse :quel potentiel en Belgique ?Exploration de l’échantillon permanent et du couplage de plusieurs bases de données médico-administratives belges.

L’utilisation des médicaments pendant la grossesse est courante aussi bien pour guérir que pour prévenir des maladies. Pour pouvoir évaluer la balance bénéfices/risques, il est important de disposer d’informations sur la sécurité du médicament pour la maman et l’enfant à naître. Malheureusement, ces informations sont rares, car les femmes enceintes ne sont généralement pas incluses dans les essais cliniques pour des raisons éthiques. Il est dès lors primordial de surveiller l’utilisation des médicaments en « vie réelle ». Les études de pharmaco-épidémiologie pour l'évaluation de la sécurité des médicaments pendant la grossesse utilisant le couplage de données collectées en routine comme les dossiers médicaux et les données de remboursement de médicaments sont devenues très courantes dans le monde, mais restent encore marginales en Belgique. Dans le cadre de cette thèse, un couplage rassemblant les bulletins de naissance, les certificats de décès des enfants de moins de 1 an, les données hospitalières et les données de remboursement de médicaments a été mis en place. Ce couplage nous a donné la possibilité d’étudier l’usage de médicaments pendant la grossesse, mais aussi d’évaluer l’impact de certaines expositions médicamenteuses sur les issues de grossesse dans le contexte belge.Doctorat en Santé Publiqueinfo:eu-repo/semantics/nonPublishe

Medication during pregnancy in Belgium: Linking three administrative databases: Challenges and opportunities

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Belgian medication exposure during pregnancy ( BeMeP ), a new nationwide linked database: Linkage methods and prevalence of medication use

Abstract Purpose This study aimed to describe the implementation of a new retrospective Belgian national cohort of pregnant women, the Belgian Medication Exposure during Pregnancy (BeMeP). Methods We linked the national dispensing data to birth and death certificates and hospital stay data for a 7‐year period between 2010 and 2016 for the first time in Belgium. We presented the characteristics of pregnancy events associated with the mothers enrolled in the linkage study. Next, we constructed a cohort of pregnancies and compared some characteristics computed using the BeMeP database with the national statistics. Finally, we described the use of medications during pregnancy based on the first level of the Anatomical Therapeutic Chemical (ATC) classification. Results We included 630 457 pregnant women with 900 159 pregnancy‐related events (843 780 livebirths, 1937 stillbirths, 6402 ectopic events, and 47 905 abortions) linked to medication exposure information. Overall, 96.3% of live births and 83.5% of stillbirths (national statistics as reference) were captured from the BeMeP. During pregnancy, excluding the week of birth, 78.9% of live birth pregnancies and 79.6% of stillbirth pregnancies were exposed to at least one medication. The most frequently dispensed medications were anti‐infectives (ATC code J = 50.2%) for live births and for stillbirths (44.0%). Conclusion We linked information on pregnancies, all reimbursed medications dispensed by community pharmacists, all medications dispensed during hospitalization, sociodemographic status, and infant health to create the BeMeP database. The database represents a valuable potential resource for studying exposure‐outcome associations for medication use during pregnancy.info:eu-repo/semantics/publishe

Increasing Prescriptions of Misoprostol Dispensed Before Delivery in Belgium (2003-2017): Evidence from Healthcare Administrative Database

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Prescription of Asthma-Control Medications Dispensed During Pregnancy in Belgium: The Trends Between 2003 and 2018 Using a Medico-Administrative Database

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Association between nursing cost and patient outcomes in intensive care units: A retrospective cohort study of Belgian hospitals

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Cost comparisons and factors related to cost per stay in intensive care units in Belgium

Abstract Background Given the variability of intensive care unit (ICU) costs in different countries and the importance of this information for guiding clinicians to effective treatment and to the organisation of ICUs at the national level, it is of value to gather data on this topic for analysis at the national level in Belgium. The objectives of the study were to assess the total cost of ICUs and the factors that influence the cost of ICUs in hospitals in Belgium. Methods This was a retrospective cohort study using data collected from the ICUs of 17 Belgian hospitals from January 01 to December 31, 2018. A total of 18,235 adult ICU stays were included in the study. The data set was a compilation of inpatient information from analytical cost accounting of hospitals, medical discharge summaries, and length of stay data. The costs were evaluated as the expenses related to the management of hospital stays from the hospital’s point of view. The cost from the hospital perspective was calculated using a cost accounting analytical methodology in full costing. We used multivariate linear regression to evaluate factors associated with total ICU cost per stay. The ICU cost was log-transformed before regression and geometric mean ratios (GMRs) were estimated for each factor. Results The proportion of ICU beds to ward beds was a median [p25-p75] of 4.7% [4.4–5.9]. The proportion of indirect costs to total costs in the ICU was 12.1% [11.4–13.3]. The cost of nurses represented 57.2% [55.4–62.2] of direct costs and this was 15.9% [12.0-18.2] of the cost of nurses in the whole hospital. The median cost per stay was €4,267 [2,050–9,658] and was €2,160 [1,545–3,221] per ICU day. The main factors associated with higher cost per stay in ICU were Charlson score, mechanical ventilation, ECMO, continuous hemofiltration, length of stay, readmission, ICU mortality, hospitalisation in an academic hospital, and diagnosis of coma/convulsions or intoxication. Conclusions This study demonstrated that, despite the small proportion of ICU beds in relation to all services, the ICU represented a significant cost to the hospital. In addition, this study confirms that nursing staff represent a significant proportion of the direct costs of the ICU. Finally, the total cost per stay was also important but highly variable depending on the medical factors identified in our results

Using administrative healthcare database records to study trends in prescribed medication dispensed during pregnancy in Belgium from 2003 to 2017

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Using administrative healthcare database records to study trends in prescribed medication dispensed during pregnancy in Belgium from 2003 to 2017

info:eu-repo/semantics/publishe