Financial and Measured Quality Performance Currently Don't Go Hand-in-Hand in Flemish Non-University Hospitals

Abstract

The value paradigm in healthcare emphasises on financial rewarding of higher quality of care at lower cost. We evaluated the financial and quality performance of all 52 Flemish (Belgium) non-university, general hospitals using 2 publicly available databases. The financial situation of many Flemish hospitals is precarious. In the observation period 2012-14, one in four hospitals had a negative profit and half of the hospitals had a net profit of less than 1 million euro. Average profitability of all hospitals was 0.9% (SD 1.4%). Measured and published quality of care in Flemish general hospitals is highly variable and ranges from ‘fairly poor’ to ‘rather well’. Accredited and larger hospitals demonstrate a higher level of measured quality performance than others. No correlation could be found between financial performance or investments and the delivery of measured quality of care. We conclude that, to date, financial and quality performance don’t go hand-in-hand in Flemish non-university hospitals. Quality of care is currently no guarantee for financial health and vice versa. Policy implication: implementing a value-driven financing model will remain a major challenge for Flemish hospitals. Longitudinal follow-up is however desirable to determine a possible gap period between quality of care improvement (patient value) and hospital financial reward.