Paper of the Week

18 03, 2020

From shops and chains to networks: rethinking value creation for complex healthcare

2020-03-18T10:50:59+00:00

This week’s blog is brought to you by: Dr Joe McManners Full reference and title from the journal: Fjeldstad, Ø. D., Johnson, J. K., Margolis, P. A., Seid, M., Höglund, P., & Batalden, P. B. (Accepted/In press). Networked health care: Rethinking value creation in learning health care systems. Learning Health Systems, [e10212]. Click here for the link to the paper Authors conclusion Attempts to “install” the value chain widely in health care systems have, however, been frustrating. As a result, well-meaning leaders seeking better value have resorted to programs of cost reduction, rather than service redesign. Professionals have not been very happy or willing participants. The work of health care service invites an expanded model of value creation, one that [...]

From shops and chains to networks: rethinking value creation for complex healthcare2020-03-18T10:50:59+00:00
12 03, 2020

How does participating in a deliberative citizens panel on healthcare priority setting influence the views of participants?

2020-03-12T12:57:08+00:00

This week’s blog is brought to you by: Professor Sir Muir Gray, Founding Director Reckers-Droog V et al (2020) et al./Health Policy 124143–151 https://doi.org/10.1016/j.healthpol.2019.11.011 The paper’s bottom line, text from the paper chosen by 3VH Conclusions Our study showed that participants’ views partly remained stable over the course of the panel, specifically regarding equal access to healthcare, prioritisation based on patients’ needs, and the importance of the size and type of treatment benefits.  Notable changes after deliberation concerned the increased support for prioritisation, consideration of costs, and relevance of a cost-effectiveness criterion in allocation decisions.  Considering the increasing interest in deliberative methods among policy makers in healthcare and the limited and empirical evidence concerning the effect of deliberative [...]

How does participating in a deliberative citizens panel on healthcare priority setting influence the views of participants?2020-03-12T12:57:08+00:00
6 03, 2020

Health Care Hotspotting — A Randomized, Controlled Trial

2020-03-06T12:19:59+00:00

This week’s blog is brought to you by: Professor Sir Muir Gray, Founding Director Full reference and title from the journal: Health Care Hotspotting — A Randomized, Controlled Trial, Finkelstein, A. et al (2020), N Engl J Med 2020;382:152-62. DOI: 10.1056/NEJMsa1906848 Authors conclusion Background There is widespread interest in programs aiming to reduce spending and improve health care quality among “superutilizers,” patients with very high use of health care services. The “hotspotting” program created by the Camden Coalition of Healthcare Providers (hereafter, the Coalition) has received national attention as a promising superutilizer intervention and has been expanded to cities around the country. In the months after hospital discharge, a team of nurses, social workers, and community health workers [...]

Health Care Hotspotting — A Randomized, Controlled Trial2020-03-06T12:19:59+00:00
25 02, 2020

Five things the NHS can do to address the Marmot report; taking a population value approach

2020-02-25T14:07:22+00:00

This week’s blog is brought to you by: Dr Tim Wilson, Managing Director Full reference and title from the journal: Health Equity in England: The Marmot Review 10 Years On. February 2020 Professor Sir Michael Marmot, Jessica Allen, Tammy Boyce, Peter Goldblatt, Joana Morrison Link to paper Authors conclusion The report highlights that: people can expect to spend more of their lives in poor health improvements to life expectancy have stalled, and declined for the poorest 10% of women the health gap has grown between wealthy and deprived areas place matters – living in a deprived area of the North East is worse for your health than living in a similarly deprived area in London, to the extent that [...]

Five things the NHS can do to address the Marmot report; taking a population value approach2020-02-25T14:07:22+00:00
20 02, 2020

Paddling against the stream- dealing with the ‘prevention paradox’

2020-02-20T14:58:17+00:00

Paper of the Week: 20th February 2020 This week’s blog is brought to you by: Dr Joe McManners Full reference and title from the journal: Paddling against the stream- dealing with the ‘prevention paradox’, link to paper: click here Authors conclusion ACOs faced significant difficulties in integrating social services with medical care. First, the ACOs were frequently “flying blind,” lacking data on both their patients’ social needs and the capabilities of potential community partners. Additionally, partnerships between ACOs and community-based organizations were critical but were only in the early stages of development. Innovation was constrained by ACOs’ difficulties in determining how best to approach return on investment, given shorter funding cycles and longer time horizons to see returns [...]

Paddling against the stream- dealing with the ‘prevention paradox’2020-02-20T14:58:17+00:00
13 02, 2020

A Prescription for Longevity in the 21st Century

2020-02-13T13:10:34+00:00

Paper of the Week: 13th February 2020 This week’s blog is brought to you by: Professor Sir Muir Gray, Founding Director Full reference and title from the journal: A Prescription for Longevity in the 21st Century Renewing Purpose, Building and Sustaining Social Engagement, and Embracing a Positive Lifestyle Pizzo P.A. (2020), JAMA. Published online January 9, 2020. doi:10.1001/jama.2019.21087 Authors conclusion An assessment of an individual’s sense of purpose, social engagement, and lifestyle choices constitute a triad associated with longevity and should be part of the health assessment. Furthermore, a plan should be developed between the physician and patient about how purpose, community, and wellness will be fostered and enhanced…. While these associations are not new, their benefits for [...]

A Prescription for Longevity in the 21st Century2020-02-13T13:10:34+00:00
5 02, 2020

Rising to the challenge of multimorbidity

2020-02-05T11:55:30+00:00

Paper of the Week: 5th February 2020 This week’s blog is brought to you by: Professor Sir Muir Gray Full reference and title from the journal: Whitty C.J.M.et al 2020, BMJ 2020;368:l6964 doi: 10.1136/bmj.l6964 (Published 6 January 2020) Link to paper: https://www.bmj.com/content/bmj/368/bmj.l6964.full.pdf The paper’s bottom line “Cluster medicine the shift includes moving from thinking about multimorbidityas a random assortment of individual conditions to recognising it as a series of largely predictable clusters of disease in the same person….Continued increases in healthy longevity depend on this different model. Clustering of diseases, and how we might better tackle management of coexisting physical and mental health problems, should be embedded into medical training and continuous” 3vh bottom line The Third Dimension [...]

Rising to the challenge of multimorbidity2020-02-05T11:55:30+00:00
30 01, 2020

The 21st Century is the century of networks: are clinical networks the future way to organize healthcare?

2020-01-30T11:11:23+00:00

Paper of the Week: 30th January 2020 This week’s blog is brought to you by: Dr Joe McManners Full reference and title from the journal: Managing the performance of general practitioners and specialists referral networks: A system for evaluating the heart failure pathway. SabinaNutiaFrancescaFerréaChiaraSeghieriaElisaForesiaTherese A.Stukelb Health Policy Volume 124, Issue 1, January 2020, Pages 44-51 Web link to paper https://www.sciencedirect.com/science/article/pii/S0168851019302581 Authors conclusion The aim of this paper is to identify and evaluate the performance of naturally occurring networks of GP's and hospital-based specialists providing care for congestive heart failure (CHF) patients in Tuscany, Italy. They demonstrate the existence of informal links between GP's and hospitals based on patterns of patient flow. An integrated approach to evaluation and performance management that [...]

The 21st Century is the century of networks: are clinical networks the future way to organize healthcare?2020-01-30T11:11:23+00:00
21 01, 2020

The Top Ten from the NEJM in 2019

2020-01-21T11:11:44+00:00

Paper of the Week: 21st January 2020 This week’s blog is brought to you by: Dr Muir Gray This is a free pdf with the full articles and accompanying editorials https://cdn.nejm.org/pdf/Notable-Articles-of-2019.pdf Authors conclusion We know that physicians need the best information in order to advise patients and to identify these vaping-related illnesses. In early September, we published a report on pulmonary illness related to e-cigarette use in Illinois and Wisconsin. The 53 cases described in this report had patterns of pneu­monitis that included acute eosinophilic pneumonia, organizing pneumonia and lipoid pneumonia, among others. Products that contained THC were the most commonly reported e-cigarette product exposure. 2019 will be remembered for emergence of vaping-related disease and this article was [...]

The Top Ten from the NEJM in 20192020-01-21T11:11:44+00:00
13 01, 2020

‘Scan because you can’, and ‘boys and toys’. Answering the question of why we persist with low value care.

2020-01-13T15:21:19+00:00

Paper of the Week: 13th January 2020 This week’s blog is brought to you by: Dr Joe McManners Full reference and title from the journal: Biases distorting priority setting: BjørnHofmann Health Policy, Volume 124, Issue 1. January 2020. Pages 52-60. Link to paper click here Authors conclusion: Despite vast challenges and extensive efforts, the outcomes of practical priority setting are scarcely documented. Why is this so? This is the key question of this study. That is, why are the outcomes of priority setting so poorly documented, e.g. in reducing low-value care, when the principles, regulations, and tools for priority setting are fairly well developed? The author looks briefly at some rational explanations for the discrepancy between theoretical efforts [...]

‘Scan because you can’, and ‘boys and toys’. Answering the question of why we persist with low value care.2020-01-13T15:21:19+00:00