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66 Hyperbaric Oxygenation Therapy KCE Reports 74
5.8 COST ANALYSIS FROM A PATIENT’S POINT OF VIEW
In this cost analysis, the following costs for the patient are considered: treatment and
physician consultation, hospitalization, and transport costs.
5.8.1 Treatment and consultation cost
For the first and second day of HBOT treatment, the fee is determined by RIZIV/INAMI
and is 100% reimbursed. From the third day onwards, the centres can freely set their
fee. Based on the questionnaire, some centres offer the treatment for free and the
hospital bears the full cost of treatment, others ask a fee of around €20-30 per 90minutes
session (covering costs of the treatment, the material needed and the
consultation), or a fixed fee of €200 if more than five sessions are needed. One hospital
has an agreement with a local sickness fund to reimburse €45 per session. Extra fees
could be charged for treatment during the night, weekends and legal holidays. For
transcutaneous oxygen measurement, some hospitals ask an extra fee of about €50,
while others provide this for free. For monitoring with strip an extra fee is sometimes
charged.
HBOT treatment at the military hospital or the marine basis at Zeebrugge is free of
charge for the patient. The only exception is for diving accidents when the sports
insurer intervenes. For diving accidents, a longer treatment (e.g. US Navy TT6
treatment) may be given, which comes at a considerably higher cost.
A physician consultation fee often has to be paid on top of the HBOT fee. The general
fees apply, which imply an out-of-pocket payment of €7.24 for a normally insured
patient and €2.47 for a preferentially insured patient.
5.8.2 Hospitalization cost
The daily patient out-of-pocket fees for the hospital stay are shown in Table 14. This
price depends on the length of stay and the patient’s insurance status. Since transport
costs are not reimbursed and because there is no difference in reimbursement of
ambulatory versus hospitalized treatment, there is limited, if any, financial incentive for
the patient to choose for the ambulatory treatment.
Table 14. Hospitalization costs (2008)
1st day 2nd to 90th day From 91th day
Normally insured €40.86 €13.59 €13.59
With children €32.10 €4.83 €4.83
Preferential insured €4.83 €4.83 €4.83
The patient also pays a marginal fixed fee of €0.62 per day for reimbursed drugs, even
when the patient has not consumed any drugs.