Organisation of aftercare for patients with severe burn injuries
Authors: Christiaens Wendy , Van de Walle Elke , Devresse Sophie , Van Halewyck Dries , Dubois Cécile , Benahmed Nadia , Desomer Anja , Van de Sande Stefaan , Van Loey Nancy , Paulus Dominique , Van Den Heede Koen 
Published: January 2025

SCIENTIFIC REPORT 7 -- 1 INTRODUCTION 7 -- 1.1 SCOPE: AFTERCARE FOR PATIENTS WITH SEVERE BURN INJURIES 7 -- 1.1.1 Severe Burns: definition & classification 7 -- 1.1.2 Aftercare 9 -- 1.2 MAGNITUDE OF THE PROBLEM 10 -- 1.2.1 Epidemiology 10 -- 1.2.2 Vulnerable groups 10 -- 1.3 RESEARCH QUESTIONS AND STUDY APPROACH 10 -- 2 BURN INJURIES IN BELGIUM: ANALYSIS OF ADMINISTRATIVE DATA 12 -- 2.1 INTRODUCTION 12 -- 2.2 RESEARCH QUESTIONS 12 -- 2.3 ANALYTIC APPROACH 13 -- 2.3.1 Databases 13 -- 2.3.2 Algorithms used to identify hospital stays in administrative databases 13 -- 2.4 RESULTS OF THE SECONDARY DATA ANALYSIS 16 -- 2.4.1 Description of data and limitations 16 -- 2.4.2 Burn Injuries 17 -- 2.4.3 Severe Burn Injuries 18 -- 2.5 RESULTS MILITARY HOSPITAL 24 -- 2.6 KEY POINTS 25 -- 3 THE ORGANISATION AND FINANCING OF AFTERCARE IN BELGIUM: ANALYSIS OF THE CURRENT SITUATION 26 -- 3.1 ACUTE CARE: SPECIALIZED BURN CARE CENTRES 26 -- 3.1.1 Introduction 26 -- 3.1.2 Legal criteria 26 -- 3.2 AFTERCARE SERVICES 27 -- 3.2.1 Specialized burn care centres 27 -- 3.2.2 Rehabilitation services 29 -- 3.2.3 Role of primary care services 30 -- 3.3 ROLE OF SUPPORTING ORGANIZATIONS 31 -- 3.3.1 Belgian Burns Foundation 31 -- 3.3.2 Organizations for children with burn injuries 32 -- 3.3.3 OSCARE VZW/ASBL 32 -- 3.3.4 Self-help groups 33 -- 3.3.5 European Burns Casualties Associations 33 -- 3.3.6 Organizations of healthcare professionals 33 -- 3.4 FINANCIAL ASPECTS: REIMBURSEMENT AND FINANCIAL PROTECTION 34 -- 3.4.1 Reimbursement 34 -- 3.4.2 Financial protection mechanisms 35 -- 3.5 KEY POINTS 35 -- 4 A QUALITATIVE ANALYSIS OF THE STRENGTHS AND WEAKNESSES OF THE AFTERCARE FOR PATIENTS WITH SEVERE BURN INJURIES 36 -- 4.1 INTRODUCTION 36 -- 4.2 METHODS 36 -- 4.2.1 Participants and recruitment 37 -- 4.2.2 Data collection process 39 -- 4.2.3 Ethical approval 39 -- 4.2.4 Data collection tools 41 -- 4.2.5 Analysis 41 -- 4.3 FINDINGS FROM THE INTERVIEWS WITH PHYSICIANS-HEALTHCARE PROFESSIONALS AND BURN CARE ORGANIZATIONS 42 -- 4.3.1 Sample description 42 -- 4.3.2 Definitions of aftercare 42 -- 4.3.3 The average burn patient does not exist 44 -- 4.3.4 Evolutions in Belgian burn care and general socio-historical context 47 -- 4.3.5 Hospital stay and preparation for discharge. 48 -- 4.3.6 Discharge to another institution: residential aftercare 54 -- 4.3.7 Return home 56 -- 4.3.8 Peer support, patient organizations and burn camps 60 -- 4.3.9 Blind spots in aftercare 61 -- 4.4 PATIENT PERSPECTIVES ON AFTERCARE SERVICES 77 -- 4.4.1 Sample description 77 -- 4.4.2 Hospital stay and preparation for discharge. 78 -- 4.4.3 Discharge to another institution: residential aftercare 79 -- 4.4.4 Return home 82 -- 4.4.5 Information and communication are of great importance 87 -- 4.4.6 Reintegration 90 -- 4.4.7 Financial implications 93 -- 4.4.8 Peer support, patient organizations and burn camps 95 -- 4.4.9 Blind spots in aftercare 96 -- 4.5 DISCUSSION. 97 -- 4.6 KEY POINTS 98 -- 5 CLINICAL GUIDELINES APPLICABLE TO AFTERCARE 100 -- 5.1 OBJECTIVE 100 -- 5.2 METHODOLOGY 100 -- 5.3 RESULTS 100 -- 5.4 DISCUSSION AND CONCLUSION 103 -- 5.4.1 Content-related weaknesses 103 -- 5.4.2 Poor methodological quality 103 -- 5.5 KEY POINTS 104 -- 6 RECOMMENDATIONS FOR A MORE EFFECTIVE FUTURE ORGANISATION OF BURN AFTERCARE SERVICES 104 -- REFERENCES 105