AIM To evaluate the characteristics of the prescription of the proton pump inhibitor drugs (PPI) and the adherence to the indications of the guidelines regulating the reimbursement limitations set forth by the Italian Drug Agency. METHODS Thirty general practitioners (GP) participated in the study, providing data on more than 40000 patients in total. The population was divided into non occasi...

Introduction The number of novel therapies that achieve registration in oncology based on limited clinical evidence like non-randomized studies (NRS) is increasing. Dutch health authorities determine the therapeutic value medicines evaluated randomized controlled trials formal criteria for minimal relative efficacy or treatment guidelines. However, there are no to benefit treatments assessed NR...

Under prevailing legislation, Medicare payments to health maintenance organizations (HMOs) are based upon projected fee-for-service reimbursement levels for enrollees' county of residence. These rates have been criticized in light of substantial variations in rates among neighboring counties and large fluctuations in rates over time. In this study, the use of nine alternative configurations and...

The introduction of telemedicine service into the health care system has been rapidly accelerated during global COVID-19 pandemic. This paper investigates optimal strategy and reimbursement policy by comparing three cases, i.e., case without service, providing with reimbursement, reimbursement. Stylized queue models are used to depict offline online serving processes. Arriving patients decide s...

The foundation of case-based prospective payment is the case classification system. The purpose of classification systems is to group together patients with similar treatment requirements. The systems described in this issue take a variety of theoretical and practical approaches to classification. The critical issue in comparing these systems is whether the variation in treatment requirements w...

Since the 1920s health insurance has been based on the principle of controlling the risk pool with specific benefit limitations used to manage costs. Due to changes in the risk pool demographics, the increase in volume and intensity of services and the array of new technologies to subscribers, additional measures are needed. This trend, called "managed care," places an emphasis on clinical crit...

Molecular diagnostic testing has become an important tool in clinical laboratories. Accreditation according to the international quality standard ISO15189:2007 for medical laboratories is required for reimbursement of several molecular diagnostic tests in Belgium. Since the ISO15189:2007 standard applies to medical laboratories in general, the particular requirements for quality and competence ...

Background Stress cardiac-magnetic-resonance (CMR) imaging can provide important diagnostic and prognostic information in patients with known or suspected coronary artery disease. However, given the rising costs of imaging, there is increasing pressure to provide evidence for direct additive impact on clinical care. Appropriate use criteria (AUC) have been developed by professional organization...