Abstract
BACKGROUND: Malignant pleural effusion (MPE) affects up to 20% of cancer patients, causing dyspnea and frequent hospitalizations. Treatment includes thoracentesis, pleurodesis, and indwelling pleural catheters (IPC). While UK pleural clinics enhance outpatient care, Denmark lacks a national strategy. This study aims to map the use of IPCs in a Nordic country, focusing on referral, placement, follow-up, and reimbursement of expenses to drainage supplies. METHODS: A national questionnaire survey was conducted from January to July 2022. The questionnaire, developed by the Danish Respiratory Society's pleural diseases group, covered IPC placement, management, follow-up, and financial aspects. It was distributed to all departments placing IPCs, identified via suppliers and expert input. Data on the number of IPCs delivered to each department in 2022 were obtained from Danish IPC retailers. RESULTS: Of the 23 identified departments, 20 completed the survey. IPCs were available in all five Danish healthcare regions, but heterogeneity was observed in prevalence, reimbursement methods, procedural organization, and follow-up strategies. IPC use was more prevalent in respiratory medical departments and in the North and Central Regions. No standardized national reimbursement policy was identified. CONCLUSION: This survey reveals regional disparities in IPC use and reimbursement in Denmark within the same public healthcare system. The lack of national guidelines and centralized funding mechanisms may contribute to these variations. The introduction of dedicated pleural clinics and standardized reimbursement policies could help ensure equitable and guideline-based MPE management across regions.