Paper of the Week

6 01, 2020

Papers of the decade in JAMA

2020-01-07T09:42:10+00:00

Paper of the Week: 6th January 2020 This week’s blog is brought to you by: Professor Sir Muir Gray and Dr Joe McManners These articles have been selected by our editors as the most important published by JAMA between 2010 and 2019. Click below to read them for free.  The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) Mervyn Singer, MD, FRCP; Clifford S. Deutschman, MD, MS; Christopher Warren Seymour, MD, MSc; et alManu 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults: Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8) Paul A. James, MD; Suzanne Oparil, MD; Barry L. Carter, PharmD; et al Antibiotic Therapy vs Appendectomy [...]

Papers of the decade in JAMA2020-01-07T09:42:10+00:00
20 12, 2019

Society wants fair, not utilitarian, approaches to value

2019-12-20T07:38:19+00:00

Paper of the Week: 20th December 2019 This week’s blog is brought to you by: Dr Tim Wilson Full reference and title from the journal: Funding orphan medicinal products beyond price: sustaining an ecosystem , Author- De Sola-Morales, Oriol, The European Journal of Health Economics (2019) 20:1283–1286 Web link to paper: https://doi.org/10.1007/s10198-019-01047-0 Authors conclusion: “it is not the individual price that matters, but whether the overall budget impact is perceived as acceptable and that manufacturers have an accept- able profit.” 3V bottom line: Ideally, a decision whether a treatment or intervention should be used in a health system is largely be driven by value and values. In the case of effective but expensive treatments for rare conditions, societal [...]

Society wants fair, not utilitarian, approaches to value2019-12-20T07:38:19+00:00
10 12, 2019

What happens when you lose access to Primary Care?

2019-12-10T15:16:27+00:00

Paper of the Week: 10th December 2019 This week’s blog is brought to you by: Dr Joe McManners Full reference and title from the journal: Association Between a Temporary Reduction in Access to Health Care and Long-term Changes in Hypertension Control Among Veterans After a Natural Disaster Aaron Baum, PhD; Michael L. Barnett,MD, MS; Juan Wisnivesky,MD, DrPH; Mark D. Schwartz, MD. JAMA Network Open. 2019;2(11):e1915111. doi:10.1001/jamanetworkopen.2019.15111 (Reprinted) November 13, 2019 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2755309 Authors conclusion: The authors used the temporary closure of a primary healthcare facility as a natural experiment to examine the association between a temporary decrease in health care access and long-term control of hypertension, diabetes, and hypercholesterolemia. The period of decreased access to healthcare services was associated [...]

What happens when you lose access to Primary Care?2019-12-10T15:16:27+00:00
2 12, 2019

Resources the same size as the annual GDP of Holland are wasted every year in the US health system, but there are solutions.

2019-12-10T15:17:12+00:00

Paper of the Week: 2nd December 2019 This week’s blog is brought to you by: Dr Joe McManners Full reference and title from the journal: Waste in the US Health Care System; Estimated Costs and Potential for Savings William H. Shrank, MD, MSHS1; Teresa L. Rogstad, MPH1; Natasha Parekh, MD, MS2 JAMA. 2019;322(15):1501-1509. https://jamanetwork.com/journals/jama/article-abstract/2752664 Authors conclusion: In this review, based on 6 previously identified domains of health care waste, the authors estimate the cost of waste in the US health care system to between $760 billion to $935 billion, this is approximately 25% of total US health care spending. The projected potential savings from interventions that reduce waste, (excluding savings from administrative complexity), range from $191 billion to $282 billion, representing a potential 25% reduction in the [...]

Resources the same size as the annual GDP of Holland are wasted every year in the US health system, but there are solutions.2019-12-10T15:17:12+00:00
18 11, 2019

Can equity be measured as accurately as quality?

2019-11-18T11:02:01+00:00

Paper of the Week: 18th November 2019 This week’s blog is brought to you by: Professor Sir Muir Gray Full reference and title from the journal: Whitehead J. et al (2019), How can the spatial equity of health services be defined and measured? A systematic review of spatial equity definitions and methods, Journal of Health Services Research & Policy Vol. 24(4) 270–278, DOI: 10.1177/1355819619837292. https://journals.sagepub.com/doi/abs/10.1177/1355819619837292?journalCode=hsrb Authors conclusion There appeared to be general agreement that spatial equity is difficult to define…Although a wide variety of methods were used, the Gini coefficient was identified as the most common method of spatial equity analysis. 3V bottom line Equity is difficult to measure accurately but it should be included in every report [...]

Can equity be measured as accurately as quality?2019-11-18T11:02:01+00:00
11 11, 2019

Buyer beware! Does the seller’s definition of value match your values?

2019-11-11T14:00:58+00:00

Paper of the Week: 11th November 2019 This week’s blog is brought to you by: Dr Tim Wilson Full reference and title from the journal: Bending the cost curve: time series analysis of a value transformation programme at an academic medical centre Chatfield SC, Volpicelli FM, Adler NM, et al. BMJ Qual Saf 2019;28:449–458. Emerging principles for health system value improvement programmes Moriates C, Valencia V. BMJ Qual Saf 2019;28:434–437. Authors conclusion: By the beginning of 2014 it had become apparent that our own health system, NYU Langone Health (NYULH), had substantial opportunity to improve value. From 2010 to 2013, our institutional losses on Medicare patients had more than doubled. … the American Association of Medical Colleges-Council of Teaching Hospitals (COTH) quarterly survey of [...]

Buyer beware! Does the seller’s definition of value match your values?2019-11-11T14:00:58+00:00
4 11, 2019

Urgent! Higher value urgent care only comes with a systems perspective

2019-11-04T07:42:06+00:00

Paper of the Week: 4th November 2019 This week’s blog is brought to you by: Dr Tim Wilson Full reference and title from the journal: Convenient primary care and emergency hospital utilisation, Edward W. Pinchbeck,  Journal of Health Economics 68 (2019) 102242. Link to paper, click here Authors conclusion: Participation and utilisation decisions lie at the heart of many public policy questions. Convenience-oriented primary care services divert three times as many patients from emergency visits, largely because patients can attend without appointments. 3V bottom line: High value interventions are neglected in favour of lower value interventions when we do not think of populations and outcomes that matter. 3VH - Implications for value: This analysis in this interesting paper [...]

Urgent! Higher value urgent care only comes with a systems perspective2019-11-04T07:42:06+00:00
28 10, 2019

Paper of the Week: 28th October 2019 – We need to talk about value

2019-10-28T10:56:11+00:00

This week’s blog is brought to you by: Dr Tim Wilson Full reference and title from the journal: Can patient centred care plus shared decision making equal lower costs? Gemma Venhuizen, BMJ 2019;367:l5900 Link to paper: https://doi.org/10.1136/bmj.l5900   Authors conclusion: “At Bernhoven, 70% of patients referred for eye care are seen by an optometrist instead of an ophthalmologist. In that way, a consultation costs €40 (£36; $44) instead of €225, and waiting lists have decreased.” (sic)  3V bottom line: The result from this paper are encouraging, but language matters. Especially when talking about value-based healthcare. So instead of focusing on lower costs, the author should have talked about “resources being freed up from lower value care for higher value”. [...]

Paper of the Week: 28th October 2019 – We need to talk about value2019-10-28T10:56:11+00:00
22 10, 2019

Paper of the Week – 22nd October 2019: The law of Diminishing Returns is evidence based

2019-10-22T08:40:50+00:00

This weeks Paper of the Week is brought to you by: Professor Sir Muir Gray Full reference and title from the journal: Estimating the Marginal Productivity of the English National Health Service From 2003 to 2012, Lomas, J et al (2019), Value in health 22;995-1002. Web Link to Paper:   https://doi.org/10.1016/j.jval.2019.04.1926 Authors conclusion:  “Taking cancer in 2012 as an illustrative example, the expenditure elasticity is interpreted as saying that a 1% increase in overall NHS expenditure leads to a 1.027% increase in cancer expenditure. The outcome elasticity suggests that cancer mortality is reduced by 0.361% as a result of a 1% increase in cancer expenditure. As outlined in the section “Translating mortality effects into quality-adjusted life-years”, these estimated [...]

Paper of the Week – 22nd October 2019: The law of Diminishing Returns is evidence based2019-10-22T08:40:50+00:00
9 10, 2019

Paper of the Week: 9th October 2019 – Can we spend too little or too much on healthcare?

2019-10-09T10:54:40+00:00

This week’s blog is brought to you by: Dr Tim Wilson Full reference and title from the journal: What level of domestic government health expenditure should we aspire to for universal health coverage? McIntyre D. et al (2017) Health Economics, Policy and Law, 12, 125–137 Web link to paper, please click here Authors conclusion: “Our analyses point towards a target of government spending on health of at least 5% of GDP for progressing towards universal health care. This can be supplemented by a per capita target of $86 to promote universal access to primary care services in low-income countries.” 3V bottom line: At a governmental level, any money going to healthcare represents budget that could otherwise be spent [...]

Paper of the Week: 9th October 2019 – Can we spend too little or too much on healthcare?2019-10-09T10:54:40+00:00