Technical-economic management models in dialytic treatment: an evolving reality. The Italian experience.
J Nephrol
; 13 Suppl 3: S20-7, 2000.
Article
en En
| MEDLINE
| ID: mdl-11132029
ABSTRACT
Health care organisations and financial factors (particularly treatment reimbursement rates) may influence the management of ESRD. We analysed the organisation of renal replacement therapy (RRT) in Italy, focusing on RRT population trends, patient distribution by treatment modality and provision, reimbursement rates, accreditation and quality control. Data from the Italian Dialysis and Transplant Registry and market research studies indicate that Italy has one of the highest dialysis and treatment acceptance rates in Europe. There is a high rate of hemodialysis (HD) and good use of peritoneal dialysis (PD), whereas the prevalence of transplanted patients is lower than the European mean. Dialytic treatment in private centers is limited by law to HD (mainly in Central-Southern Italy) and covers nearly 25-30% of the demand for RRT which means that, although Italy has a public national health care system, the provision of RRT is based on a "mixed" model. Regions with a higher prevalence of "private" dialysis have more dialysis centers, but a lower prevalence of PD since it is not permitted in private facilities, and fewer transplanted patients. The "public" system is not an automatic guarantee of quality and efficacy, and the "private" system is not necessarily a synonym of poor quality treatment due to its need to make a profit. The coexistence of private and public facilities (if well balanced and integrated) may in fact help overcoming bureaucracy in the public administration in relation to the demand for innovation and improving performances by means of fair competition.
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Bases de datos:
MEDLINE
Asunto principal:
Terapia de Reemplazo Renal
/
Modelos Teóricos
Tipo de estudio:
Health_economic_evaluation
/
Prognostic_studies
/
Risk_factors_studies
País/Región como asunto:
Europa
Idioma:
En
Revista:
J Nephrol
Año:
2000
Tipo del documento:
Article
País de afiliación:
Italia