Scientific Reports (Jun 2024)
A precise performance-based reimbursement model for the multi-centre NAPKON cohorts – development and evaluation
- Katharina S. Appel,
- Chin Huang Lee,
- Susana M. Nunes de Miranda,
- Daniel Maier,
- Jens-Peter Reese,
- Gabriele Anton,
- Thomas Bahmer,
- Sabrina Ballhausen,
- Beate Balzuweit,
- Carla Bellinghausen,
- Arne Blumentritt,
- Markus Brechtel,
- Irina Chaplinskaya-Sobol,
- Johanna Erber,
- Karin Fiedler,
- Ramsia Geisler,
- Ralf Heyder,
- Thomas Illig,
- Mirjam Kohls,
- Jenny Kollek,
- Lilian Krist,
- Roberto Lorbeer,
- Olga Miljukov,
- Lazar Mitrov,
- Carolin Nürnberger,
- Christian Pape,
- Christina Pley,
- Christian Schäfer,
- Jens Schaller,
- Mario Schattschneider,
- Margarete Scherer,
- Nick Schulze,
- Dana Stahl,
- Hans Christian Stubbe,
- Thalea Tamminga,
- Johannes Josef Tebbe,
- Maria J. G. T. Vehreschild,
- Silke Wiedmann,
- Jörg Janne Vehreschild
Affiliations
- Katharina S. Appel
- Goethe University Frankfurt, University Hospital, Center for Internal Medicine, Medical Department 2 (Hematology/Oncology and Infectious Diseases)
- Chin Huang Lee
- University of Cologne, Faculty of Medicine and University Hospital of Cologne, Department I for Internal Medicine
- Susana M. Nunes de Miranda
- University of Cologne, Faculty of Medicine and University Hospital of Cologne, Department I for Internal Medicine
- Daniel Maier
- Goethe University Frankfurt, University Hospital, Center for Internal Medicine, Medical Department 2 (Hematology/Oncology and Infectious Diseases)
- Jens-Peter Reese
- University of Würzburg, Institute for Clinical Epidemiology and Biometry
- Gabriele Anton
- Medical School OWL, Bielefeld University
- Thomas Bahmer
- Internal Medicine Department I, Pneumology Section, University Hospital Schleswig-Holstein Campus Kiel
- Sabrina Ballhausen
- Internal Medicine Department I, Pneumology Section, University Hospital Schleswig-Holstein Campus Kiel
- Beate Balzuweit
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Infectious Diseases, Respiratory Medicine and Critical Care
- Carla Bellinghausen
- Department I of Internal Medicine, Goethe University Frankfurt, University Hospital Frankfurt
- Arne Blumentritt
- Independent Trusted Third Party of the University Medicine Greifswald
- Markus Brechtel
- University of Cologne, Faculty of Medicine and University Hospital of Cologne, Department I for Internal Medicine
- Irina Chaplinskaya-Sobol
- Department of Medical Informatics at the University Medical Center Göttingen
- Johanna Erber
- TUM School of Medicine and Health, Department of Clinical Medicine, Clinical Department for Internal Medicine II, Technical University of Munich, University Medical Center
- Karin Fiedler
- Goethe University Frankfurt, University Hospital, Center for Internal Medicine, Medical Department 2 (Hematology/Oncology and Infectious Diseases)
- Ramsia Geisler
- Goethe University Frankfurt, University Hospital, Center for Internal Medicine, Medical Department 2 (Hematology/Oncology and Infectious Diseases)
- Ralf Heyder
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, NUM Coordination Office
- Thomas Illig
- Hannover Medical School, Hannover Unified Biobank
- Mirjam Kohls
- University of Würzburg, Institute for Clinical Epidemiology and Biometry
- Jenny Kollek
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Infectious Diseases, Respiratory Medicine and Critical Care, Clinical Trial Unit Berlin
- Lilian Krist
- Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin
- Roberto Lorbeer
- Deutsches Herzzentrum der Charité, Institute of Computer-Assisted Cardiovascular Medicine
- Olga Miljukov
- University of Würzburg, Institute for Clinical Epidemiology and Biometry
- Lazar Mitrov
- University of Cologne, Faculty of Medicine and University Hospital of Cologne, Department I for Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf
- Carolin Nürnberger
- University of Würzburg, Institute for Clinical Epidemiology and Biometry
- Christian Pape
- Department of Medical Informatics at the University Medical Center Göttingen
- Christina Pley
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Clinical Trial Office
- Christian Schäfer
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald
- Jens Schaller
- Deutsches Herzzentrum der Charité, Institute of Computer-Assisted Cardiovascular Medicine
- Mario Schattschneider
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald
- Margarete Scherer
- Goethe University Frankfurt, University Hospital, Center for Internal Medicine, Medical Department 2 (Hematology/Oncology and Infectious Diseases)
- Nick Schulze
- Goethe University Frankfurt, University Hospital, Center for Internal Medicine, Medical Department 2 (Hematology/Oncology and Infectious Diseases)
- Dana Stahl
- Independent Trusted Third Party of the University Medicine Greifswald
- Hans Christian Stubbe
- Department of Medicine II, University Hospital, LMU Munich
- Thalea Tamminga
- Internal Medicine Department I, Pneumology Section, University Hospital Schleswig-Holstein Campus Kiel
- Johannes Josef Tebbe
- Hospital Lippe, Department of Gastroenterology and Infectious Diseases
- Maria J. G. T. Vehreschild
- Goethe University Frankfurt, University Hospital Frankfurt, Department II of Infectious Diseases
- Silke Wiedmann
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, NUM Coordination Office
- Jörg Janne Vehreschild
- Goethe University Frankfurt, University Hospital, Center for Internal Medicine, Medical Department 2 (Hematology/Oncology and Infectious Diseases)
- DOI
- https://doi.org/10.1038/s41598-024-63945-5
- Journal volume & issue
-
Vol. 14,
no. 1
pp. 1 – 11
Abstract
Abstract Fair allocation of funding in multi-centre clinical studies is challenging. Models commonly used in Germany - the case fees (“fixed-rate model”, FRM) and up-front staffing and consumables (“up-front allocation model”, UFAM) lack transparency and fail to suitably accommodate variations in centre performance. We developed a performance-based reimbursement model (PBRM) with automated calculation of conducted activities and applied it to the cohorts of the National Pandemic Cohort Network (NAPKON) within the Network of University Medicine (NUM). The study protocol activities, which were derived from data management systems, underwent validation through standardized quality checks by multiple stakeholders. The PBRM output (first funding period) was compared among centres and cohorts, and the cost-efficiency of the models was evaluated. Cases per centre varied from one to 164. The mean case reimbursement differed among the cohorts (1173.21€ [95% CI 645.68–1700.73] to 3863.43€ [95% CI 1468.89–6257.96]) and centres and mostly fell short of the expected amount. Model comparisons revealed higher cost-efficiency of the PBRM compared to FRM and UFAM, especially for low recruitment outliers. In conclusion, we have developed a reimbursement model that is transparent, accurate, and flexible. In multi-centre collaborations where heterogeneity between centres is expected, a PBRM could be used as a model to address performance discrepancies. Trial registration: https://clinicaltrials.gov/ct2/show/NCT04768998 ; https://clinicaltrials.gov/ct2/show/NCT04747366 ; https://clinicaltrials.gov/ct2/show/NCT04679584 .
Keywords
- Performance-based reimbursement
- Funding allocation
- Clinical studies
- COVID-19
- Research infrastructure
- Germany
