International Journal of Health Care Finance and Economics

, Volume 7, Issue 2, pp 149-169

First online:

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

  • Braden J. MannsAffiliated withDepartment of Medicine, University of CalgaryDepartment of Community Health Sciences, University of CalgaryInstitute of Health Economics Email author 
  • , David C. MendelssohnAffiliated withHumber River Regional Hospital, University of Toronto
  • , Kenneth J. TaubAffiliated withDepartment of Medicine, University of Calgary

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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.


End-stage renal disease Dialysis Health care financing Medical costs Reimbursement Canada

JEL Classification

I10 I11 I12 I18