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102 Musculoskeletal & Neurological Rehabilitation KCE reports 57 25.000.000 20.000.000 15.000.000 10.000.000 5.000.000 -5.000.000 Figure 5.31: Yearly expenditures growth (absolute figures) for the subsectors of musculoskeletal rehabilitation 0 € K-Nomenclature Convention 950 Convention 771 Source: RIZIV/INAMI 2006 Figure 5.32 shows the net growth (absolute) for each subsector from 2000 to 2004. The K-nomenclature expenses increase throughout 2000-2004 (net growth of €21 105 802). The convention 9.50 has a positive but relatively small growth of €2 432 354 for 2000-2004, the convention 7.71 shows a more significant growth in three out of four years, representing €6 483 259. 2004 2003 2002 2001
KCE reports 57 Musculoskeletal & Neurological Rehabilitation 103 190% 180% 170% 160% 150% 140% 130% 120% 110% 100% Figure 5.32: Trend analysis of the expenditures of the subsectors of Rehabilitation (%) 2000 2001 2002 2003 2004 Source: RIZIV/INAMI 2006 % K-Nomenclature Convention 950 Convention 771 The expenditures evolution in percentage points (2000 = 100 %) shows (Figure 5.32): • K nomenclature: a growth of 50% during the period 2000 – 2004 with a slowdown in growth in the period 2001-2002. • Convention 9.50: a growth of 45 % during the period 2000 – 2004 with a slow down in growth in the period 2003-2004 • Convention 7.71: a growth of 83 % during the period 2000 – 2004 with negative growth in the period 2002 – 2003. The effect of the new K-nomenclature in August 2004 and the new convention 9.50 in July 2005 are analysed in the previous paragraphs. Explanatory factors for the increase of the expenditures in the different subsectors might be the following: During the last decade the length of stay (LoS) decreased significantly in the acute departments of the Belgian hospitals, due to the “PAL/NAL” system (a system in which a hospital is financially penalized if there are a “positive number of hospitalisation days”, as compared to the country’s average, taking into account differences in pathology between hospitals). This system was applied until July 2002. Since then, the system of “justified beds” has similar incentives. Patients are transferred to rehabilitation centres much sooner now. This had as a consequence that several acute beds were converted into Sp-beds (cf. KB 12-06-2002). So the number of Sp-beds grew over the last years. For instance, between 2002 and 2005 the number of neurological Sp beds increased from 1203 to 1304 and of musculoskeletal Sp beds from 1582 to 1915. The number of departments PM&R grew the last decades and only few hospitals do not have a specialist in PM&R nowadays. Another hypothesis is that due to ‘progress in medicine’, an increasing number of very severely ill (e.g. critically ill patients staying several months in intensive care) or severely disabled patients (e.g. high tetraplegics dependent on artificial ventilation) survive. So,
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Dépôt légal : D/2007/10.273/19
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35. Etude relative aux coûts poten
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