Low-value care practice in headache : a Spanish mixed methods research study
Pozo-Rosich, Patricia (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Layos-Romero, Almudena (Complejo Hospitalario Universitario de Albacete)
Martin-Delgado, Jimmy (ATENEA research group (Alacant))
Pascual Gómez, Julio (Universidad de Cantabria)
Bailón-Santamaría, Cristina (Hospital Universitario Marqués de Valdecilla (Santander, Cantabria))
Tentor, Ana (Barrio del Pilar Health Center (Madrid))
Santiago, Alejandro (Hospital Universitario Infanta Leonor)
Ignacio, Emilio (Cádiz University)
Torrés, Antonio (Patient Safety Observatory, Andalusian Healthcare Quality Agency, Seville, Spain)
Mira, José Joaquín (Universitat Miguel Hernández)
Universitat Autònoma de Barcelona

Data:	2020
Resum:	Headache is one of the most prevalent diseases. The Global Burden of Disease Study ranks it as the seventh most common disease overall and the second largest neurological cause of disability in the world. The "Do Not Do" recommendations are a strategy for increasing the quality of care and reducing the cost of care for headache. This study aimed to identify specific low-value practices in headache care, determine their frequency, and estimate the cost overrun that they represent, in order to establish "Do not Do" recommendations specifically for headache by consensus and according to scientific evidence. This was a mixed methods research study that combined qualitative consensus-building techniques, involving a multidisciplinary panel of experts to define the "Do Not Do" recommendations in headache care, and a retrospective observational study with review of a randomized set of patient records from the past 6 months in four hospitals, to quantify the frequency of these "Do Not Do" practices. We calculated the sum of direct costs of medical consultations, medicines, and unnecessary diagnostic tests. Seven "Do Not Do" recommendations were established for headache. In total, 3507 medical records were randomly reviewed. Low-value practices had a highly variable occurrence, depending on the hospital and type of headache. Overall, 34. 1% of low-value practices were related to treatment, 21% were related to overuse of imaging in consultation, and 19% were related to emergency care. The estimated cost of low-value practices in the four hospitals was 203,520. 47 euros per 1000 patients. This study identified low-value headache practices that need to be eradicated and provided data on their frequency and cost overruns.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Care ; Cost ; Do not Do recommendations ; Headache ; Patient safety ; Mixed methods
Publicat a:	Journal of headache and pain, Vol. 21 (june 2020) , ISSN 1129-2377

DOI: 10.1186/s10194-020-01147-w
PMID: 32522142

8 p, 365.5 KB

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