SNS financed 98.5% of hemodialysis courses in 2023

The National Health Service (SNS) financed 98.5% of haemodialysis treatments in 2023, reaching 262.5 million euros, an increase of 11.6% compared to the previous year, the Health Regulatory Authority (ERS) reported this Monday.

The health regulator has published a report with information on monitoring the conventional haemodialysis sector, covering data for the past year to December 31, analysing “supply, competitive structure of markets and compliance with quality requirements in the provision of haemodialysis care”, providing an opportunity to check the progress recorded.

Data from the Integrated Platform for Disease Management (PGID) show that in 2023 there was “a very significant reduction in the number of users funded by government subsystems (reaching near zero values) and a corresponding increase in the number” of those treated through SNS.

As of that date, the platform had 12,750 registered users for haemodialysis treatment, 11,727 (92.0%) of whom were treated in 104 dialysis units in the private and social sectors and 1,023 (8.0%) in public hospitals.

The report notes that for clinical quality indicators, “almost all global averages exceed the targets set by the DGS (Directorate General of Health)”, as has been the case in recent years, “with five indicators fully achieved by all units (100% compliance)”.

On the other hand, it was estimated that about 69% of users were treated at the unit closest to their place of residence, and that the average travel time between arrival at their place of residence and the haemodialysis unit was “00 hours 16 minutes, representing a reduction of approximately two hours and minutes compared to the average of the previous year.”

ERS also attempted to understand user satisfaction levels by analysing the ‘complaints, compliments and suggestions (REC processes)’ in the General Complaints System (SGREC), which found that 27.2% of the processes were ‘compliments/praises on the service provided’.

“In terms of complaints, it was found that 24.5% of processes related to health and patient safety, followed by issues related to user orientation (16.6%).”

And also that the issues that generated the largest relative number of processes “were common to public and private sector institutions: health and patient safety (38.3% in the private sector and 32.6% in the public sector) and user focus (20% from the private sector and 30.2% from the public sector).”

According to PGID, in December 2023 there were 137 units providing haemodialysis care, of which 104 (two more than in December 2022) were from the private and social sectors, and that “in two regions, care continued to be provided by the SNS hospital units located there, without recourse to the agreed sector”.

In terms of competition, ERS found that the combined share of the two largest national groups in the sector fell by one percentage point compared to December 2022, remaining at 70.9%.

The regulator notes that the national market and most regional markets continue to have “high levels of concentration,” “with five regions in a monopoly structure.” The exception is the Porto metropolitan area, the only one with a moderate level of concentration.

The report also found that last year, hemodialysis stood out as “the area of ​​agreement with the largest expenditure volume, representing 28.6% of total government expenditure in the agreed sector, followed by the area of ​​clinical analysis, with 25.6%,” adding that there was also “an increase in the relative weight of hemodialysis in congressional expenditure of 4.6 percentage points compared to 2022.”