title: The health system in Chile: the nephrologist perspective.
abstract: Chile is a country with 17 million inhabitants, 13% of them living in rural areas, and with a per capita income of approximately US $14,500. Three percent of national income is assigned to the health budget, with a mixed public and private system, with guaranteed medical benefits from the state to cover chronic kidney disease (CKD) and renal replacement therapy (RRT). Hemodialysis has reached in 2009 a prevalence of 857 patients per million population (pmp). Peritoneal dialysis is less developed, with a prevalence of 40 patients pmp. Both therapies show good quality indexes with a patient mortality rate close to 12% per year. A centralized national renal transplantation program registered 5,949 renal transplants performed up to 2009. Renal survival at 5 years is 86% for living and 76% for cadaveric donor transplants. Organ donation is relatively low with 7.1 cadaveric donors pmp in 2009, despite legal and educational strategies to increase it. Although the country demonstrates one of the highest standards for RRT indexes in Latin America, the proportion of resources invested makes it necessary to improve early diagnosis and renal prevention policies to avoid having the growing incidence of CKD constrain the national health budget.
authors.affiliation: Department of Nephrology, Universidad Austral de Chile, Valdivia, Chile.
authors.forename: Leopoldo G
authors.initials: LG
authors.lastname: Ardiles
authors.forename: Hugo
authors.initials: H
authors.lastname: Poblete
authors.forename: Mireya
authors.initials: M
authors.lastname: Ortiz
authors.forename: Susana
authors.initials: S
authors.lastname: Elgueta
authors.forename: Ana María
authors.initials: AM
authors.lastname: Cusumano
authors.forename: Antonio
authors.initials: A
authors.lastname: Vukusich
authors.forename: Sergio
authors.initials: S
authors.lastname: Mezzano
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002677:Chile / Q000453:epidemiology; D002908:Chronic Disease; D003695:Delivery of Health Care / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006306:Health Surveys; D006801:Humans; D007674:Kidney Diseases / Q000191:economics / Q000453:epidemiology* / Q000628:therapy*; D016030:Kidney Transplantation / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000191:economics / Q000706:statistics & numerical data; D015995:Prevalence; D012042:Registries; D006435:Renal Dialysis / Q000191:economics / Q000706:statistics & numerical data; D017582:Renal Replacement Therapy / Q000191:economics / Q000379:methods* / Q000706:statistics & numerical data; D012189:Retrospective Studies; D055815:Young Adult