Reimbursement decisions for medical services in Austria: an analysis of influencing factors for the hospital individual services catalogue between 2008 and 2020

dc.contributor.authorGoetz, Gregor
dc.contributor.authorPanteli, Dimitra
dc.contributor.authorBusse, Reinhard
dc.contributor.authorWild, Claudia
dc.date.accessioned2022-05-25T13:23:48Z
dc.date.available2022-05-25T13:23:48Z
dc.date.issued2022-02-15
dc.description.abstractObjectives: To (1) describe the (evidence-based) reimbursement process of hospital individual services, (2) evaluate the accordance between evidence-based recommendations and reimbursement decision of individual services and (3) elaborate potential aspects that play a role in the decision-making process in Austria. Method: The reimbursement process is described based on selected relevant sources such as official documents. Evidence-based recommendations and subsequent reimbursement decisions for the annual maintenance of the hospital individual service catalogue in Austria between 2008 and 2020 were analysed using a mixed methods approach, encompassing descriptive statistics and a focus group with Austrian decision makers. Results: 118 evidence-based recommendations were analysed. There were 93 (78.8%) negative and 25 (21.2%) positive evidence-based recommendations. In total, 107 out of 118 evidence-based recommendations (90.1%) did not lead to a deviating reimbursement decision. We identified six aspects that may have played a role in the decision-making process for the annual maintenance of the hospital individual service catalogue, with clinical evidence being the most notable. Further aspects included quality assurance/organisational aspects (i.e., structural quality assurance), costs (if comparable to already existing medical services, not: cost-effectiveness), procedural aspects (e.g., if certain criteria for adoption have not been met formally through the proposals), “other countries” (i.e., taking into account how other countries decided) and situational aspects (such as the COVID-19 pandemic). Conclusions: There is good accordance between evidence-based recommendations and reimbursement decisions regarding hospital individual services in Austria. Beyond clinical evidence, organisational aspects seem to be considered often with regard to quality assurance but costs do not appear to play a major role. The Austrian system has mechanisms in place that can restrict widespread adoption of novel hospital individual services with uncertain clinical benefits. Future studies could investigate how well these mechanisms work and how they compare to other health systems in Europe.en
dc.description.sponsorshipTU Berlin, Open-Access-Mittel – 2022en
dc.identifier.eissn1472-6963
dc.identifier.urihttps://depositonce.tu-berlin.de/handle/11303/16996
dc.identifier.urihttp://dx.doi.org/10.14279/depositonce-15775
dc.language.isoenen
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/en
dc.subject.ddc610 Medizin und Gesundheitde
dc.subject.othercoverageen
dc.subject.otherreimbursementen
dc.subject.otherbenefit catalogueen
dc.subject.othermedical servicesen
dc.subject.otherAustriaen
dc.titleReimbursement decisions for medical services in Austria: an analysis of influencing factors for the hospital individual services catalogue between 2008 and 2020en
dc.typeArticleen
dc.type.versionpublishedVersionen
dcterms.bibliographicCitation.articlenumber205en
dcterms.bibliographicCitation.doi10.1186/s12913-022-07531-3en
dcterms.bibliographicCitation.journaltitleBMC Health Services Researchen
dcterms.bibliographicCitation.originalpublishernameSpringer Natureen
dcterms.bibliographicCitation.originalpublisherplaceHeidelbergen
dcterms.bibliographicCitation.volume22en
tub.accessrights.dnbfreeen
tub.affiliationFak. 7 Wirtschaft und Management>Inst. Technologie und Management (ITM)>FG Management im Gesundheitswesende
tub.affiliation.facultyFak. 7 Wirtschaft und Managementde
tub.affiliation.groupFG Management im Gesundheitswesende
tub.affiliation.instituteInst. Technologie und Management (ITM)de
tub.publisher.universityorinstitutionTechnische Universität Berlinen
Files
Original bundle
Now showing 1 - 1 of 1
Loading…
Thumbnail Image
Name:
Goetz_etal_Reinbursement_2022.pdf
Size:
1.76 MB
Format:
Adobe Portable Document Format
Description:
Collections