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104 Musculoskeletal & Neurological Rehabilitation KCE reports 57 even though prevention for road traffic and working accidents improves, the need for rehabilitation seems to increase. Part of the growth in expenditures is due to inflation. However, comparing the growth in the expenditures for rehabilitation to the overall growth in RIZIV/INAMI expenditures in Figure 5.28, it is clear that the growth in rehabilitation expenditures is larger than the overall growth in RIZIV/INAMI expenditures. 5.1.9.2 Relation between subsectors and in- versus outpatients An analysis of the treatments, given to in- and outpatients in the different systems (based on the RIZIV-INAMI data from 2000-2004) gives following results: Figure 5.33: Overview of treatments for in- and outpatients (cumulative for years 2000 to 2004) Treatments Inpatient Outpatient K-nomenclature 3.303.654 63% 1.920.117 37% Convention 9.50 249.351 22% 897.667 78% Convention 7.71 312.134 62% 188.805 38% Source: RIZIV/INAMI 2006 The proportion of treatment sessions, given to inpatient / outpatient is different for all systems: • In the 9.50 convention the majority of the treatments focuses on outpatients • In K nomenclature and 7.71 convention the majority of the treatments focuses on inpatients The fact that in the 9.50 population there are substantially more outpatients, might be explained as follows: • The transport convention is mostly linked to the convention system (mostly 9.50). • It often happens that if a patient is a candidate for reimbursement of the expenditures for transport (only for wheelchair bound patients), he is “switched” from K to 9.50 when he is discharged from hospital and starting ambulatory rehabilitation. (This mechanism is impossible since the “new” 9.50 convention (cf. chapter 1.6), starting August 1st 2006.) • Some centres with a 7.71 convention also have a transport convention. As they usually deal with severely impaired patients in an early postacute phase, the majority of the patients is hospitalised. In the ambulatory phase they can be referred to a regional 9.50 centre, closer to the patients home. • Some other 7.71 centres deal with chronic patients (mostly MS) and then thus often treat ambulatory patients 5.1.9.3 Expenditures of the “transport convention” A specific expenditure that has to be added for the musculoskeletal and neurological rehabilitation sector is the expenditures of the “transport convention”. This allows wheelchair bound patients to travel with reimbursement between their home and the rehabilitation centre. Several centres with a convention 9.50/7.71 have this transport agreement with RIZIV/INAMI. The total fees (Source: RIZIV/INAMI 2006) account for the following cumulated (2000- 2004) expenditures:
KCE reports 57 Musculoskeletal & Neurological Rehabilitation 105 • Convention 7.71: €6 940 586 • Convention 9.50: €16 714 566 Based on the aggregated data (expenditures for transport were only available for the 5 years period 2000-2004 as a whole) is concluded: • For the convention 7.71 transport fees account for 11% of the total expenditures (therapy + transport); • For the convention 9.50 transport fees account for 33% of the total expenditures (therapy + transport). This difference can be explained by the large proportion of outpatients in the 9.50 convention (78%) versus the lower proportion of outpatients in the 7.71 convention (38%) 5.1.9.4 Total expenditures for musculoskeletal and neurological rehabilitation The total expenditures for musculoskeletal and neurological rehabilitation is calculated based on: • K-Nomenclature: all treatment expenditures • Convention 9.50 / 7.71: all treatment expenditures + transport fees (the total transport expenditure was distributed equally over the 5 years as only aggregated data were at our disposal) Figure 5.34: Total expenditures for musculoskeletal and neurological rehabilitation (K nomenclature, 9.50/ 7.71 convention incl. transport fees) € 2000 2001 2002 2003 2004 K-Nomenclature 39.369.316 45.025.801 47.306.026 55.888.616 60.475.118 Convention 950 8.796.711 9.853.716 10.081.042 11.247.376 11.229.064 Convention 771 9.174.068 11.001.612 13.417.851 12.945.513 15.657.327 Total (incl. transport) 57.340.095 65.881.129 70.804.919 80.081.505 87.361.509 Source: RIZIV/INAMI 2006 As indicated before, these total expenditures are an underestimation of the total expenditures for musculoskeletal and neurological rehabilitation because the part of the M-nomenclature and R-nomenclature cannot be allocated to musculoskeletal and neurological rehabilitation (due to lacking data). The total expenditures for musculoskeletal and neurological rehabilitation, as defined above, over a five year period (2000-2004) are visualised in Figure 5.35.
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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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