Health care variation: time to act

Duggan, Anne; Hargreaves, Jenny; Scott, Ian; Slawomirski, Luke

doi:10.5694/mja15.01360

Cited by 24 publications

(25 citation statements)

References 22 publications

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“…As a result, this makes the reliability of applying extracted data questionable in a clinical audit. Buchan et al (2016) noted the implications of incomplete data or inconsistency in coding were that it can create unnecessary variations in care, with Duggan et al (2016) suggesting that this can lead to real patient harm due to patients not receiving the right care. The Australian Commission on Safety and Quality in Health Care (2012) reported that the data used to measure the occurrence of problems in health care is unavailable or unreliable, and patient safety is probably more difficult to assess due to the lack of systematic approaches to identify issues (Phillips et al 2010b).…”

Section: Review Of Literature On Similar Casesmentioning

confidence: 99%

Primary Sense: a new population health management tool for general practice

Davies¹

2020

Aust. J. Prim. Health

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Primary Sense is a new data extraction, analysis and reporting tool that the Gold Coast Primary Health Network (GCPHN) has developed to enable practical and effective population health management in general practice and also on a regional level. Once installed, the tool de-identifies data within the practice before running it through various clinical risk algorithms to create practical information that can easily be actioned within the general practice business model in at least two ways. The first is to generate up-to-date reports of patients who are most likely to benefit from specific interventions or occasions of service. The second is to identify potentially serious medication safety issues, alerting clinicians in real time at point of prescribing. Formal live testing of the system was completed in nine practices where 22 managers and nurses and 42 GPs used the tool over a 5-month period in 2019. The live test monitored the use of reports and alerts, and regular feedback from users enabled small but important improvements to the tool. Practice teams successfully used the reports to target specific groups of patients with outstanding care needs or who were at greatest risk of adverse health outcomes. The results of the live test showed that users found Primary Sense to be easy to use and beneficial to general practice. The next phase of this project is now underway to further trial the scalability and change management requirements for full implementation of Primary Sense. As more and more practices adopt the tool, the aggregated data will increasingly help to support population health planning, commissioning of local services, active health surveillance and other related activities.

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Section: Review Of Literature On Similar Casesmentioning

confidence: 99%

Primary Sense: a new population health management tool for general practice

Davies¹

2020

Aust. J. Prim. Health

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“…Moreover, employing the domains of STEEEP may reduce variation in how care is delivered and practiced, revealing differences that exist across geographic, cost, and personal (e.g. racial) characteristics [6,7].…”

Section: Introductionmentioning

confidence: 99%

U.S. hospital performance methodologies: a scoping review to identify opportunities for crossing the quality chasm

Craig

McKillop

Huang

et al. 2020

BMC Health Serv Res

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Background: Hospital performance quality assessments inform patients, providers, payers, and purchasers in making healthcare decisions. These assessments have been developed by government, private and non-profit organizations, and academic institutions. Given the number and variability in available assessments, a knowledge gap exists regarding what assessments are available and how each assessment measures quality to identify top performing hospitals. This study aims to: (a) comprehensively identify current hospital performance assessments, (b) compare quality measures from each methodology in the context of the Institute of Medicine's (IOM) six domains of STEEEP (safety, timeliness, effectiveness, efficiency, equitable, and patient-centeredness), and (c) formulate policy recommendations that improve value-based, patient-centered care to address identified gaps. Methods: A scoping review was conducted using a systematic search of MEDLINE and the grey literature along with handsearching to identify studies that provide assessments of US-based hospital performance whereby the study cohort examined a minimum of 250 hospitals in the last two years (2017-2019). Results: From 3058 unique records screened, 19 hospital performance assessments met inclusion criteria. Methodologies were analyzed across each assessment and measures were mapped to STEEEP. While safety and effectiveness were commonly identified measures across assessments, efficiency, and patient-centeredness were less frequently represented. Equity measures were also limited to risk-and severity-adjustment methods to balance patient characteristics across populations, rather than stand-alone indicators to evaluate health disparities that may contribute to community-level inequities. Conclusions: To further improve health and healthcare value-based decision-making, there remains a need for methodological transparency across assessments and the standardization of consensus-based measures that reflect the IOM's quality framework. Additionally, a large opportunity exists to improve the assessment of health equity in the communities that hospitals serve.

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“…Thus, numerous studies have evaluated the factors that lead a patient with CLBP to seek professional help (Buchan, Duggan, Hargreaves, Scott, & Slawomirski, 2016;IJzelenberg & Burdorf, 2004;Traeger, Buchbinder, Elshaug, Croft, & Maher, 2019). Research has shown that there is a positive association between care seeking and sociodemographic variables such as age, PeerJ reviewing PDF | (2019:08:40707:2:0:CHECK 5 Feb 2020)…”

Section: Introductionmentioning

confidence: 99%

Peer Review #2 of "Relationship between healthcare seeking and pain expansion in patients with nonspecific chronic low back pain (v0.2)"

Hoegh¹

2020

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Low back pain (LBP) is the most prevalent musculoskeletal problem, which implies a high rate of chronicity. The chronicity of symptoms can lead to pain expansion. The main objective of this study was to assess whether there were differences between patients with nonspecific chronic LBP (CLBP) who sought healthcare compared to those who did not in terms of pain expansion. Methods: Ninety individuals participated in the study and were divided into 3 groups: 30 patients who sought care; 30 patients who did not seek care; and 30 asymptomatic individuals. The primary variable analyzed was pain expansion. Secondary physical and psychological variables were assessed later, and a regression analysis was performed. Results: Patients who sought help showed significant differences in pain expansion and pain intensity compared with the group who did not seek help, with a medium effect size (0.50-0.79). The regression model for the care-seeking group showed that dynamic balance with the left leg and depression were predictors of percentage pain surface area (34.6%). The combination of dynamic balance, range of movement in flexoextension and depression were predictors of widespread pain (48.5%). Conclusion: Patients whosoughtcare presented greater pain expansion than patients whodidnot. A combination of functional and psychological variables can significantly predict pain expansion in patients with nonspecific CLBP who seek help.

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Health care variation: time to act

Cited by 24 publications

References 22 publications

Primary Sense: a new population health management tool for general practice

Primary Sense: a new population health management tool for general practice

U.S. hospital performance methodologies: a scoping review to identify opportunities for crossing the quality chasm

Peer Review #2 of "Relationship between healthcare seeking and pain expansion in patients with nonspecific chronic low back pain (v0.2)"

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