Soraya Ghebleh - Variation in Healthcare Delivery

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This is a presentation by Soraya Ghebleh that discusses some of the main points in unwarranted variation in healthcare and strategies that can potentially reduce it.

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Soraya Ghebleh - Variation in Healthcare Delivery

  1. 1. Soraya Ghebleh UNWARRANTED VARIATION IN HEALTHCARE DELIVERY
  2. 2. Unwarranted variation refers to differences in the practice of medicine that cannot be explained by illness, medical need, or evidence-based medicine. DEFINITION
  3. 3. ¡ Effective Care ¡ Preference-Sensitive Care ¡ Supply-Sensitive Care THREE MAIN CAUSES
  4. 4. Interventions for which benefits far outweigh the risks and the right rate of treatment is for every patient that meets clinical guidelines to be in need. EFFECTIVE CARE
  5. 5. When given two equally viable treatment options, the patient must make a decision about their treatment and the correct rate of use should depend on patient choice. PREFERENCE-SENSITIVE CARE
  6. 6. Refers to capacity determining the amount of treatment a patient receives rather than whether the treatment is necessary for a better patient outcome. SUPPLY-SENSITIVE CARE
  7. 7. Regions with higher use DO NOT demonstrate better outcomes overall.
  8. 8. Unwarranted variation is one of the drivers of excessive waste in the healthcare system.
  9. 9. It contributes to wide differences in the quality of care and disparities in health outcomes across clinical settings.
  10. 10. ¡ Shared-decision making ¡ Re-aligning financial incentives with value-based care ¡ Improving health outcomes research and disseminating information accordingly to providers STRATEGIES TO REDUCE UNWARRANTED VARIATION
  11. 11. ¡ Addresses preference-sensitive care by providing the means for patients to understand the implications of decisions about healthcare ¡ Increases patient education ¡  Involves the patient in the decision ¡ Helps patients ask the right questions about how to proceed with care SHARED-DECISION MAKING
  12. 12. ¡ Under fee-for-service model of reimbursement, physicians are rewarded for volume-based care ¡ Key driver in supply-sensitive care ¡ Introduce new payment models that can reduce utilization and provide and reward care based on value and need rather than quantity ¡ Shift from the “more is necessarily better” attitude in healthcare delivery RE-ALIGNING FINANCIAL INCENTIVES
  13. 13. ¡ Many providers are unaware that their outcomes differ from other providers, even within their own institutions ¡ Development of strong, evidence-based outcomes data is essential in determining what is effective and necessary care ¡ Creation of national registries ¡ Sharing more data ¡ Partner with providers to create more transparency in outcomes HEALTH OUTCOMES RESEARCH
  14. 14. ¡  This information is based on research done by Dr. Jack Wennberg and colleagues at The Dartmouth Institute for Health Policy and Clinical Practice ¡  Read More: §  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1124450/ §  http://www.dartmouth-hitchcock.org/dhmc-internet-upload/ file_collection/Wennberg%20JE%20-%20Practice %20Variations.pdf SOURCE

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