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Did the evidence-based intervention (EBI) programme reduce inappropriate procedures, lessen unwarranted variation or lead to spill-over effects in the National Health Service?
BACKGROUND: Health systems are under pressure to maintain services within limited resources. The Evidence-Based Interventions (EBI) programme published a first list of guidelines in 2019, which aimed to reduce inappropriate use of interventions within the NHS in England, reducing potential harm and...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10473535/ https://www.ncbi.nlm.nih.gov/pubmed/37656701 http://dx.doi.org/10.1371/journal.pone.0290996 |
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author | Glynn, Joel Jones, Timothy Bell, Mike Blazeby, Jane Burton, Christopher Conefrey, Carmel Donovan, Jenny L. Farrar, Nicola Morley, Josie McNair, Angus Owen-Smith, Amanda Rule, Ellen Thornton, Gail Tucker, Victoria Williams, Iestyn Rooshenas, Leila Hollingworth, William |
author_facet | Glynn, Joel Jones, Timothy Bell, Mike Blazeby, Jane Burton, Christopher Conefrey, Carmel Donovan, Jenny L. Farrar, Nicola Morley, Josie McNair, Angus Owen-Smith, Amanda Rule, Ellen Thornton, Gail Tucker, Victoria Williams, Iestyn Rooshenas, Leila Hollingworth, William |
author_sort | Glynn, Joel |
collection | PubMed |
description | BACKGROUND: Health systems are under pressure to maintain services within limited resources. The Evidence-Based Interventions (EBI) programme published a first list of guidelines in 2019, which aimed to reduce inappropriate use of interventions within the NHS in England, reducing potential harm and optimising the use of limited resources. Seventeen procedures were selected in the first round, published in April 2019. METHODS: We evaluated changes in the trends for each procedure after its inclusion in the EBI’s first list of guidelines using interrupted time series analysis. We explored whether there was any evidence of spill-over effects onto related or substitute procedures, as well as exploring changes in geographical variation following the publication of national guidance. RESULTS: Most procedures were experiencing downward trends in the years prior to the launch of EBI. We found no evidence of a trend change in any of the 17 procedures following the introduction of the guidance. No evidence of spill-over increases in substitute or related procedures was found. Geographic variation in the number of procedures performed across English CCGs remained at similar levels before and after EBI. CONCLUSIONS: The EBI programme had little success in its aim to further reduce the use of the 17 procedures it deemed inappropriate in all or certain circumstances. Most procedure rates were already decreasing before EBI and all continued with a similar trend afterwards. Geographical variation in the number of procedures remained at a similar level post EBI. De-adoption of inappropriate care is essential in maintaining health systems across the world. However, further research is needed to explore context specific enablers and barriers to effective identification and de-adoption of such inappropriate health care to support future de-adoption endeavours. |
format | Online Article Text |
id | pubmed-10473535 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-104735352023-09-02 Did the evidence-based intervention (EBI) programme reduce inappropriate procedures, lessen unwarranted variation or lead to spill-over effects in the National Health Service? Glynn, Joel Jones, Timothy Bell, Mike Blazeby, Jane Burton, Christopher Conefrey, Carmel Donovan, Jenny L. Farrar, Nicola Morley, Josie McNair, Angus Owen-Smith, Amanda Rule, Ellen Thornton, Gail Tucker, Victoria Williams, Iestyn Rooshenas, Leila Hollingworth, William PLoS One Research Article BACKGROUND: Health systems are under pressure to maintain services within limited resources. The Evidence-Based Interventions (EBI) programme published a first list of guidelines in 2019, which aimed to reduce inappropriate use of interventions within the NHS in England, reducing potential harm and optimising the use of limited resources. Seventeen procedures were selected in the first round, published in April 2019. METHODS: We evaluated changes in the trends for each procedure after its inclusion in the EBI’s first list of guidelines using interrupted time series analysis. We explored whether there was any evidence of spill-over effects onto related or substitute procedures, as well as exploring changes in geographical variation following the publication of national guidance. RESULTS: Most procedures were experiencing downward trends in the years prior to the launch of EBI. We found no evidence of a trend change in any of the 17 procedures following the introduction of the guidance. No evidence of spill-over increases in substitute or related procedures was found. Geographic variation in the number of procedures performed across English CCGs remained at similar levels before and after EBI. CONCLUSIONS: The EBI programme had little success in its aim to further reduce the use of the 17 procedures it deemed inappropriate in all or certain circumstances. Most procedure rates were already decreasing before EBI and all continued with a similar trend afterwards. Geographical variation in the number of procedures remained at a similar level post EBI. De-adoption of inappropriate care is essential in maintaining health systems across the world. However, further research is needed to explore context specific enablers and barriers to effective identification and de-adoption of such inappropriate health care to support future de-adoption endeavours. Public Library of Science 2023-09-01 /pmc/articles/PMC10473535/ /pubmed/37656701 http://dx.doi.org/10.1371/journal.pone.0290996 Text en © 2023 Glynn et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Glynn, Joel Jones, Timothy Bell, Mike Blazeby, Jane Burton, Christopher Conefrey, Carmel Donovan, Jenny L. Farrar, Nicola Morley, Josie McNair, Angus Owen-Smith, Amanda Rule, Ellen Thornton, Gail Tucker, Victoria Williams, Iestyn Rooshenas, Leila Hollingworth, William Did the evidence-based intervention (EBI) programme reduce inappropriate procedures, lessen unwarranted variation or lead to spill-over effects in the National Health Service? |
title | Did the evidence-based intervention (EBI) programme reduce inappropriate procedures, lessen unwarranted variation or lead to spill-over effects in the National Health Service? |
title_full | Did the evidence-based intervention (EBI) programme reduce inappropriate procedures, lessen unwarranted variation or lead to spill-over effects in the National Health Service? |
title_fullStr | Did the evidence-based intervention (EBI) programme reduce inappropriate procedures, lessen unwarranted variation or lead to spill-over effects in the National Health Service? |
title_full_unstemmed | Did the evidence-based intervention (EBI) programme reduce inappropriate procedures, lessen unwarranted variation or lead to spill-over effects in the National Health Service? |
title_short | Did the evidence-based intervention (EBI) programme reduce inappropriate procedures, lessen unwarranted variation or lead to spill-over effects in the National Health Service? |
title_sort | did the evidence-based intervention (ebi) programme reduce inappropriate procedures, lessen unwarranted variation or lead to spill-over effects in the national health service? |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10473535/ https://www.ncbi.nlm.nih.gov/pubmed/37656701 http://dx.doi.org/10.1371/journal.pone.0290996 |
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