Complementary Medicine Provision in an Academic Hospital: Evaluation and Structuring Project

Abstract

Objectives: Complementary medicine (CM) has become increasingly available in hospital settings in several countries. Nonetheless, there are disparities in the provision and organization of CM between hospitals and even within a single hospital. This was the case at Lausanne University Hospital, where neither a registry of CM practices nor homogeneous guidelines for the provision of CM existed. The board of directors mandated the use of an internal consultant to assess practices, delineate the ward's needs, and draft proposals to structure the provision of CM services. Design: Lescarbeau et al.'s integrated model of consultation was used. Settings/Location: Academic medical center, Switzerland. Subjects: Heads of departments, medical and nurse directors, and CM practitioners. Interventions: Semi-structured interviews, online survey, and focus groups were used to focus on CM availability, needs, and practices; CM practitioner background, training, and position in the hospital; and the type of patients treated. Results: The assessment identified 15 types of CM in 51 wards, provided by CM practitioners who represented the profiles of 8 types of health care professionals. Three barriers to implementing CM were identified: heterogeneity in CM practitioners' training and project implementation, lack of CM information for patients and health care professionals, and variable access to CM among hospital wards and resulting lack in continuity of care. Three main needs regarding CM were delineated: to ensure CM quality, to provide structured interdepartmental CM clinical services, and to provide CM information to patients and health care professionals. Three action priorities were selected by the board of directors: to develop structured CM clinical services; to select CM provision based on the specific criteria of scientific evidence, therapies already available at hospital, and specific ward's needs; and to provide CM information to patients and health care professionals. Conclusions: This assessment permitted to structure CM provision according to internal consultation.

Feasibility of implementing pranic healing as a complementary service: A case study at Sanglah General Hospital, Denpasar

“…We give information in the form of leaflets Efforts to increase demand for services such as promoting services to the public and health workers, were needed to increase public demand for complementary services. 9, 19 Our survey results showed that more than 50% were willing to have pranic therapy, and 77.5% were willing to recommend it to other people (Table 4). The main reason for receiving pranic service was disease severity (71%).…”

Complementary and Integrative Medicine: a plea for a better resource allocation by the SwissDRG grouping algorithm

“…Complementary and integrative medicine has been successfully integrated in academic centres and also appears to be of greater utility among patients with serious, chronic, or recurrent illnesses [6]. The first academic centre of its kind in Romandie, the Lausanne University Hospital (CHUV), began its clinical activity in the field after a pilot project in the oncology department supported by philanthropic foundations between 2017 and 2019 [7]. Today, the CHUV's Centre for Integrative and Complementary Medicine (CEMIC) delivers structured, specialised inpatient care to about 500 patients annually.…”

“…Rodondi et al [7] reported that barriers to implementing complementary medicine are mainly due to the reimbursement strategy. The SwissDRG algorithm's classification method is accurate when patients are admitted specifically for complementary and integrative medicine management, such as in a rehabilitation clinic.…”

“…However, complex cases may have a cost weight of >5 points and thus be costly for the provider if a complementary and integrative medicine CHOP code is assigned. Deployed in the Oncology Department of the CHUV [7], complementary and integrative medicine is currently dispensed to patients undergoing complex chemotherapy schemes. These patients tend to be classified into the DRG R50B (highly complex chemotherapy) with an inlier cost weight of 6.842 points in 2023.…”