What drives centralisation in cancer care?

Kilsdonk, Melvin J.; Siesling, Sabine; Dijk, Boukje A. C. van; Wouters, Michel W. J. M.; Harten, Wim H. van

doi:10.1371/journal.pone.0195673

Cited by 30 publications

(23 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In cases where these standards are not met, criteria applied to comply with them vary between countries. Some deny authorisation for practicing the surgical procedure at hand, while others withhold reimbursement from low-volume hospitals for the procedures [43,44]. This is an example of how reimbursement can be used to support…”

Section: Resultsmentioning

confidence: 99%

Innovation, value and reimbursement in radiation and complex surgical oncology: Time to rethink

Borràs

Corral

Aggarwal

et al. 2022

Radiotherapy and Oncology

View full text Add to dashboard Cite

Background and purpose: Complex surgery and radiotherapy are the central pillars of loco-regional oncology treatment. This paper describes the reimbursement schemes used in radiation and complex surgical oncology, reports on literature and policy reviews. Material and methods: A systematic review of the literature of the reimbursement models has been carried out separately for radiotherapy and complex cancer surgery based on PRISMA guidelines. Using searches of PubMed and grey literature, we identified articles from scientific journals and reports published since 2000 on provider payment or reimbursement systems currently used in radiation oncology and complex cancer surgery, also including policy models. Results: Most European health systems reimburse radiotherapy using a budget-based, fee-for-service or fraction-based system; while few reimburse services according to an episode-based model. Also, the reimbursement models for cancer surgery are mostly restricted to differences embedded in the DRG system and adjustments applied to the fees, based on the complexity of each surgical procedure. There is an enormous variability in reimbursement across countries, resulting in different incentives and different amounts paid for the same therapeutic strategy. Conclusion:A reimbursement policy, based on the episode of care as the basic payment unit, is advocated for. Innovation should be tackled in a two-tier approach: one defining the common criteria for reimbursement of proven evidence-based interventions; another for financing emerging innovation with uncertain definitive value. Relevant clinical and economic data, also collected real-life, should support reimbursement systems that mirror the actual cost of evidence-based practice.

show abstract

Section: Resultsmentioning

confidence: 99%

Innovation, value and reimbursement in radiation and complex surgical oncology: Time to rethink

Borràs

Corral

Aggarwal

et al. 2022

Radiotherapy and Oncology

View full text Add to dashboard Cite

show abstract

Section: Advantages Disadvantagesmentioning

confidence: 99%

Innovation, value and reimbursement in radiation and complex surgical oncology: Time to rethink

Borràs

Corral²,

Aggarwal

et al. 2021

European Journal of Surgical Oncology

View full text Add to dashboard Cite

Background and purpose: Complex surgery and radiotherapy are the central pillars of loco-regional oncology treatment. This paper describes the reimbursement schemes used in radiation and complex surgical oncology, reports on literature and policy reviews. Material and methods: A systematic review of the literature of the reimbursement models has been carried out separately for radiotherapy and complex cancer surgery based on PRISMA guidelines. Using searches of PubMed and grey literature, we identified articles from scientific journals and reports published since 2000 on provider payment or reimbursement systems currently used in radiation oncology and complex cancer surgery, also including policy models. Results: Most European health systems reimburse radiotherapy using a budget-based, fee-for-service or fraction-based system; while few reimburse services according to an episode-based model. Also, the reimbursement models for cancer surgery are mostly restricted to differences embedded in the DRG system and adjustments applied to the fees, based on the complexity of each surgical procedure. There is an enormous variability in reimbursement across countries, resulting in different incentives and different amounts paid for the same therapeutic strategy. Conclusion: A reimbursement policy, based on the episode of care as the basic payment unit, is advocated for. Innovation should be tackled in a two-tier approach: one defining the common criteria for reimbursement of proven evidence-based interventions; another for financing emerging innovation with uncertain definitive value. Relevant clinical and economic data, also collected real-life, should support reimbursement systems that mirror the actual cost of evidence-based practice.

show abstract

“…Although the benefits of centralization of care of rare diseases are now widely accepted, they typically reflect a long process. Very strong scientific evidence is needed to drive physicians to alter their patterns of care [21].…”

Section: Structure Indicatorsmentioning

confidence: 99%

Value and Quality of Care in Head and Neck Oncology

et al. 2020

View full text Add to dashboard Cite

Purpose of Review The concept of value-based health care (VBHC) was articulated more than a decade ago. However, its clinical implementation remains an ongoing process and a particularly demanding one for the domain of head and neck cancer (HNC). These cancers often present with fast growing tumors in functionally and cosmetically sensitive sites and afflict patients with differing circumstances and comorbidity. Moreover, the various treatment modalities and protocols have different effects on functional outcomes. Hence, the interpretation of what constitutes VBHC in head and neck oncology remains challenging. Recent Findings This monograph reviews developments in specific aspects of VBHC for HNC patients, including establishment of registries and quality indices (such as infrastructure, process, and outcome indicators). It emphasizes the importance of the multidisciplinary team, "time to treatment intervals," and adherence to guidelines. The discussion addresses major indicators including survival, quality of life and functional outcomes, and adverse events. Also, strengths and weaknesses of nomograms, prognostic and decision models, and variation of care warrant attention. Summary Health care professionals, together with patients, must properly define quality and relevant outcomes, both for the individual patient as well as the HNC population. It is essential to capture and organize the relevant data so that they can be analyzed and the results used to improve both outcomes and value. Keywords Head and neck. Cancer. Quality of care. Indicators. Value-based health care This article was written by members and invitees of the International Head and Neck Scientific Group (www.IHNSG.com). This article is part of the Topical Collection on Head and Neck Cancers.

show abstract

What drives centralisation in cancer care?

Cited by 30 publications

References 23 publications

Innovation, value and reimbursement in radiation and complex surgical oncology: Time to rethink

Innovation, value and reimbursement in radiation and complex surgical oncology: Time to rethink

Innovation, value and reimbursement in radiation and complex surgical oncology: Time to rethink

Value and Quality of Care in Head and Neck Oncology

Contact Info

Product

Resources

About