Financing of certified centers: a willingness-to-pay analysis.
Arch Gynecol Obstet
; 287(3): 495-509, 2013 Mar.
Article
in En
| MEDLINE
| ID: mdl-23080545
ABSTRACT
INTRODUCTION:
Although care in certified breast centers is now established throughout Germany, numerous services are still not being reimbursed. This also affects other centers involved in the specialty of gynecology such as gynecological cancer centers, perinatal centers, and endometriosis centers. Although a certified center is entitled to charge additional fees, these are in most cases not reimbursed. Calculation of additional costs is limited by the fact that data from the Institute for the Hospital Reimbursement System (Institut für das Entgeltsystem im Krankenhaus, InEK) do not reflect interdisciplinary services and procedures. For decision-makers, society's willingness to pay is an important factor in guiding decisions on the basis of social priorities. A hypothetical maximum willingness to pay can be calculated using a willingness-to-pay analysis, making it possible to identify deficiencies in the arbitrary setting of health budgets at the macro-level. MATERIALS ANDMETHODS:
In a multicenter study conducted between November 2009 and December 2010, 2,469 patients at a university hospital and at a non-university hospital were asked about the extent of their awareness of certified centers, the influence of centers on hospital presentation, and about personal attitudes toward quality-oriented reimbursement. A subjective assessment of possible additional charges was calculated using a willingness-to-pay analysis.RESULTS:
In the overall group, 53.4 % of the patients were aware of what a certified center is and 27.4 % had specific information (obstetrics 40.0/32.3 %; mastology 66.8/23.2 %; gynecological oncology 54.7/27.3 %; P < 0.001). For 43.8 %, a certified center was one reason or the major reason for presentation (obstetrics 26.2 %; mastology 66.8 %; gynecological oncology 46.6 %; P < 0.001). A total of 72.6 % were in favor of quality-oriented reimbursement and 69.7 % were in favor of an additional charge for a certified center amounting to 538.56 (mastology 643.65, obstetrics 474.67, gynecological oncology 532.47). In all, 33.9 % would accept an increase in health-insurance fees (averaging 0.3865 %), and 28.3 % were in favor of reduced remuneration for non-certified centers.CONCLUSIONS:
The existence of certified centers is being increasingly recognized by patients. Additional charges for certified centers are generally supported. There is therefore a clear demand for them-from patients as well. This may be useful when negotiations are being conducted.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Reimbursement Mechanisms
/
Cancer Care Facilities
/
Attitude to Health
/
Hospitals, Maternity
Type of study:
Clinical_trials
/
Health_economic_evaluation
/
Prognostic_studies
Aspects:
Determinantes_sociais_saude
/
Patient_preference
Limits:
Female
/
Humans
Country/Region as subject:
Europa
Language:
En
Journal:
Arch Gynecol Obstet
Journal subject:
GINECOLOGIA
/
OBSTETRICIA
Year:
2013
Document type:
Article
Affiliation country:
Germany