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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,