CESAV - Centre for Health Economics, Mario Negri Institute for Pharmacological Research, Villa Camozzi, Ranica (BG), Italy.
Health Policy. 2010 Mar;94(3):246-54. doi: 10.1016/j.healthpol.2009.09.017. Epub 2009 Nov 12.
We examined Continuing Medical Education (CME) systems in a sample of six EU countries: Austria, Belgium, France, Italy, Norway, and the UK. The aim of this comparative study was to assess the main country-specific institutional settings applied by governments.
A common scheme of analysis was applied to investigate the following variables: (i) CME institutional framework; (ii) benefits and/or penalties to participants; (iii) types of CME activities and system of credits; (iv) accreditation of CME providers and events; (v) CME funding and sponsorship. The analysis involved reviewing the literature on CME policy and interviewing a selected panel of local experts in each country (at least one public manager, one representative of medical associations and one pharmaceutical manager).
CME is formally compulsory in Austria, France, Italy and the UK, although no sanctions are enforced against non-compliant physicians in practice. The only two countries that offer financial incentives to enhance CME participation are Belgium and Norway, although limited to specific categories of physicians. Formal accreditation of CME providers is required in Austria, France and Italy, while in the other three countries accreditation is focused on activities. Private sponsorship is allowed in all countries but Norway, although within certain limits.
This comparative exercise provides an overview of the CME policies adopted by six EU countries to regulate both demand and supply. The substantial variability in the organization and accreditation of schemes indicates that much could be done to improve effectiveness. Although further analysis is needed to assess the results of these policies in practice, lessons drawn from this study may help clarify the weaknesses and strengths of single domestic policies in the perspective of pan-European CME harmonization.
我们考察了六个欧盟国家（奥地利、比利时、法国、意大利、挪威和英国）的继续医学教育（CME）系统。本项比较研究的目的是评估政府实施的主要特定于国家的体制设置。
采用通用分析方案，对以下变量进行了调查：（i）CME 体制框架；（ii）参与者的利益和/或惩罚；（iii）CME 活动类型和学分系统；（iv）CME 提供者和活动的认证；（v）CME 资金和赞助。分析涉及审查 CME 政策文献，并在每个国家（至少有一名公共管理人员、一名医学协会代表和一名制药管理人员）中选择一个小组进行访谈。
奥地利、法国、意大利和英国正式规定 CME 为强制性，但实际上并未对不遵守规定的医生实施制裁。比利时和挪威是仅有的两个为提高 CME 参与度提供财政激励的国家，尽管仅限于特定类别的医生。奥地利、法国和意大利要求对 CME 提供者进行正式认证，而在其他三个国家，认证则侧重于活动。除了挪威以外，所有国家都允许私人赞助，但有一定限制。
这项比较研究提供了对六个欧盟国家为规范需求和供应而采用的 CME 政策的概述。在计划的组织和认证方面存在的实质性差异表明，在提高效率方面还有很多工作要做。尽管需要进一步分析以评估这些政策在实践中的结果，但从这项研究中吸取的经验教训可能有助于在泛欧 CME 协调方面阐明单一国内政策的弱点和优势。
