Value-based Care
Cluster randomized controlled trial: An innovative telemedical network to improve infectious disease management in critically ill patients and outpatients.
3 Feb, 2022 | 08:53h | UTCRelated:
The “Choosing Wisely” initiative in infectious diseases – German Society of Infectious Diseases (link to abstract – $ for full-text)
Infectious Diseases Society of America: Five Things Physicians and Patients Should Question
The Lancet Commission: Experts warn of the increasing overmedicalization of death, call for radical rethink of how society cares for dying people.
1 Feb, 2022 | 09:55h | UTCHomepage: Lancet Commission on the Value of Death (free registration required for all articles)
Report of the Lancet Commission on the Value of Death: bringing death back into life
The precariousness of balancing life and death
Ros Taylor: seeing palliative care as relational
Commentary on Twitter (thread – click for more)
Increasing overmedicalisation at the end of life is denying people & their families a good death.
Towards a compassionate community model: The Lancet #ValueofDeath Commission calls for a radical rethink of care for the dying & attitudes to death. https://t.co/DpJiu1tOcV pic.twitter.com/FU9MgCO1J6
— The Lancet (@TheLancet) January 31, 2022
Observational study: Pharmacist involvement in the care of critically ill patients may reduce resource utilization, adverse drug events, and medical costs.
1 Feb, 2022 | 09:47h | UTC
Commentary from the author on Twitter (thread – click for more)
PHARM-CRIT Study
👩🔬 215 ICU PharmDs at 85 centers
💊55,926 accepted interventions on 27,681 patients over 3,148 shifts
💵$23,404,089 cost avoidance; monetary benefit-to-cost ratio for ICU pharmacists $3.3:1 – $9.6:1@SCCM_CPP @SCCM #TwitteRx #PharmICU https://t.co/Hv4jPwU6eb— Megan Rech, PharmD, MS (@MeganARech) December 16, 2021
Observational Study: Same-day mastectomy and axillary lymph node dissection seems safe for most patients with breast cancer.
1 Feb, 2022 | 08:38h | UTC
RCT: A comprehensive geriatric assessment hospital at home may be a cost-effective alternative to hospital admission.
1 Feb, 2022 | 08:32h | UTC
Most physicians in the U.S. paid by volume, despite push for quality and value.
30 Jan, 2022 | 13:39h | UTCNews Release: Most physicians paid by volume, despite push for quality and value – Rand Corporation
Original Study: Physician Compensation Arrangements and Financial Performance Incentives in US Health Systems – JAMA Health Forum
Commentary on Twitter
This mixed-methods study found that despite growth in value-based payment arrangements from payors, health systems currently incentivize physicians to maximize volume, thereby maximizing health system revenues. @RachOReid https://t.co/p2N2ls8Qox
— JAMA Health Forum (@JAMAHealthForum) January 28, 2022
The positive side of the coin: Sars-Cov-2 pandemic has taught us how much Telemedicine is useful as standard of care procedure in real life.
28 Jan, 2022 | 08:30h | UTC
Development and use of a calculator to measure pediatric low-value care delivered in US children’s hospitals.
28 Jan, 2022 | 08:19h | UTCCommentary: Pediatric Services With Limited Benefits Cost Millions – MedPage Today (free registration required)
ASH-ASPHO Choosing Wisely Campaign: 5 hematologic tests and treatments to question in children.
25 Jan, 2022 | 09:33h | UTCSee complete lists of low-value practices: Choosing Wisely U.S. / Choosing Wisely UK / Choosing Wisely Australia AND Choosing Wisely Canada
Developing a how-to-guide for Health Technology Reassessment: “The HTR Playbook”.
25 Jan, 2022 | 09:26h | UTC
Study shows many patients with metastatic cancer near the end of life still receive guideline-nonconcordant radiotherapy.
18 Jan, 2022 | 09:35h | UTCCommentary: Study: Cancer patients given high-dose radiation treatments even near end of life – UPI
N95 respirators can be safely decontaminated up to 25 times, research shows.
17 Jan, 2022 | 00:26h | UTCNews Release: N95 Respirators Can Be Safely Decontaminated Up to 25 Times, Research Shows – Beth Israel Deaconess Medical Center
Original Study: Assessing changes to N95 respirator filtration efficiency, qualitative and quantitative fit, and seal check with repeated vaporized hydrogen peroxide (VHP) decontamination – American Journal of Infection Control (link to abstract – $ for full-text)
Viewpoint: Hierarchical payment models—a path for coordinating population- and episode-based payment models.
16 Jan, 2022 | 22:52h | UTCHierarchical Payment Models—A Path for Coordinating Population- and Episode-Based Payment Models – JAMA (free for a limited period)
Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS 2022) statement: updated reporting guidance for health economic evaluations.
13 Jan, 2022 | 08:13h | UTC
A qualitative study identified a wide variation of expected impacts of the 626 low-value services spotted by the US Choosing Wisely recommendations.
7 Dec, 2021 | 08:39h | UTCLongitudinal Content Analysis of the Characteristics and Expected Impact of Low-Value Services Identified in US Choosing Wisely Recommendations – JAMA Internal Medicine (free for a limited period)
Editorial: The Next Frontier of Less Is More—From Description to Implementation – JAMA Internal Medicine (free for a limited period)
See complete lists of low-value practices: Choosing Wisely U.S. / Choosing Wisely UK / Choosing Wisely Australia AND Choosing Wisely Canada
Viewpoint: The growing phenomenon of “virtual-first” primary care.
24 Nov, 2021 | 08:39h | UTCThe Growing Phenomenon of “Virtual-First” Primary Care – JAMA (free for a limited period)
Nursing care for oncologic patients undergoing surgery using an enhanced recovery approach.
17 Nov, 2021 | 08:22h | UTCOncologic Surgical Care Using an Enhanced Recovery Approach – AACN Advanced Critical Care
News release: Enhanced Recovery Approach Changes Care for Surgical Oncology Patients – American Association of Critical-Care Nurses
Related: Complete List of Enhanced Recovery After Surgery (ERAS) Society Guidelines
Choosing Wisely: Nine pediatric otolaryngology recommendations.
9 Nov, 2021 | 01:09h | UTCSee complete lists of low-value practices: Choosing Wisely U.S. / Choosing Wisely UK / Choosing Wisely Australia AND Choosing Wisely Canada
Systematic Review | Management of High-Need, High-Cost Patients.
9 Nov, 2021 | 01:20h | UTCSee also:
Related:
Systematic review of high-cost patients’ characteristics and healthcare utilization – BMJ Open
Multimorbidity: a priority for global health research – The Academy of Medical Sciences
The global burden of multiple chronic conditions: A narrative review – Preventive Medicine Reports
Redesigning Care for High-Cost, High-Risk Patients – Harvard Business Review
Multimorbidity: clinical assessment and management – NICE Guideline
Richard Smith: The challenge of high need, high cost patients – The BMJ Blogs
Better Care for People with Complex Needs – Institute for Healthcare Improvement
Choosing Wisely for Thyroid Conditions: Ten things clinicians and patients should question – “Do not order thyroid ultrasound for nodule detection in patients without thyroid anatomic anomalies on clinical examination”.
9 Nov, 2021 | 01:11h | UTCSee complete lists of low-value practices: Choosing Wisely U.S. / Choosing Wisely UK / Choosing Wisely Australia AND Choosing Wisely Canada
Choosing Wisely in Pediatric Hospital Medicine: 5 New Recommendations to Improve Value.
20 Oct, 2021 | 09:58h | UTCSee complete lists of low-value practices: Choosing Wisely U.S. / Choosing Wisely UK / Choosing Wisely Australia AND Choosing Wisely Canada
Viewpoint: Surgical overtreatment and shared decision-making—the limits of choice. – “Payment models further incentivize surgical intervention. Fee-for-service payment plans reward surgeons for operating, not for ensuring that surgery is right for a patient”.
17 Oct, 2021 | 21:17h | UTCSurgical Overtreatment and Shared Decision-making—The Limits of Choice – JAMA Surgery (free for a limited period)
Commentary on Twitter
“Adjusting payment models to mitigate financial incentives..to overtreat is a start. However..greater focus should be given to the myriad other causes of overtreatment,” such as triggers of care cascades, write Clapp, Schwarze & @LeeAFleisher. https://t.co/f4mPsnxyVB
— Ben Harder #BlackLivesMatter (@benharder) October 14, 2021
Choosing Wisely: Seven things physicians and residents/patients should question in long term care.
7 Oct, 2021 | 10:31h | UTCSee complete lists of low-value practices: Choosing Wisely U.S. / Choosing Wisely UK / Choosing Wisely Australia AND Choosing Wisely Canada
New analysis shows use and predictors of low-value care in health systems – “Patients at health systems with smaller shares of primary care physicians and without teaching hospitals were more likely to receive low-value services”.
28 Sep, 2021 | 09:08h | UTCNews release: New analysis shows use and predictors of low-value care in health systems nationwide – Brigham and Women’s Hospital
Original study: Low-Value Care at the Actionable Level of Individual Health Systems – JAMA Internal Medicine
Author interview: Low-Value Care at the Actionable Level of Individual Health Systems
Commentary on Twitter
New study measures and reports use of 41 low-value care services + composite measure for 556 health systems across US. More low-value care in systems w ↓ PCPs, w/o major teaching hospital, HQ'ed in South+West, in areas w ↑ healthcare spending https://t.co/0qdkflxwWF
— JAMA Internal Medicine (@JAMAInternalMed) September 27, 2021
Cochrane Special Collection | De-implementation of low-value health care: resource prioritization in the COVID-19 pandemic era.
23 Sep, 2021 | 10:13h | UTCEditorial: Making wise choices about low‐value health care in the COVID‐19 pandemic – Cochrane Library
Commentary: Choosing health care wisely when resources are scarce – Evidently Cochrane
Commentaries on Twitter
📰Our new editorial @cochranecollab: Making wise choices about low‐value health care in the COVID‐19 pandemic👉https://t.co/qABVg7emRi
Linked Special Collection on low-value care: https://t.co/fstV8P8OQS#FreeAccess pic.twitter.com/h9KZGUm2kp
— Juan Franco 🏳️🌈 (@juan_francomd) September 22, 2021
Sadly, some medical interventions are in use despite evidence against them. With @Cochrane_SH, we have published a Special Collection of Cochrane reviews of Low Value Care interventions and described the issue in an Editorial. We cannot afford wasted HC. https://t.co/PXUhaMZud2
— Karsten Juhl Jørgensen (@KarstenJuhl) September 22, 2021