The economics of end-stage renal disease care in Canada: incentives and impact on delivery of care

Int J Health Care Finance Econ. 2007 Sep;7(2-3):149-69. doi: 10.1007/s10754-007-9022-y.


Examining international differences in health outcomes for end-stage renal disease (ESRD) patients requires an understanding of ESRD funding structures. In Canada, funding for all aspects of dialysis and transplant care, with the exception of drugs (for which supplementary insurance can be purchased), is provided for all citizens. Although ESRD programs across Canada's 10 provinces differ in funding structure, they share important economic characteristics, including being publicly funded and universal, and providing most facets of ESRD care for free. This paper explains how ESRD care fits into the Canadian health care system, describes the epidemiology of ESRD in Canada, and offers economic explanations for international discrepancies.

Publication types

  • Review

MeSH terms

  • Canada / epidemiology
  • Delivery of Health Care / economics
  • Delivery of Health Care / organization & administration*
  • Dialysis / economics
  • Guideline Adherence
  • Health Expenditures
  • Health Services / economics
  • Health Services / statistics & numerical data
  • Humans
  • Kidney Failure, Chronic / economics*
  • Kidney Failure, Chronic / epidemiology
  • Kidney Failure, Chronic / therapy*
  • Models, Econometric
  • National Health Programs / economics
  • National Health Programs / organization & administration*
  • Practice Guidelines as Topic
  • Quality of Health Care / economics
  • Reimbursement Mechanisms / organization & administration