Abstract
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.
| Original language | English |
|---|---|
| Pages (from-to) | 56-64 |
| Number of pages | 9 |
| Journal | Oral Oncology |
| Volume | 91 |
| DOIs | |
| Publication status | Published - 1 Apr 2019 |
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Keywords
- UT-Hybrid-D
- Europe
- Facilitators
- Heat and moister exchanger (HME)
- Laryngectomy rehabilitation
- Medical devices
- Prescription
- Reimbursement
- Technology acceptance model
- Voice prosthesis
- Barriers
Cite this
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Patient access to voice prostheses and heat and moisture exchangers : Factors influencing physician's prescription and reimbursement in eight European countries. / Beck, A. C.C. (Corresponding Author); Retèl, V. P.; van den Brekel, M. W.M.; van Harten, W. H.
In: Oral Oncology, Vol. 91, 01.04.2019, p. 56-64.Research output: Contribution to journal › Article › Academic › peer-review
TY - JOUR
T1 - Patient access to voice prostheses and heat and moisture exchangers
T2 - Factors influencing physician's prescription and reimbursement in eight European countries
AU - Beck, A. C.C.
AU - Retèl, V. P.
AU - van den Brekel, M. W.M.
AU - van Harten, W. H.
N1 - Elsevier deal
PY - 2019/4/1
Y1 - 2019/4/1
N2 - 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.
AB - 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.
KW - UT-Hybrid-D
KW - Europe
KW - Facilitators
KW - Heat and moister exchanger (HME)
KW - Laryngectomy rehabilitation
KW - Medical devices
KW - Prescription
KW - Reimbursement
KW - Technology acceptance model
KW - Voice prosthesis
KW - Barriers
UR - http://www.scopus.com/inward/record.url?scp=85062303671&partnerID=8YFLogxK
U2 - 10.1016/j.oraloncology.2019.02.017
DO - 10.1016/j.oraloncology.2019.02.017
M3 - Article
AN - SCOPUS:85062303671
VL - 91
SP - 56
EP - 64
JO - Oral Oncology
JF - Oral Oncology
SN - 1368-8375
ER -