Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium; Ghent University, Ghent, Belgium.
Ghent University, Ghent, Belgium; European Society for Radiotherapy and Oncology, Brussels, Belgium.
Lancet Oncol. 2020 Jan;21(1):e42-e54. doi: 10.1016/S1470-2045(19)30794-6.
Reimbursement is a key factor in defining which resources are made available to ensure quality, efficiency, availability, and access to specific health-care interventions. This Policy Review assesses publicly funded radiotherapy reimbursement systems in Europe. We did a survey of the national societies of radiation oncology in Europe, focusing on the general features and global structure of the reimbursement system, the coverage scope, and level for typical indications. The annual expenditure covering radiotherapy in each country was also collected. Most countries have a predominantly budgetary-based system. Variability was the major finding, both in the components of the treatment considered for reimbursement, and in the fees paid for specific treatment techniques, fractionations, and indications. Annual expenses for radiotherapy, including capital investment, available in 12 countries, represented between 4·3% and 12·3% (average 7·8%) of the cancer care budget. Although an essential pillar in multidisciplinary oncology, radiotherapy is an inexpensive modality with a modest contribution to total cancer care costs. Scientific societies and policy makers across Europe need to discuss new strategies for reimbursement, combining flexibility with incentives to improve productivity and quality, allowing radiation oncology services to follow evolving evidence.
在确定提供哪些资源以确保特定医疗保健干预措施的质量、效率、可及性和可及性时，报销是一个关键因素。本政策审查评估了欧洲公共资助的放射治疗报销系统。我们对欧洲放射肿瘤学国家学会进行了调查，重点关注报销系统的一般特征和总体结构、覆盖范围以及典型适应症的水平。还收集了每个国家用于放射治疗的年度支出。大多数国家都有以预算为基础的系统。主要发现是治疗中考虑的治疗部分以及特定治疗技术、分割和适应症的支付费用存在差异。在 12 个国家中，包括资本投资在内的放射治疗年度支出占癌症护理预算的 4.3%至 12.3%（平均 7.8%）。尽管放射治疗是多学科肿瘤学的重要支柱，但它是一种廉价的治疗方式，对癌症护理总成本的贡献不大。欧洲各地的科学学会和政策制定者需要讨论新的报销策略，将灵活性与提高生产力和质量的激励措施相结合，使放射肿瘤学服务能够遵循不断发展的证据。
