How the reimbursement system may influence physicians’ decisions results from focus groups interviews in France

Huttin, Christine; Andral, J

doi:10.1016/s0168-8510(00)00101-9

Cited by 23 publications

(23 citation statements)

References 19 publications

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“…There is a level of disagreement with medical paternalism; the notion that the doctor will consider what is best for patients [29]. Out-of-pocket costs for patients may influence the information and recommendations provided about treatment options by doctors [28]. It is generally accepted that physicians want to protect their patients against stressful situations, particularly expensive treatment options which may be deemed unaffordable.…”

Section: Patient-physician Relationshipmentioning

confidence: 99%

“…However, some report the need for autonomy in their treatment decisions and are unwilling to accept restrictions imposed by governments and health authorities and will resist or find ways to overcome these restrictions [15]. Physicians -in their role as patient advocates -would like politicians to take responsibility for funding decisions [28,43]. Physicians saw the need to have "direct consumer representation in an open and transparent process" [12].…”

Section: Health Policymentioning

confidence: 99%

“…The fact that physicians may not be easily able to manage conversations relating to the funding of HCM may also influence whether the subject is being mentioned. Alternative options for the patients are shift to cheaper, older drugs or drugs with different reimbursement characteristics [28].…”

Section: Patient-physician Relationshipmentioning

confidence: 99%

“…There is a school of thought that believe drug costs should not play a major role in influencing decision making for individual patient care [28]. Physicians who agree a reasonable cost-effectiveness threshold often ignore this threshold when deciding about therapy for an individual patient [48].…”

Section: Cost-effectiveness and Social Responsibilitymentioning

confidence: 99%

“…This shows the potential for conflict and tension between societal responsibility and the well-being of individual patients. In some countries, the costs to the health care system are more relevant to physicians than the costs for patients [28]. Physicians' preferences for certain treatment benefits can be different from health economic considerations.…”

Section: Cost-effectiveness and Social Responsibilitymentioning

confidence: 99%

See 4 more Smart Citations

Identifying stakeholder opinion regarding access to “high-cost medicines”: A systematic review of the literature

et al. 2014

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AbstractObjective: To identify the viewpoints and perceptions of different stakeholders regarding high cost medicines (HCMs). Methods: A systematic review of the literature was performed to identify original research articles. Using predefined categories, data related to the viewpoints of different stakeholders was systematically extracted and analyzed. Results: Thirty seven original research articles matched the criteria. The main stakeholders identified include physicians, patients, public and health funding authorities. The influence of media and other economic and ethical issues were also identified in the literature. A large number of stakeholders were concerned about lack of access to HCMs. Physicians have difficulty balancing the the rational use of expensive drugs while at the same time acting as “patients’ advocate”. Patients would like to know about all treatment options, even if they may not be able to afford them. The process and criteria for reimbursement should be transparent and access has to be equitable across patient groups. Conclusion: Access to HCMs could be improved through transparency and involvement of all stakeholders, especially patients and the public. Moral issues and the “rule of rescue” could influence decision-making process significantly. At system level, objectivity is important to ensure that the system is equitable and transparent.

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Section: Patient-physician Relationshipmentioning

confidence: 99%

Section: Health Policymentioning

confidence: 99%

Section: Patient-physician Relationshipmentioning

confidence: 99%

Section: Cost-effectiveness and Social Responsibilitymentioning

confidence: 99%

Section: Cost-effectiveness and Social Responsibilitymentioning

confidence: 99%

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Identifying stakeholder opinion regarding access to “high-cost medicines”: A systematic review of the literature

et al. 2014

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Hypertension

2006

Wiley Handbook of Current and Emerging Drug Therapies

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Physician perspectives on the implications of the diagnosis‐related groups for medical practice in Turkey: A qualitative study

Aktas

2022

Health Planning & Management

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Hospital reimbursement models might have unintended consequences for medical practice. In Turkey, a mixed reimbursement scheme, based on the diagnosis-related group (DRG) model and global budget, was gradually introduced as part of the country's 2003 healthcare reforms. This article examines the impacts of the DRG model on medical practice in Turkey, as perceived by physicians working in public and private hospitals. This study draws on an analysis of 14 interviews with physicians. The findings reveal that the implementation of the DRG has transformed medical practice into a process of cost-benefit optimisation which involves balancing the income and expenses of hospitals against patients' medical needs. To mitigate the negative effects of the DRG, the current model may need to be reformed, particularly to grant exemptions from the standard reimbursement structure for patients who are experiencing complications and/or multiple health conditions.

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How the reimbursement system may influence physicians’ decisions results from focus groups interviews in France

Cited by 23 publications

References 19 publications

Identifying stakeholder opinion regarding access to “high-cost medicines”: A systematic review of the literature

Identifying stakeholder opinion regarding access to “high-cost medicines”: A systematic review of the literature

Hypertension

Physician perspectives on the implications of the diagnosis‐related groups for medical practice in Turkey: A qualitative study

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