Spending with unnecessary complementary tests for hypertension and diabetes in health services

Tr, Arena; C, Jericó Mde; Lc, de Castro; Castilho, Valéria; Af, Lima

doi:10.1590/1983-1447.2014.04.44793

Cited by 3 publications

(3 citation statements)

References 5 publications

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“…1 ) ( 8 , 18–109 ), including seven studies for which full texts could not be retrieved, so data were abstracted from the abstract ( 101 , 102 , 104 , 106–109 ). Six included non-English papers were in French, German, Hebrew, Hungarian, Polish and Portuguese, which were translated and assessed by the review team ( 34 , 40 , 110–113 ).…”

Section: Resultsmentioning

confidence: 99%

“…The most common aim was ‘how does monitoring vary’ ( n = 38), in which studies described the variation in monitoring between regions, patient subgroups or over time. Three studies investigated the costs of over-testing, but none of the studies reported on the possible harms of over-testing to patients ( 34 , 78 , 105 ).…”

Section: Resultsmentioning

confidence: 99%

“…Thirteen studies (14%) reported patient outcomes ( 18 , 19 , 22 , 30 , 60 , 70 , 71 , 82 , 84 , 90 , 93 , 103 , 115 ), such as disease progression or incidence of complications. Seven studies (7%) reported costs as the outcome ( 34 , 52 , 76 , 78 , 92 , 99 , 105 ), such as cost-effectiveness of a screening program for certain patient subgroups. Two studies investigated the response to test results ( 51 , 72 ), i.e.…”

Section: Resultsmentioning

confidence: 99%

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What methods are being used to create an evidence base on the use of laboratory tests to monitor long-term conditions in primary care? A scoping review

et al. 2020

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Background Studies have shown unwarranted variation in test ordering among GP practices and regions, which may lead to patient harm and increased health care costs. There is currently no robust evidence base to inform guidelines on monitoring long-term conditions. Objectives To map the extent and nature of research that provides evidence on the use of laboratory tests to monitor long-term conditions in primary care, and to identify gaps in existing research. Methods We performed a scoping review—a relatively new approach for mapping research evidence across broad topics—using data abstraction forms and charting data according to a scoping framework. We searched CINAHL, EMBASE and MEDLINE to April 2019. We included studies that aimed to optimize the use of laboratory tests and determine costs, patient harm or variation related to testing in a primary care population with long-term conditions. Results Ninety-four studies were included. Forty percent aimed to describe variation in test ordering and 36% to investigate test performance. Renal function tests (35%), HbA1c (23%) and lipids (17%) were the most studied laboratory tests. Most studies applied a cohort design using routinely collected health care data (49%). We found gaps in research on strategies to optimize test use to improve patient outcomes, optimal testing intervals and patient harms caused by over-testing. Conclusions Future research needs to address these gaps in evidence. High-level evidence is missing, i.e. randomized controlled trials comparing one monitoring strategy to another or quasi-experimental designs such as interrupted time series analysis if trials are not feasible.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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What methods are being used to create an evidence base on the use of laboratory tests to monitor long-term conditions in primary care? A scoping review

et al. 2020

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Solicitação de exames de apoio diagnóstico por médicos na Atenção Primária à Saúde

et al. 2017

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This is a qualitative study with family physicians from Montes Claros (MG), aimed at understanding the request for exams by physicians in Primary Health Care. Data were obtained by means of unstructured interviews and were examined through discourse analysis. The request for exams is influenced by professional education; by Family Health Strategy characteristics, the first contact on health issues; by carrying out integral and continued care, coordinated by the team; by the possibility of managing attendance duration; by multi-professional work; and by difficulties faced: demand for exams by the patients and pressure by managers for less requests. KEYWORDS

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Razão oferta/necessidade de consultas médicas, exames de diagnóstico e acompanhamento da doença renal crônica no Sistema Único de Saúde: estudo descritivo, estado de São Paulo, 2019

Samaan

Gutierrez

Kirsztajn

et al. 2022

Epidemiol. Serv. Saúde

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Objetivo: Determinar a razão oferta/necessidade de procedimentos relacionados com o diagnóstico e assistência à doença renal crônica no Sistema Único de Saúde (SUS), no estado de São Paulo, Brasil, 2019. Métodos: Estudo descritivo, utilizando dados dos sistemas de informações ambulatoriais e hospitalares do SUS. O número de consultas médicas e exames diagnósticos e acompanhamento da doença renal, realizados no período, foi comparado com as estimativas de necessidade, obtidas por diretrizes ministeriais. Resultados: Usuários exclusivos do SUS foram 28.791.244, e indivíduos com hipertensão e/ou diabetes mellitus, 5.176.188. O número de procedimentos realizados e a razão entre esse número e a necessidade da população foi de 389.414 consultas com nefrologista (85%), 11.540.371 dosagens de creatinina sérica (223%), 705.709 dosagens de proteinúria (14%), 438.123 ultrassonografias renais (190%) e 1.045 biópsias renais (36%). Conclusão: Na assistência à doença renal crônica no SUS, existe, simultaneamente, falta de oferta, desperdício e rastreamento deficiente de procedimentos importantes.

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Spending with unnecessary complementary tests for hypertension and diabetes in health services

Cited by 3 publications

References 5 publications

What methods are being used to create an evidence base on the use of laboratory tests to monitor long-term conditions in primary care? A scoping review

What methods are being used to create an evidence base on the use of laboratory tests to monitor long-term conditions in primary care? A scoping review

Solicitação de exames de apoio diagnóstico por médicos na Atenção Primária à Saúde

Razão oferta/necessidade de consultas médicas, exames de diagnóstico e acompanhamento da doença renal crônica no Sistema Único de Saúde: estudo descritivo, estado de São Paulo, 2019

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