Ongoing measles outbreak in Wallonia, Belgium, December 2016 to March 2017: characteristics and challenges.

We describe characteristics of an ongoing measles outbreak in Wallonia, Belgium, and difficulties in control measures implementation. As at 12 March 2017, 177 measles cases were notified, of which 50% were 15 years and older, 49% female. Atypical clinical presentation and severe complications, mainly among adults, in combination with late notification, low or unknown vaccination coverage of contacts, infected healthcare workers and increased workload due to contact tracing, are the main concerns for outbreak management.

Impact of the medical home model on the quality of primary care: the Belgian experience.

BACKGROUND: The Belgium medical home (MH) model, which has been garnering support of late, resembles its US counterpart in that it aims at improving the quality of health care while containing costs. OBJECTIVES: To compare the quality of care offered by MHs with that offered by traditional individual practices (IPs) in Belgium in terms of the extent of their adherence to clinical practice guidelines in antibiotherapy, cervical-cancer screening, influenza vaccination, and the management of diabetes. RESEARCH DESIGN: This is a retrospective study using public insurance claims data. Data consisted of a random sample of patients using the services of MHs and IPs who were previously matched according to sex, age category, location, disability, and socioeconomic status. We applied the McNemar test, the t test, or the Wilcoxon test, depending on the type of variable being compared. SUBJECTS: The final sample comprised 43,678 patients in the year 2004. MEASURES: On the basis of a review of the literature, we selected 4 themes, corresponding to 25 indicators: antibiotherapy, cervical-cancer screening, influenza vaccination, and the management of diabetes. RESULTS: MHs were more likely than IPs to adhere to evidence-based clinical practice guidelines. They prescribed less and more appropriate antibiotherapy, provided wider influenza-vaccination coverage for target groups, and provided a better follow-up for diabetics than did IPs. In regard to cervical-cancer screening, no significant differences were found. CONCLUSIONS: MHs, as they combine a greater adherence to guidelines and savings in secondary care, are a cost-effective alternative to traditional IPs and therefore should be encouraged.

[Cost evaluation of hospital inpatient stays induced by injuries due to falls for elderly people]. / Évaluation économique des lésions associées aux chutes des personnes âgées vivant à domicile.

Thirty percent of people aged 65 and older, living at home fall at least once a year. Few economic data are available in Belgium on this issue. We evaluated the cost borne by social security. 823 inpatient stays aged 65 and more, from home and admitted for injuries after a fall were selected. We observe an average (SD) age of 81 years. The proportion of women is 76%. 75% of admissions are related to fractures. 18% of patients are 'institutionalized' after falls. The death rate is 6%. The median (Q1-Q3) of cost is € 4.182 (2.385-6.820), for a length of stay median (Q1-Q3) of 11 days (4-25). The cost of hospital stays is estimated at €135 millions. Based on population projections, the cost could be estimated at € 243 millions in 2050. The overall cost of the treatment of these lesions is much more important, because costs are also generated after the hospitalization.

[Analysis of factors influencing self-rated health among older persons: synthesis of the biomedical literature]. / Analyse des facteurs influençant la santé subjective des personnes âgées : synthèse de la littérature biomédicale.

Self-rated health is a frequently used measure, notably in the field of gerontology. Different authors have studied factors that can influence self-rated health among older persons and, according to studies, the factors taken into account and their influence vary. This article aims at synthesising the biomedical literature, published since 1993, on factors that influence self-rated health of non-institutionalised older persons aged 65 years and over, with a focus on cross-sectional quantitative studies. Of the 1801 articles that were identified by our search strategy in the Medline database, 22 were retained. The proportion of older persons assessing their health positively ranged, depending on the studies, from 48.4% to 78.0%. Fifteen studies out of 22 investigated what was rather associated with an unfavourable self-rated health. Two studies took into account only one kind of independent variables. In more than half of the studies, 1 to several variables belonging to at least 3 kinds of independent variables were associated with self-rated health in multivariable analysis. The associations between these different kinds of independent variables considered (sociodemographic characteristics - morbidity - functional status - mental health - social support - other variables) and self-rated health are here presented and synthesized. This work shows that the factors that influence self-rated health among older people, factors measured differently according to authors, are varied and belong to different domains. These domains include morbidity, functional status, as well as sociodemographic characteristics, mental health, certain aspects of social support and other kinds of factors.

Fear of falling and associated activity restriction in older people. results of a cross-sectional study conducted in a Belgian town.

OBJECTIVES: This article aims at describing, in a Belgian town, the frequency of the fear of falling and of subsequent activity restriction among non-institutionalised people aged 65 years and over, and at identifying persons affected by these two issues. METHODS: Cross-sectional survey conducted in Fontaine l'Evêque (Belgium) in 2006, using a self-administered questionnaire. RESULTS: The participants could fill in the questionnaire on their own or with the help of a third party if needed. The latter were not taken into account in this article. Analyses covered 419 questionnaires. Fear of falling and activity restriction were reported by, respectively, 59.1% and 33.2% of participants. They were more frequent among fallers but also affected non-fallers. In logistic regression analyses: gender, the fact of living alone and the number of falls were significantly associated with fear of falling; gender, age and the number of falls were significantly associated with activity restriction. CONCLUSIONS: Our study, despite various limitations, shows the importance of fear of falling and of subsequent activity restriction among older people, among fallers as well as among non-fallers. It also provides information, though limited, concerning persons affected by these two issues in Belgium, and in other contexts as well. Given the ageing of our populations, it is important to take these problems into account when caring for older people.