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Table 6 Summary of findings regarding aspects taken into consideration into the decision making process

From: Reimbursement decisions for medical services in Austria: an analysis of influencing factors for the hospital individual services catalogue between 2008 and 2020

Aspects

Findings

Clinical evidence:

Decision makers noted that this was the most essential aspect, as also shown in the accordance between evidence-based recommendation and reimbursement decision.

Quality assurance/ organisational aspects:

Structural quality assurance through setting conditions for the use of a medical service (provider’s capacity, infrastructure and processes to provide the specific care in high-quality). These are often linked to organisational aspects.

Costs

If costs are comparable to already existing medical services, the new medical service may not be included in the catalogue separately.

Procedural aspects

These aspects are linked to the general criteria for adoption of novel hospital medical service (e.g., incomplete proposal may lead not to include a hospital service).

Other countries

How other countries (especially Germany) decided on the potential adoption of a certain medical service may have also influenced some reimbursement decisions.

Situational aspects

The COVID-19 pandemic was identified as a situational aspect hindering a reimbursement of medical services.

  1. Notes: Three HTA-related aspects from the deductive coding categories were either not mentioned or not applicable: ethical and social aspects, regulatory aspects, and legal aspects