value

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
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
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
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
10 09, 2019

Paper of the Week: 10th September 2019 – At last, value measured by the opportunity cost of an intervention

2019-09-10T09:43:21+00:00

This week’s blog is brought to you by: Professor Sir Muir Gray Full reference and title from the journal: Uterus at a price: Disability insurance and hysterectomy Fan E. (et al) Journal of Health Economics 66 (2019) 1-17 Link to Paper: https://www.sciencedirect.com/science/article/abs/pii/S0167629618308142?dgcid=rss_sd_all Authors conclusion: Taiwanese Labor, Government Employee, and Farmer Insurance programs provide 5 to 6 months of salary to enrollees who undergo hysterectomies or oophorectomies before their 45th birthday. These programs create incentives for more and earlier treatments, …..Induced hysterectomies increase benefit payments and surgical costs, at about the cost of a mammogram and 5 pap smears per enrollee. 3V bottom line: Expressing value in terms of other things that could be one with the same amount [...]

Paper of the Week: 10th September 2019 – At last, value measured by the opportunity cost of an intervention2019-09-10T09:43:21+00:00
22 07, 2019

Paper of the Week – 22nd July 2019: The 7 Habits of Highly Effective Cost-of-Care Conversations

2019-07-22T06:46:10+00:00

  This weeks blog is brought to you by: Professor Sir Muir Gray, Founding Director. Authors conclusion Cost-conversation practice certainly will not make us perfect, given the logistical and informational barriers that exist. However, it will move us closer to the kind of patient-centered care that characterizes the ideals of our profession.   Text from the paper chosen by 3VH (this may, or may not be the ‘conclusion’) Out-of-pocket expenditures have increased rapidly in the United States over the past decade. In 2018, 29% of people with private insurance were enrolled in high-deductible health plans, compared with just 4% in 2006. Out-of-pocket costs are high for many publicly insured people, too. Medicare beneficiaries with cancer who do not [...]

Paper of the Week – 22nd July 2019: The 7 Habits of Highly Effective Cost-of-Care Conversations2019-07-22T06:46:10+00:00
12 07, 2019

Paper of the Week 12th July 2019: Why are we wasting precious resources to deliver low value at the end of life?

2019-07-12T10:02:02+00:00

Warraich, H. J., & Meier, D. E. (2019). Serious-Illness Care 2.0 — Meeting the Needs of Patients with Heart Failure. New England Journal of Medicine, 380(26), 2492–2494. https://doi.org/10.1056/NEJMp1900584 WEB LINK TO PAPER   This week's paper of the week is brought to you by Dr Tim Wilson, Managing Director   Authors conclusion Heart failure is the most common cause of hospitalizations among elderly Americans, and despite much medical and scientific progress, it remains a source of substantial suffering, expense, and caregiver burden. Palliative care can improve quality of life, symptoms, and functioning for people with serious illnesses, and a recent observational study in patients with heart failure showed that enrollment in home hospice was associated with fewer emergency [...]

Paper of the Week 12th July 2019: Why are we wasting precious resources to deliver low value at the end of life?2019-07-12T10:02:02+00:00
5 07, 2019

Paper of the Week 5th July 2019: The inverse care law continues to thrive in the NHS for vascular surgery (and probably more)

2019-07-05T17:19:32+00:00

Giuseppe Moscelli, Luigi Siciliani, Nils Gutacker, Richard Cookson (2018) Socioeconomic inequality of access to healthcare: Does choice explain the gradient? Journal of Health Economics, 57, 290–314.   This week's blog is brought to you by: Dr Tim Wilson   Bottom Line For planned vascular surgery, there is inequity in NHS provision for people living in the poorest and wealthiest neighbourhoods, representing an addressable cause of lower value.   Authors conclusion Equity of access is a key policy objective in publicly-funded healthcare systems. However, observed inequalities of access by socioeconomic status may result from differences in patients’ choices. Using data on non-emergency coronary revascularisation procedures in the English National Health Service, we found substantive differences in waiting times within [...]

Paper of the Week 5th July 2019: The inverse care law continues to thrive in the NHS for vascular surgery (and probably more)2019-07-05T17:19:32+00:00