Abstract
BackgroundEvidence-based medicine has broadened its scope and is starting to reach insurance medicine. Although still in its initial stages, physicians in the area of insurance medicine should keep up-to-date with the evidence on various diseases in order to correctly assess disability and to give appropriate advice about health care reimbursement. In order to explore future opportunities of evidence-based medicine to improve daily insurance medicine, there is a need for qualitative studies to better understand insurance physicians' perceptions of EBM. The present study was designed to identify the attitude of insurance physicians towards evidence-based medicine and clinical practice guidelines, and to determine their ability to access, retrieve and appraise the health evidence and the barriers for applying evidence to practice.MethodsA cross-sectional survey study was carried out among all Dutch-speaking insurance physicians employed at one of the six Belgian social insurance sickness funds and at the National Institute of Disability and Health care Insurance (n = 224). Chi-square tests were used to compare nominal and ordinal variables. Student's t-tests, ANOVA, Mann-Whitney and Kruskal-Wallis were used to compare means of continuous variables for different groups.ResultsThe response rate was 48.7%. The majority of respondents were positive towards evidence-based medicine and clinical practice guidelines. Their knowledge of EBM was rather poor. Perceived barriers for applying evidence to practice were mainly time and lack of EBM skills.ConclusionAlthough the majority of physicians were positive towards EBM and welcomed more guidelines, the use of evidence and clinical practice guidelines in insurance medicine is low at present. It is in the first place important to eradicate the perceived inertia which limits the use of EBM and to further investigate the EBM principles in the context of insurance medicine. Available high-quality evidence-based resources (at the moment mainly originating from other medical fields) need to be structured in a way that is useful for insurance physicians and global access to this information needs to be ensured.
Highlights
Evidence-based medicine has broadened its scope and is starting to reach insurance medicine
Insurance physicians from private organisations were not included in the study. 164 physicians employed at the Belgian social insurance sickness funds and 60 physicians employed at the NIDHI were invited to participate
The majority of respondents were men, 42.9% represented the 45- to 54-years old group and Attitudes towards evidence-based medicine and clinical practice guidelines 56.2% had read about evidence-based medicine, 50.5% had attended an Evidence-based medicine (EBM) course and 18.1% became familiar with EBM during their basic medical training
Summary
Evidence-based medicine has broadened its scope and is starting to reach insurance medicine. Still in its initial stages, physicians in the area of insurance medicine should keep up-to-date with the evidence on various diseases in order to correctly assess disability and to give appropriate advice about health care reimbursement. Evidence-based medicine has broadened its scope to include areas other than clinical disciplines and is starting to reach the field of insurance medicine. Social insurance physicians working for the Belgian Sickness and Health care Insurance evaluate a patient's ability to work and a patient's entitlement to sickness benefits from the social security system. They assess the legal criteria for reimbursement of expensive health care costs. A Master's in insurance medicine and medico-legal expertise can be obtained after following a 2-year academic training course [2]
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