Regular dialysis treatment in Germany: the role of non-profit organisations.
Germany's healthcare system is almost entirely premium-funded through compulsory insurance. Doctors practicing in an outpatient setting are obliged to be members of the "Kassenarztliche Vereinigung" (KV), a kind of union for physicians that has to guarantee adequate medical care for all insured patients. Health money is transferred from health insurances to KV and then distributed to individual doctors. In 1998, 47,000 patients were treated in Germany by dialysis, 40% in privately-owned units, 22% in hospital units and 40% by non-profit facilities. Of these, 35% have diabetes mellitus, 50% of the patients new to dialysis. A total of 92% are treated in HD units, 1.5% at home, and 6.7% by PD. Not-for-profit organisations were founded in 1969 to overcome the shortage of dialysis facilities. These organisations provide all the non-medical components of dialysis therapy such as machines, disposables, buildings, employment, and management of staff. Nephrologists who are employed by or work with not-for-profit organisations are free to choose the best medical therapy, with no economic bias. Assessment of dialysis quality is not yet official in Germany and it is not clear whether there are different provider associated outcomes.
Wizemann
V
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Georg-Haas Dialysis Center, Giessen, Germany.
D015897:Comorbidity; D005858:Germany; D017048:Health Care Costs; D006268:Health Facilities; D006801:Humans; D009939:Organizations, Nonprofit; D010361:Patients; D017149:Private Sector; D006435:Renal Dialysis