Department of Cardiovascular Medicine, University Hospitals Leuven, Leuven, Belgium, and Department of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven, Belgium.
EuroIntervention. 2017 May 15;13(Z):Z14-Z16. doi: 10.4244/EIJ-D-16-00825.
In a ranking of the gross domestic product per capita in 2015, Belgium ranked 19th in the world according to the International Monetary Fun1d and the World Bank. It has a Human Development Index of 0.890, in which it is preceded by only 20 other countries in the world. This is, at least in part, due to a well-developed social security system on which all citizens can rely. Over the last 5-10 years, however, this system has come under increasing pressure. This has resulted in insufficient, incomplete and late reimbursement of all technologies that were introduced over the last ten years in the cathlab: intracoronary imaging techniques are not reimbursed at all, and FFR only to a vastly insufficient degree. For several structural heart interventions, a system of limited and incomplete reimbursement has recently been set up, with a requirement to organise these procedures within the frames of hospital networks. Numbers of PCIs have risen by 15% over the last four years, coinciding with an increase in the number of cathlabs by 50%, aiming at better access to primary PCI for STEMI patients. This has also resulted in a decrease in the average procedure volume per centre. Two thirds of PCIs are performed via the radial access. DES penetration has increased to 74%, approaching 100% in some centres, while the uptake of BRS has been very limited so far.
在根据国际货币基金组织和世界银行的数据对 2015 年人均国内生产总值进行的排名中，比利时位列全球第 19 位。它的人类发展指数为 0.890，在全球仅排在 20 个其他国家之后。这至少部分归因于其完善的社会保障体系，所有公民都可以依赖该体系。然而，在过去的 5-10 年中，该体系面临越来越大的压力。这导致过去十年间在 cathlab 中引入的所有技术的报销不足、不完整和延迟：腔内影像学技术根本没有得到报销，FFR 也只是得到了非常不足的报销。对于几种结构性心脏介入技术，最近建立了一种有限和不完整的报销制度，并要求在医院网络框架内组织这些程序。过去四年，经皮冠状动脉介入治疗（PCI）的数量增加了 15%，同时 cathlab 的数量增加了 50%，旨在为 STEMI 患者提供更好的直接经皮冠状动脉介入治疗（PCI）机会。这也导致每个中心的平均手术量减少。三分之二的 PCI 通过桡动脉入路进行。药物洗脱支架（DES）的使用率已上升至 74%，某些中心已接近 100%，而生物可吸收支架（BRS）的使用率迄今为止非常有限。
