Department of Radiology, Clarindon Wing, B Floor, Leeds General Infirmary, Leeds Teaching Hospital Trust, Leeds, LS1 3EX, UK.
Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
Pediatr Radiol. 2023 Feb;53(2):273-281. doi: 10.1007/s00247-022-05485-6. Epub 2022 Sep 13.
Perinatal and childhood postmortem imaging has been accepted as a noninvasive alternative or adjunct to autopsy. However, the variation in funding models from institution to institution is a major factor prohibiting uniform provision of this service.
To describe current funding models employed in European and non-European institutions offering paediatric postmortem imaging services and to discuss the perceived barriers to future postmortem imaging service provision.
A web-based 16-question survey was distributed to members of the European Society of Paediatric Radiology (ESPR) and ESPR postmortem imaging task force over a 6-month period (March-August 2021). Survey questions related to the radiologic and autopsy services being offered and how each was funded within the respondent's institute.
Eighteen individual responses were received (13/18, 72.2% from Europe). Only one-third of the institutions (6/18, 33.3%) have fully funded postmortem imaging services, with the remainder receiving partial (6/18, 33.3%) or no funding (5/18, 27.8%). Funding (full or partial) was more commonly available for forensic work (13/18, 72%), particularly where this was nationally provided. Where funding was not provided, the imaging and reporting costs were absorbed by the institute.
Increased access is required for the expansion of postmortem imaging into routine clinical use. This can only be achieved with formal funding on a national level, potentially through health care commissioning and acknowledgement by health care policy makers and pathology services of the value the service provides following the death of a fetus or child. Funding should include the costs involved in training, equipment, reporting and image acquisition.
围产期和儿童期死后影像学已被接受为尸检的非侵入性替代或辅助手段。然而,机构间资金模式的差异是阻碍这项服务统一提供的主要因素。
描述提供小儿死后影像学服务的欧洲和非欧洲机构目前采用的资金模式,并讨论对未来死后影像学服务提供的感知障碍。
在 6 个月的时间里(2021 年 3 月至 8 月),通过网络向欧洲儿科放射学会(ESPR)成员和 ESPR 死后成像工作组的成员分发了一份包含 16 个问题的调查。调查问题涉及正在提供的放射学和尸检服务,以及受访者所在机构如何为每项服务提供资金。
共收到 18 份个人回复(18 份中的 13 份,来自欧洲的 72.2%)。只有三分之一的机构(18 份中的 6 份,33.3%)拥有全额资助的死后成像服务,其余机构获得部分(18 份中的 6 份,33.3%)或没有资助(18 份中的 5 份,27.8%)。资金(全部或部分)更常用于法医工作(18 份中的 13 份,72%),特别是在全国范围内提供这种资金的情况下。在没有提供资金的情况下,成像和报告费用由机构承担。
需要增加获得死后成像的机会,将其扩展为常规临床应用。这只能通过国家一级的正式资金来实现,可能通过医疗保健招标和医疗保健政策制定者和病理服务部门承认该服务在胎儿或儿童死亡后提供的价值来实现。资金应包括培训、设备、报告和图像采集所涉及的费用。