Organization and reimbursement of enteral and parenteral nutrition in and outside the hospital in Belgium

KCE Reports 315C (2019)

In Belgium, 33% of hospital patients, 16% of residential care residents, and nearly 13% of elderly people living at home suffer from malnutrition. For people who are not or no longer capable of feeding themselves normally, food must be administered via a tube into their digestive tract (enteral nutrition), or via a drip directly into their blood stream (parenteral nutrition).

In Belgium, the reimbursement rules for these two types of nutrition are not always logical. Thus, in hospital, nutrition via a tube costs the patient nothing, whereas, at home, it costs them between €11 and €28 per day. Conversely, parenteral nutrition costs a hospital patient around €11 per day, but is practically free at home. KCE recommends changing the reimbursement procedures so that the costs payable by patients are similar, regardless of where they are being treated and what type of nutrition they require.

Full reimbursement would represent a budget increase for health insurance of around €16 million.