Patient access to voice prostheses and heat and moisture exchangers: Factors influencing physician's prescription and reimbursement in eight European countries
| Autor: | M. W. M. van den Brekel, Ann Jean C.C. Beck, W.H. van Harten, Valesca P. Retèl |
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| Přispěvatelé: | Academic Medical Center, MKA AMC (OII, ACTA), Health Technology & Services Research, Maxillofacial Surgery (AMC) |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty Hot Temperature Facilitators Heat and moister exchanger (HME) media_common.quotation_subject medicine.medical_treatment UT-Hybrid-D Voice prosthesis Technology acceptance model Prescription Reimbursement Mechanisms 03 medical and health sciences 0302 clinical medicine Surveys and Questionnaires Humans Medicine Practice Patterns Physicians' Medical prescription 030223 otorhinolaryngology Reimbursement media_common Rehabilitation business.industry Workload Laryngectomy rehabilitation Europe Oncology Feeling 030220 oncology & carcinogenesis Family medicine Medical devices Female Oral Surgery Larynx Artificial business Barriers Qualitative research |
| Zdroj: | Oral oncology, 91, 56-64. Elsevier Limited Oral Oncology, 91, 56-64. Elsevier Beck, A C C, Retèl, V P, van den Brekel, M W M & van Harten, W H 2019, ' Patient access to voice prostheses and heat and moisture exchangers: Factors influencing physician's prescription and reimbursement in eight European countries ', Oral Oncology, vol. 91, pp. 56-64 . https://doi.org/10.1016/j.oraloncology.2019.02.017 Oral Oncology, 91, 56-64. Elsevier Limited |
| ISSN: | 1368-8375 |
| DOI: | 10.1016/j.oraloncology.2019.02.017 |
| Popis: | Objectives: Patient access to the voice prosthesis and heat and moisture exchanger (HME) is not always guaranteed in Europe. Therefore, the aim of this qualitative study is to evaluate factors influencing physician's prescription and reimbursement of these devices in eight European countries, and to identify barriers of and facilitators to effective patient access.Materials and methods: In this mixed methods study, we conducted a survey among stakeholders evaluating prescription (Part 1 of the survey), reimbursement (Part 2), and barriers of and facilitators to effective patient access (Part 3). Part 1 was completed by head and neck surgeons employed in France, Germany, the United Kingdom, Italy, Spain, Belgium, the Netherlands and Poland. Part 2 and 3 were completed by medical device company representatives in respective countries, followed by semi-structured interviews.Results: Based on the survey, filled in by 36 surgeons, all prescribed the voice prosthesis. Four surgeons didn't prescribe the HME in Italy and Poland due to lack of both reimbursement and experience/training, and feeling uncomfortable with device use. Most restrictive factors (e.g. increased workload, insufficient staff) occurred in countries with decentralized healthcare systems including Spain and Italy.Conclusion: Non-HME-usage was influenced by economical and physician-related factors. Restrictive factors were related to limited regional device reimbursement and provision. Nationwide reimbursement, guideline implementation, support for physicians by training/education and providing a rehabilitation team will increase device use. |
| Databáze: | OpenAIRE |
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