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Low-value care practice in headache: a Spanish mixed methods research study

BACKGROUND: 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 a...

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Autores principales: Pozo-Rosich, Patricia, Layos-Romero, Almudena, Martin-Delgado, Jimmy, Pascual, Julio, Bailón, Cristina, Tentor, Ana, Santiago, Alejandro, Ignacio, Emilio, Torrés, Antonio, Mira, José Joaquín
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Milan 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7288523/
https://www.ncbi.nlm.nih.gov/pubmed/32522142
http://dx.doi.org/10.1186/s10194-020-01147-w
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author Pozo-Rosich, Patricia
Layos-Romero, Almudena
Martin-Delgado, Jimmy
Pascual, Julio
Bailón, Cristina
Tentor, Ana
Santiago, Alejandro
Ignacio, Emilio
Torrés, Antonio
Mira, José Joaquín
author_facet Pozo-Rosich, Patricia
Layos-Romero, Almudena
Martin-Delgado, Jimmy
Pascual, Julio
Bailón, Cristina
Tentor, Ana
Santiago, Alejandro
Ignacio, Emilio
Torrés, Antonio
Mira, José Joaquín
author_sort Pozo-Rosich, Patricia
collection PubMed
description BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: This study identified low-value headache practices that need to be eradicated and provided data on their frequency and cost overruns.
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spelling pubmed-72885232020-06-11 Low-value care practice in headache: a Spanish mixed methods research study Pozo-Rosich, Patricia Layos-Romero, Almudena Martin-Delgado, Jimmy Pascual, Julio Bailón, Cristina Tentor, Ana Santiago, Alejandro Ignacio, Emilio Torrés, Antonio Mira, José Joaquín J Headache Pain Research Article BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: This study identified low-value headache practices that need to be eradicated and provided data on their frequency and cost overruns. Springer Milan 2020-06-10 /pmc/articles/PMC7288523/ /pubmed/32522142 http://dx.doi.org/10.1186/s10194-020-01147-w Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Pozo-Rosich, Patricia
Layos-Romero, Almudena
Martin-Delgado, Jimmy
Pascual, Julio
Bailón, Cristina
Tentor, Ana
Santiago, Alejandro
Ignacio, Emilio
Torrés, Antonio
Mira, José Joaquín
Low-value care practice in headache: a Spanish mixed methods research study
title Low-value care practice in headache: a Spanish mixed methods research study
title_full Low-value care practice in headache: a Spanish mixed methods research study
title_fullStr Low-value care practice in headache: a Spanish mixed methods research study
title_full_unstemmed Low-value care practice in headache: a Spanish mixed methods research study
title_short Low-value care practice in headache: a Spanish mixed methods research study
title_sort low-value care practice in headache: a spanish mixed methods research study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7288523/
https://www.ncbi.nlm.nih.gov/pubmed/32522142
http://dx.doi.org/10.1186/s10194-020-01147-w
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