Reimbursement of Dialysis
| Autor: | Raymond, Vanholder, Andrew, Davenport, Thierry, Hannedouche, Jeroen, Kooman, Andreas, Kribben, Norbert, Lameire, Gerhard, Lonnemann, Peter, Magner, David, Mendelssohn, Subodh J, Saggi, Rachel N, Shaffer, Sharon M, Moe, Wim, Van Biesen, Frank, van der Sande, Rajnish, Mehrotra, Bessie, Young |
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| Přispěvatelé: | Interne Geneeskunde, RS: NUTRIM - R3 - Chronic inflammatory disease and wasting, RS: CARIM School for Cardiovascular Diseases |
| Rok vydání: | 2012 |
| Předmět: |
CHRONIC KIDNEY-DISEASE
HEMODIALYSIS medicine.medical_specialty medicine.medical_treatment Medizin Pay for performance Gross domestic product Peritoneal dialysis Reimbursement Mechanisms Renal Dialysis Environmental health Health care medicine Humans PROSPECTIVE-PAYMENT SYSTEM POSITION STATEMENT ESRD Intensive care medicine POPULATION Reimbursement PERITONEAL-DIALYSIS Ontario business.industry Home hemodialysis ANEMIA MANAGEMENT General Medicine CARE United States Europe Incentive PERSPECTIVES Nephrology Kidney Failure Chronic Prospective payment system business |
| Zdroj: | Journal of the American Society of Nephrology, 23(8), 1291-1298. American Society of Nephrology |
| ISSN: | 1046-6673 |
| DOI: | 10.1681/asn.2011111094 |
| Popis: | Reimbursement for chronic dialysis consumes a substantial portion of healthcare costs for a relatively small proportion of the total population. Each country has a unique reimbursement system that attempts to control rising costs. Thus, comparing the reimbursement systems between countries might be helpful to find solutions to minimize costs to society without jeopardizing quality of treatment and outcomes. We conducted a survey of seven countries to compare crude reimbursement for various dialysis modalities and evaluated additional factors, such as inclusion of drugs or physician payments in the reimbursement package, adjustment in rates for specific patient subgroups, and pay for performance therapeutic thresholds. The comparison examines the United States, the province of Ontario in Canada, and five European countries (Belgium, France, Germany, The Netherlands, and the United Kingdom). Important differences between countries exist, resulting in as much as a 3.3-fold difference between highest and lowest reimbursement rates for chronic hemodialysis. Differences persist even when our data were adjusted for per capita gross domestic product. Reimbursement for peritoneal dialysis is lower in most countries except Germany and the United States. The United Kingdom is the only country that has implemented an incentive if patients use an arteriovenous fistula. Although home hemodialysis (prolonged or daily dialysis) allows greater flexibility and better patient outcomes, reimbursement is only incentivized in The Netherlands. Unfortunately, it is not yet clear that such differences save money or improve quality of care. Future research should focus on directly testing both outcomes. |
| Databáze: | OpenAIRE |
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