Reimbursement of dialysis: A comparison of seven countries

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 Moe, Wim Van Biesen, Frank Van Der Sande, Rajnish Mehrotra

Research output: Contribution to journalArticle

68 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)1291-1298
Number of pages8
JournalJournal of the American Society of Nephrology
Volume23
Issue number8
DOIs
StatePublished - Aug 2012

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Dialysis
Netherlands
Germany
Home Hemodialysis
Incentive Reimbursement
Gross Domestic Product
Social Adjustment
Cost Control
Quality of Health Care
Belgium
Arteriovenous Fistula
Peritoneal Dialysis
Ontario
Health Care Costs
France
Canada
Renal Dialysis
Motivation
Physicians
Costs and Cost Analysis

ASJC Scopus subject areas

  • Nephrology

Cite this

Vanholder, R., Davenport, A., Hannedouche, T., Kooman, J., Kribben, A., Lameire, N., ... Mehrotra, R. (2012). Reimbursement of dialysis: A comparison of seven countries. Journal of the American Society of Nephrology, 23(8), 1291-1298. https://doi.org/10.1681/ASN.2011111094

Reimbursement of dialysis : A comparison of seven countries. / Vanholder, Raymond; Davenport, Andrew; Hannedouche, Thierry; Kooman, Jeroen; Kribben, Andreas; Lameire, Norbert; Lonnemann, Gerhard; Magner, Peter; Mendelssohn, David; Saggi, Subodh J.; Shaffer, Rachel N.; Moe, Sharon; Van Biesen, Wim; Van Der Sande, Frank; Mehrotra, Rajnish.

In: Journal of the American Society of Nephrology, Vol. 23, No. 8, 08.2012, p. 1291-1298.

Research output: Contribution to journalArticle

Vanholder, R, Davenport, A, Hannedouche, T, Kooman, J, Kribben, A, Lameire, N, Lonnemann, G, Magner, P, Mendelssohn, D, Saggi, SJ, Shaffer, RN, Moe, S, Van Biesen, W, Van Der Sande, F & Mehrotra, R 2012, 'Reimbursement of dialysis: A comparison of seven countries', Journal of the American Society of Nephrology, vol. 23, no. 8, pp. 1291-1298. https://doi.org/10.1681/ASN.2011111094
Vanholder R, Davenport A, Hannedouche T, Kooman J, Kribben A, Lameire N et al. Reimbursement of dialysis: A comparison of seven countries. Journal of the American Society of Nephrology. 2012 Aug;23(8):1291-1298. https://doi.org/10.1681/ASN.2011111094
Vanholder, Raymond ; Davenport, Andrew ; Hannedouche, Thierry ; Kooman, Jeroen ; Kribben, Andreas ; Lameire, Norbert ; Lonnemann, Gerhard ; Magner, Peter ; Mendelssohn, David ; Saggi, Subodh J. ; Shaffer, Rachel N. ; Moe, Sharon ; Van Biesen, Wim ; Van Der Sande, Frank ; Mehrotra, Rajnish. / Reimbursement of dialysis : A comparison of seven countries. In: Journal of the American Society of Nephrology. 2012 ; Vol. 23, No. 8. pp. 1291-1298.
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