Hyperbare Zuurstoftherapie: Rapid Assessment - KCE

2 Hyperbaric Oxygenation Therapy KCE Reports 74
4.5 CONCLUSION ..................................................................................................................................54
5 THE BELGIAN SITUATION .................................................................................. 55
5.1 HISTORICAL CONTEXT....................................................................................................................55
5.2 CURRENT RIZIV/INAMI NOMENCLATURE AND REGULATION ................................................55
5.2.1 RIZIV/INAMI fee-for-service system in general................................................................55
5.2.2 RIZIV/INAMI nomenclature for hyperbaric oxygen therapy .........................................55
5.3 CURRENT RIZIV TARIFF....................................................................................................................56
5.3.1 RIZIV/INAMI tariff level .........................................................................................................56
5.3.2 RIZIV/INAMI reimbursement level......................................................................................56
5.3.3 RIZIV/INAMI military hospital fee........................................................................................56
5.4 RIZIV/INAMI EXPENDITURES FOR HBOT IN BELGIUM .............................................................56
5.5 PREVIOUS PROPOSAL FOR AN ADAPTED NOMENCLATURE.......................................................57
5.6 PROVIDERS OF HBOT ....................................................................................................................59
5.7 CURRENT PRACTICE BY INDICATION............................................................................................60
5.7.1 Results from questionnaire to hyperbaric centres...........................................................60
5.7.2 Results from financial and clinical registration data..........................................................63
5.8 COST ANALYSIS FROM A PATIENT’S POINT OF VIEW..................................................................66
5.8.1 Treatment and consultation cost.........................................................................................66
5.8.2 Hospitalization cost ................................................................................................................66
5.8.3 Transportation cost ................................................................................................................67
5.9 COST ANALYSIS FROM A HOSPITAL’S POINT OF VIEW................................................................67
5.9.1 Investment costs and expected lifetime of equipment....................................................67
5.9.2 Operational costs....................................................................................................................68
5.9.3 Overview of analyzed scenarios...........................................................................................71
5.9.4 Variables with probability distribution functions ..............................................................71
5.9.5 Results: cost per patient per session...................................................................................72
5.9.6 Impact of lifetime of the equipment ....................................................................................75
5.9.7 Discussion.................................................................................................................................76
6 INTERNATIONAL COMPARISON......................................................................... 78
6.1 THE NETHERLANDS ........................................................................................................................78
6.1.1 Hyperbaric centres .................................................................................................................78
6.1.2 Covered indications................................................................................................................78
6.1.3 Non-covered indications .......................................................................................................79
6.1.4 Reimbursement level ..............................................................................................................79
6.2 FRANCE.............................................................................................................................................79
6.2.1 Hyperbaric centres .................................................................................................................79
6.2.2 Covered indications................................................................................................................80
6.2.3 Reimbursement level ..............................................................................................................80
6.3 UNITED KINGDOM..........................................................................................................................81
6.3.1 Hyperbaric centres .................................................................................................................81
6.3.2 Covered indications................................................................................................................82
6.3.3 Fees for HBOT ........................................................................................................................82
6.4 UNITED STATES ...............................................................................................................................83
6.4.1 Medicare covered indications...............................................................................................83
6.4.2 Non covered indications........................................................................................................84
6.4.3 Medicare charges for HBOT.................................................................................................85
6.5 GERMANY .........................................................................................................................................86
6.5.1 Hyperbaric centres .................................................................................................................86
6.5.2 Covered indications................................................................................................................86
6.5.3 Fees for HBOT ........................................................................................................................87
6.6 AUSTRALIA........................................................................................................................................87
6.6.1 Hyperbaric centres .................................................................................................................87
6.6.2 Covered indications and fees for HBOT............................................................................87