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Innovation, value and reimbursement in radiation and complex surgical oncology: time to rethink
- Source :
- Dipòsit Digital de la UB, Universidad de Barcelona, EJSO, RADIOTHERAPY AND ONCOLOGY
- Publication Year :
- 2022
- Publisher :
- Elsevier, 2022.
-
Abstract
- 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. (C) 2021 The Author(s). Published by Elsevier Ltd. on behalf of British Association of Surgical Oncology and European Society of Surgical Oncology, and Elsevier B.V.
- Subjects :
- IMPACT
CLINICAL BENEFIT
Psychological intervention
Surgical oncology
Common Criteria
Neoplasms
Medicine and Health Sciences
Medicine
Càncer
AMERICAN SOCIETY
Reimbursement
SCALE
media_common
Cancer
Complex cancer surgery
COST
Fee-for-Service Plans
Grey literature
Hematology
General Medicine
Surgical Oncology
Incentive
Oncology
TECHNOLOGIES
Radiology
ACCESS
Value
media_common.quotation_subject
Radioteràpia
Nuclear Medicine and imaging
Unit (housing)
Reimbursement Mechanisms
Cirurgia oncològica
Humans
Radiology, Nuclear Medicine and imaging
Innovation
Tumors
Actuarial science
Radiotherapy
business.industry
Payment
FRAMEWORK
CANCER-SURGERY
EXTERNAL-BEAM RADIOTHERAPY
Radiation Oncology
Surgery
Business
Subjects
Details
- ISSN :
- 07487983, 15322157, 01678140, and 18790887
- Database :
- OpenAIRE
- Journal :
- Dipòsit Digital de la UB, Universidad de Barcelona, EJSO, RADIOTHERAPY AND ONCOLOGY
- Accession number :
- edsair.doi.dedup.....6489d25f3e5321b8c8b05e7b4c636065