Over 150 potentially low-value health care practices: an Australian study

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dc.contributor.authorElshaug, A.
dc.contributor.authorWatt, A.
dc.contributor.authorMundy, L.
dc.contributor.authorWillis, C.
dc.date.issued2012
dc.description.abstractOBJECTIVE: To develop and apply a novel method for scanning a range of sources to identify existing health care services (excluding pharmaceuticals) that have questionable benefit, and produce a list of services that warrant further investigation. DESIGN AND SETTING: A multiplatform approach to identifying services listed on the Australian Medicare Benefits Schedule (MBS; fee-for-service) that comprised: (i) a broad search of peer-reviewed literature on the PubMed search platform; (ii) a targeted analysis of databases such as the Cochrane Library and National Institute for Health and Clinical Excellence (NICE) “do not do” recommendations; and (iii) opportunistic sampling, drawing on our previous and ongoing work in this area, and including nominations from clinical and nonclinical stakeholder groups. MAIN OUTCOME MEASURES: Non-pharmaceutical, MBS-listed health care services that were flagged as potentially unsafe, ineffective or otherwise inappropriately applied. RESULTS: A total of 5209 articles were screened for eligibility, resulting in 156 potentially ineffective and/or unsafe services being identified for consideration. The list includes examples where practice optimisation (ie, assessing relative value of a service against comparators) might be required. CONCLUSION: The list of health care services produced provides a launchpad for expert clinical detailing. Exploring the dimensions of how, and under what circumstances, the appropriateness of certain services has fallen into question, will allow prioritisation within health technology reassessment initiatives.
dc.description.statementofresponsibilityAdam G. Elshaug, Amber M. Watt, Linda Mundy and Cameron D. Willis
dc.identifier.citationMedical Journal of Australia, 2012; 197(10):556-560
dc.identifier.doi10.5694/mja12.11083
dc.identifier.issn0025-729X
dc.identifier.issn1326-5377
dc.identifier.orcidElshaug, A. [0000-0002-4939-5379]
dc.identifier.orcidMundy, L. [0000-0002-7874-4232]
dc.identifier.urihttp://hdl.handle.net/2440/75925
dc.language.isoen
dc.publisherAustralasian Med Publ Co Ltd
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/627061
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1013165
dc.rightsCopyright status unknown
dc.source.urihttps://doi.org/10.5694/mja12.11083
dc.subjectHumans
dc.subjectHealth Services
dc.subjectUnnecessary Procedures
dc.subjectInsurance Benefits
dc.subjectNational Health Programs
dc.subjectQuality of Health Care
dc.subjectAustralia
dc.subjectPatient Safety
dc.titleOver 150 potentially low-value health care practices: an Australian study
dc.typeJournal article
pubs.publication-statusPublished

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