PDF(Pubmed)
Abstract：
The adoption of digital health care within health systems is determined by various factors, including pricing and reimbursement. The reimbursement landscape for digital health in Europe remains underresearched. Although various emergency reimbursement decisions were made during the COVID-19 pandemic to enable health care delivery through videoconferencing and asynchronous care (eg, digital apps), research so far has primarily focused on the policy innovations that facilitated this outside of Europe.
This study examines the digital health reimbursement strategies in 8 European countries (Belgium, France, Germany, Italy, the Netherlands, Poland, Sweden, and the United Kingdom) and Israel.
We mapped available digital health reimbursement strategies using a scoping review and policy mapping framework. We reviewed the literature on the MEDLINE, Embase, Global Health, and Web of Science databases. Supplementary records were identified through Google Scholar and country experts.
Our search strategy yielded a total of 1559 records, of which 40 (2.57%) were ultimately included in this study. As of August 2023, digital health solutions are reimbursable to some extent in all studied countries except Poland, although the mechanism of reimbursement differs significantly across countries. At the time of writing, the pricing of digital health solutions was mostly determined through discussions between national or regional committees and the manufacturers of digital health solutions in the absence of value-based assessment mechanisms. Financing digital health solutions outside traditional reimbursement schemes was possible in all studied countries except Poland and typically occurs via health innovation or digital health-specific funding schemes. European countries have value-based pricing frameworks that range from nonexistent to embryonic.
Studied countries show divergent approaches to the reimbursement of digital health solutions. These differences may complicate the ability of patients to seek cross-country health care in another country, even if a digital health app is available in both countries. Furthermore, the fragmented environment will present challenges for developers of such solutions, as they look to expand their impact across countries and health systems. An increased emphasis on developing a clear conceptualization of digital health, as well as value-based pricing and reimbursement mechanisms, is needed for the sustainable integration of digital health. This study can therein serve as a basis for further, more detailed research as the field of digital health reimbursement evolves.
This study examines the digital health reimbursement strategies in 8 European countries (Belgium, France, Germany, Italy, the Netherlands, Poland, Sweden, and the United Kingdom) and Israel.
We mapped available digital health reimbursement strategies using a scoping review and policy mapping framework. We reviewed the literature on the MEDLINE, Embase, Global Health, and Web of Science databases. Supplementary records were identified through Google Scholar and country experts.
Our search strategy yielded a total of 1559 records, of which 40 (2.57%) were ultimately included in this study. As of August 2023, digital health solutions are reimbursable to some extent in all studied countries except Poland, although the mechanism of reimbursement differs significantly across countries. At the time of writing, the pricing of digital health solutions was mostly determined through discussions between national or regional committees and the manufacturers of digital health solutions in the absence of value-based assessment mechanisms. Financing digital health solutions outside traditional reimbursement schemes was possible in all studied countries except Poland and typically occurs via health innovation or digital health-specific funding schemes. European countries have value-based pricing frameworks that range from nonexistent to embryonic.
Studied countries show divergent approaches to the reimbursement of digital health solutions. These differences may complicate the ability of patients to seek cross-country health care in another country, even if a digital health app is available in both countries. Furthermore, the fragmented environment will present challenges for developers of such solutions, as they look to expand their impact across countries and health systems. An increased emphasis on developing a clear conceptualization of digital health, as well as value-based pricing and reimbursement mechanisms, is needed for the sustainable integration of digital health. This study can therein serve as a basis for further, more detailed research as the field of digital health reimbursement evolves.
摘要：
背景：卫生系统中数字医疗保健的采用取决于各种因素，包括定价和报销。欧洲数字健康的报销前景仍未得到充分研究。尽管在COVID-19大流行期间做出了各种紧急报销决定，以通过视频会议和异步护理提供医疗保健(例如，数字应用程序)，到目前为止，研究主要集中在促进欧洲以外的政策创新上。
目的：本研究调查了8个欧洲国家的数字医疗报销策略（比利时，法国,德国,意大利,荷兰,波兰,瑞典,和联合王国)和以色列。
方法：我们使用范围审查和政策映射框架来映射可用的数字医疗报销策略。我们回顾了关于MEDLINE的文献，Embase,全球卫生,和WebofScience数据库。补充记录是通过谷歌学者和国家专家确定的。
结果：我们的搜索策略总共产生了1559条记录，其中40（2.57%）最终纳入本研究。截至2023年8月，数字健康解决方案在除波兰以外的所有研究国家都可以在一定程度上报销。尽管各国的报销机制差异很大。在撰写本文时,在缺乏基于价值的评估机制的情况下，数字健康解决方案的定价主要是通过国家或地区委员会与数字健康解决方案制造商之间的讨论来确定的。除波兰外，所有研究国家都可以在传统报销计划之外为数字医疗解决方案提供资金，通常通过卫生创新或数字卫生特定资金计划进行。欧洲国家拥有基于价值的定价框架，从不存在到萌芽。
结论：研究的国家在数字医疗解决方案的报销方面表现出不同的方法。这些差异可能会使患者在另一个国家寻求跨国医疗保健的能力复杂化，即使数字健康应用程序在这两个国家都可用。此外，分散的环境将为此类解决方案的开发人员带来挑战，因为他们希望扩大对国家和卫生系统的影响。越来越重视发展数字健康的清晰概念，以及基于价值的定价和报销机制，数字健康的可持续整合是必需的。这项研究可以作为进一步的基础，随着数字医疗报销领域的发展，更详细的研究。
目的：本研究调查了8个欧洲国家的数字医疗报销策略（比利时，法国,德国,意大利,荷兰,波兰,瑞典,和联合王国)和以色列。
方法：我们使用范围审查和政策映射框架来映射可用的数字医疗报销策略。我们回顾了关于MEDLINE的文献，Embase,全球卫生,和WebofScience数据库。补充记录是通过谷歌学者和国家专家确定的。
结果：我们的搜索策略总共产生了1559条记录，其中40（2.57%）最终纳入本研究。截至2023年8月，数字健康解决方案在除波兰以外的所有研究国家都可以在一定程度上报销。尽管各国的报销机制差异很大。在撰写本文时,在缺乏基于价值的评估机制的情况下，数字健康解决方案的定价主要是通过国家或地区委员会与数字健康解决方案制造商之间的讨论来确定的。除波兰外，所有研究国家都可以在传统报销计划之外为数字医疗解决方案提供资金，通常通过卫生创新或数字卫生特定资金计划进行。欧洲国家拥有基于价值的定价框架，从不存在到萌芽。
结论：研究的国家在数字医疗解决方案的报销方面表现出不同的方法。这些差异可能会使患者在另一个国家寻求跨国医疗保健的能力复杂化，即使数字健康应用程序在这两个国家都可用。此外，分散的环境将为此类解决方案的开发人员带来挑战，因为他们希望扩大对国家和卫生系统的影响。越来越重视发展数字健康的清晰概念，以及基于价值的定价和报销机制，数字健康的可持续整合是必需的。这项研究可以作为进一步的基础，随着数字医疗报销领域的发展，更详细的研究。
