Value-based Healthcare: The Challenge of Identifying and Addressing Low-value Interventions

Zywiel, Michael G.; Liu, Tiffany C.; Bozic, Kevin J.

doi:10.1007/s11999-017-5298-5

Cited by 10 publications

(8 citation statements)

References 19 publications

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“…The clinical evidence he documents makes a highly compelling case. We also agree with Dr. Zywiel and his colleagues [7] that physicians are best suited to lead efforts to improve med-ical effectiveness by developing and implementing evidence-based guidelines.…”

Section: W E At the Society For Patient Centeredsupporting

confidence: 59%

Letter to Editor: Editorial: Appropriate Use? Guidelines on Arthroscopic Surgery for Degenerative Meniscus Tears Need Updating

Rickert¹,

Boniface

Burney

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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Section: W E At the Society For Patient Centeredsupporting

confidence: 59%

Letter to Editor: Editorial: Appropriate Use? Guidelines on Arthroscopic Surgery for Degenerative Meniscus Tears Need Updating

Rickert¹,

Boniface

Burney

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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“…There are very few alternative sources of encounter data with which to compare our findings, but it is widely recognised that achieving the highest quality health care possible requires that value‐based health care be patient‐focused and that health resources be judiciously allocated 8 . ‐ 10 Identifying and defining low value care continues to be challenging 10 . The high proportion of administrative request encounters at which care planning and coordination were undertaken (35.4%) is encouraging, given the evidence that they can improve health, self‐management and psychological outcomes in patients with long term health conditions 11 .…”

Section: Discussionmentioning

confidence: 99%

“…[8][9][10] Identifying and defining low value care continues to be challenging. 10 The high proportion of administrative request encounters at which care planning and coordination were undertaken (35.4%) is encouraging, given the evidence that they can improve health, self-management and psychological outcomes in patients with long term health conditions. 11 As the workload in this area increases for GPs, however, the MBS review must ensure that care planning continues to be comprehensive, intensive and integrated, as this maximises its benefits.…”

Section: Discussionmentioning

confidence: 99%

Administrative encounters in general practice: low value or hidden value care?

Trevena

Harrison

Britt

2018

Medical Journal of Australia

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Objective: To determine the frequency of general practice administrative encounters, and to determine whether they represent low value care. Design: Secondary analysis of data from the Bettering Evaluation and Care of Health (BEACH) dataset. Setting: 1 568 100 GP–patient encounters in Australia, 2000–01 to 2015–16. Participants: An annual nationally representative random sample of about 1000 GPs, who each recorded the details of 100 consecutive encounters with patients. Main outcome measures: Proportions of general practice encounters that were potentially low value care encounters (among the patient's reasons for the encounter was at least one administrative, medication, or referral request) and potentially low value care only encounters (such reasons were the sole reason for the encounter). For 2015–16, we also examined other health care provided by GPs at these encounters. Results: During 2015–16, 18.5% (95% CI, 17.7–19.3%) of 97 398 GP–patient encounters were potentially low value care request encounters; 7.4% (95% CI, 7.0–7.9%) were potentially low value care only encounters. Administrative work was requested at 3.8% (95% CI, 3.5–4.0%) of GP visits, 35.4% of which were for care planning and coordination, 33.5% for certification, and 31.2% for other reasons. Medication requests were made at 13.1% (95% CI, 12.4–13.7%) of encounters; other health care was provided at 57.9% of medication request encounters, counselling, advice or education at 23.4%, and pathology testing was ordered at 16.7%. Referrals were requested at 2.8% (95% CI, 1.7–3.0%) of visits, at 69.4% of which additional health care was provided. The problems managed most frequently at potentially low value care only encounters were chronic diseases. Conclusion: Most patients requested certificates, medications and referrals in the context of seeking help for other health needs. Additional health care, particularly for chronic diseases, was provided at most GP administrative encounters. The MBS Review should consider the hidden value of these encounters.

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“…4 In response, the orthopaedic surgery literature has paralleled these national trends with an increasing volume of health economic studies published. [5][6][7][8][9][10][11] Cost-utility studies are one kind of health economic analysis, and reviews of the orthopaedic cost-utility study literature from 1976 to 2001 was previously performed by Brauer et al 12,13 More recently, Nwachukwu et al reviewed the quality of US-based health economic studies in orthopaedic trauma, 14 spine, 15 sports medicine, 16 and arthroplasty 17 " insights for the practicing orthopaedic surgeon. While a similar analysis for orthopaedic foot and ankle surgery would be valuable, a comprehensive analysis of the available cost-utility analyses nor a review of the quality of the available evidence has yet been performed.…”

mentioning

confidence: 99%

“…4 In response, the orthopaedic surgery literature has paralleled these national trends with an increasing volume of health economic studies published. 5-11…”

mentioning

confidence: 99%

Cost-Utility Analyses in US Orthopaedic Foot and Ankle Surgery: A Systematic Review

Karhade

Kwon

2018

Foot & Ankle Specialist

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Value-based Healthcare: The Challenge of Identifying and Addressing Low-value Interventions

Cited by 10 publications

References 19 publications

Letter to Editor: Editorial: Appropriate Use? Guidelines on Arthroscopic Surgery for Degenerative Meniscus Tears Need Updating

Letter to Editor: Editorial: Appropriate Use? Guidelines on Arthroscopic Surgery for Degenerative Meniscus Tears Need Updating

Administrative encounters in general practice: low value or hidden value care?

Cost-Utility Analyses in US Orthopaedic Foot and Ankle Surgery: A Systematic Review

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