Centers likely would need dedicated resources or reimbursement mechanisms to contract with experienced interventionists and/or to invest in training psychiatric rehabilitation staff to conduct appropriate intervention components.
This set of barriers and facilitators will be described on different levels: study guideline, care provider, patient, colleague, organisation, and financial resources and reimbursement[ 23].
Moreover, lack of collaboration with other types of healthcare professionals and lack of motivation, time, resources and reimbursement are also shown as a barrier to implementation [ 12].
Competing priorities related to the need for dialysis centres to focus on specific dialysis programmes often at the expense of home haemodialysis initiatives because of limited resources and reimbursement policies.
Our final model revealed a goodness-of-fit of 8.7% (i.e. Cragg-Uhler test) indicating that many other factors affected physician guideline adherence, including external barriers such as patient preferences and environmental factors (i.e. lack of time, resources and reimbursement) that are difficult to overcome [ 25].
In addition to an emerging evidence base of safety and effectiveness, it was reasoned that context-dependent elements such as available resources, funding, reimbursement and legal issues as well as popularity, utilisation patterns and potential referral pathways might be among the important determinants in the selection process.
To overcome this limitation, we used the Medstat disease staging algorithm, which is widely applied to measure the different phases of disease and analyze resource utilization, reimbursement, and quality of care.
Barriers to the provision of obesity treatment include the increasing complexity of primary care visits [ 4- 6] as well as limitations in time, resources, training, and reimbursement [ 7- 10].
Environmental factors, such as lack of time, lack of resources, lack of reimbursement and organizational constraints, may also preclude adoption of guidelines.
However, taking into account the government's limited resources for universal reimbursement, the price of NIPT should first be lowered substantially before this can be realised.
