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106 Musculoskeletal & Neurological Rehabilitation KCE reports 57 90.000.000 85.000.000 80.000.000 75.000.000 70.000.000 65.000.000 60.000.000 55.000.000 50.000.000 Figure 5.35: Evolution of the estimated total expenditures for musculoskeletal and neurological rehabilitation (Euro) 57.340.095 65.881.129 € 70.804.919 80.081.505 2000 2001 2002 2003 2004 Source: Riziv/Inami 2006 87.361.509 The evolution of the expenditures for musculoskeletal and neurological rehabilitation has a high year-to-year growth rate that slows down from 2001 to 2002, but picks up in 2003. The total expenditures growth for the three sub sectors in the period 2000 – 2004 is 52 %. 5.1.9.5 Expenditures for the Sp hospitalisation day price Another expenditure that was not included in the above calculation is the day price that hospitals receive for a hospitalised patient. Musculoskeletal and neurological rehabilitation patients however can stay in different types of “beds” (cf. S2/S3) and will not always be in Sp-beds (also acute, geriatric, paediatric etc.). Therefore we include the total expenditures of the Specialist beds (Sp) as an indication, without including this in the total expenditures for musculoskeletal rehabilitation. The years do not correspond to those in the other paragraphs concerning K nomenclature and conventions but due to organisational changes at the Federal Public Service of Public Health (FOD Volksgezondheid/SPF Santé Publique) it was more coherent to analyse the data starting with the year 2003.
KCE reports 57 Musculoskeletal & Neurological Rehabilitation 107 Figure 5.36: S-beds per type 2003 2004 2005 S310 CARDIO-PULMONAIRES 426 463 449 S311 AFFECTIONS NEUROLOGIQUES 1219 1240 1304 S312 AFFECTIONS LOCOMOTRICES 1776 1856 1915 S313 AFFECTIONS CHRONIQUES 1084 1052 1021 S314 Service de soins palliatifs 369 373 385 S315 PSYCHO-GERIATRIE 1027 1029 1014 Total 5899 6013 6088 Source r: FOD Volksgezondheid/SPF Santé Publique 2006 Figure 5.36 shows that the proportion of S2/S3 to the total number of Sp-beds is approximately half of the total number of beds for the different years. Figure 5.37: Total expenditures for Sp-beds 2003 2004 2005 € € € Total hospital expenditures 10.190.433.459 10.645.257.850 10.516.129.503 Sp-beds expenditures 290.319.961 299.240.812 303.088.961 % of Sp-beds expenditures in total 2,85% 2,81% 2,88% Average expenditure (day price) 217 204 212 Minimum expenditure (day price) 60 47 47 Maximum expenditure (day price) 911 473 683 Source: FOD Volksgezondheid/SPF Santé Publique 2006 The total expenditures of S-beds increase with 4% in 3 years. This is in line with the overall expenditure growth of hospital financing, where we notice a 3% growth in 3 years (Figure 5.37). Earlier data (2000-2002) are not comparable to later years, due to a change in the reimbursement scheme (ex-post to à priori). The norms for specialist beds (cf. regulation on specialist beds s ) stipulate that with an 80% occupancy ratio, the hospital has to provide additional therapeutic personnel. This does not cover other interventions financed by RIZIV/INAMI or other third parties. • For every 30 S2/S3 beds, with 80% occupancy: 2 FTE occupational therapist, speech therapist or paramedical with relevant rehabilitation experience; availability of a psychologist The requirements include minimal staffing for nurses and physicians. The day price t is composed of different elements (infrastructure, nurses, etc.). 5.1.9.6 Proportion cases/expenditures in the different subsectors We notice in Figure 5.38 that the proportion of cases to the total expenditures is different for each sub sector (due to different pricing of the treatments). r There are two different databases for the inventory of S2/S3 beds. The first database gives an overview of the total number of beds at a certain point in time (e.g. figure 4), the second source calculates a year-to-date average of the total number of beds and takes into account the variation per institution in this given year (e.g. figure 30). These databases diverge for the indicator “total number of beds” given their different calculation. s Koningklijk Besluit / Arrêté Royale – 21 October 1998 t FPS Public Health 2006
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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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