International study of health care organization and financing: development of renal replacement therapy in Germany.
The German health system represents the case of a global budget with negotiated fees and competing medical insurance companies. Physicians in private practice and non-profit dialysis provider associations provide most dialysis therapy. End-stage renal disease (ESRD) modalities are well integrated into the overall health care system. Dialysis therapy, independent of the mode of treatment, is reimbursed at a weekly flat rate. Mandatory health insurance covers health expenses, including those related to ESRD, for more than 90% of the population. Both employees and employers contribute to the premium for this insurance. Private medical insurance covers the remainder of the population. Access to treatment, including dialysis therapy, is uniformly available.
Kleophas
Werner
W
Dialysis Center Karlstrasse, Karlstr. 17-19, Duesseldorf, 40210, Germany. kleophas@nierenpraxis.de
Reichel
Helmut
H
D003956:Dialysis / Q000191:economics; D005858:Germany / Q000453:epidemiology; D005102:Health Expenditures; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data; D006297:Health Services Accessibility; D006801:Humans; D007676:Kidney Failure, Chronic / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D016030:Kidney Transplantation / Q000191:economics; D009313:National Health Programs / Q000191:economics / Q000458:organization & administration*; D012051:Reimbursement Mechanisms / Q000458:organization & administration
Int J Health Care Finance Econ. 2007 Dec;7(4):301-18
17602296
Int J Health Care Finance Econ. 2007 Sep;7(2-3):133-48
17638074
Am J Kidney Dis. 2004 Jul;44(1):94-111
15211443
Int J Health Care Finance Econ. 2007 Dec;7(4):283-99
17653861
Int J Health Care Finance Econ. 2007 Sep;7(2-3):201-15
17641969
Int J Health Care Finance Econ. 2007 Dec;7(4):269-81
17657602
Int J Health Care Finance Econ. 2007 Dec;7(4):233-52
17638073
Int J Health Care Finance Econ. 2007 Dec;7(4):253-67
17602295
Am J Kidney Dis. 2005 Jan;45(1 Suppl 1):A5-7, S1-280
15640975
Int J Health Care Finance Econ. 2007 Sep;7(2-3):73-111
17653860
Int J Health Care Finance Econ. 2007 Sep;7(2-3):171-83
17680359
Nephrol Dial Transplant. 2004 Jan;19(1):108-20
14671046
Am J Kidney Dis. 2002 Sep;40(3):611-22
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