Reimbursement for radiotherapy treatment in the EU countries: how to encourage efficiency, quality and access?

In this paper, the radiotherapy reimbursement systems actually used in the EU countries are compared. From this overview, it is concluded that up to date health care policy makers have not yet tapped all opportunities to encourage efficient, accessible radiotherapy delivery of high quality, through the reimbursement system. Therefore, some recommendations are given on how the reimbursement system can be designed in order to promote efficiency, accessibility and/or quality.

A retrospective study of resource utilisation in the treatment of advanced colorectal cancer in Europe.

An estimation of resource utilisation in the treatment of advanced colorectal cancer has been carried out by the European Organization for Research and Treatment of Cancer. Data on resource utilisation were collected retrospectively from 10 European centres, examining 20 consecutive patient files in each centre. Data from eight centres are reported in this paper. 160 patients were included in the sample, followed up for a median of 530 days. All patients were hospitalised and almost all underwent surgery. Fifty-four per cent received chemotherapy, and most visited the hospital as an outpatient. Including hospital stay and outpatient visits, patients spent almost 10% of their time in hospital or associated travelling. The most common diagnostic tests were chest X-ray, electrocardiogram and abdomen ultrasound. There was considerable variation between hospitals in resource utilisation, both within and between countries. Surgical procedures, chemotherapy, hospitalisation, diagnostic tests and outpatient visits are major cost determinants in the treatment of colorectal cancer. The variation in resource utilisation suggests that efficiency could be improved.

The reimbursement of the expenses for medical treatment received by 'transnational' patients in EU-countries.

The number of 'transnational' EU-patients, i.e. EU-citizens receiving medical treatment in another country than their working state--where they contribute for social security--is growing steadily. This article describes the EU and member states' rules governing the reimbursement of the expenses for medical treatment received abroad, for the case where patients travel abroad with the sole purpose of medical care in the framework of the national health insurance (treatment authorised by E112-form). It is illustrated that some countries' national rules comply with the EU-rules, a number of countries apply stricter rules, while other EU-members have established legislation that is more favourable for their citizens, than the EU-rules. Furthermore, the financial burden of treatment abroad also differs widely, since some countries reimburse travel and living expenses for the patient, and sometimes also for an accompanying person, while other countries do not provide such reimbursements. The article concludes with some policy implications.