Belgium's mixed private/public health care system and its impact on the cost of end-stage renal disease.
Belgium has a mixed, public-private health care system, with state-organized reimbursements but private providers. The system is fee for service. For end-stage renal disease (ESRD), the fee-for-service system discourages preventive strategies, early referral to the nephrology unit, and the use of home-based therapies. The aging of the general population is reflected in the rapidly increasing number of very old dialysis patients, requiring more complicated and, therefore, more costly care. As dialysis costs increase, the ability to provide unrestricted access to dialysis treatment may be unsustainable. To aid in decision-making processes, nephrologists must be aware of financial and organizational issues.
Van Biesen
Wim
W
Renal Division, Department of Internal Medicine, University Hospital Ghent, De Pintelaan 185, 9000 Ghent, Belgium. Wim.vanbiesen@ugent.be
Lameire
Norbert
N
Peeters
Patrick
P
Vanholder
Raymond
R
D001530:Belgium / Q000453:epidemiology; D019411:Clinical Laboratory Techniques / Q000191:economics; D003956:Dialysis / Q000191:economics; D018588:Fee-for-Service Plans / Q000458:organization & administration; D005102:Health Expenditures; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007676:Kidney Failure, Chronic / Q000191:economics* / Q000628:therapy*; D016030:Kidney Transplantation / Q000191:economics; D009313:National Health Programs / Q000458:organization & administration*; D017149:Private Sector / Q000458:organization & administration*; D017150:Public Sector / Q000458:organization & administration*