Wennberg International Collaborative Conference 'Developing a disinvestment strategy for the Spanish National Health Service'. S.García-Armesto, Septiembre 2015
'Developing a disinvestment strategy for the Spanish National Health Service'. S.García-Armesto, Wennberg International Collaborative Conference. Septiembre 2015
Today, there is a strong media coverage on the increasing cost of health care in the United States andin many other countries around the world. This gives rise to a common concern in these countries. So, the question is how best to control the rate of growth in health care expenditures whilst still delivering good healthcare.
Abstract public private partnerships in healthcare. Evaluation of 10 years´ex...Antonio Clemente Collado
Abstract of a study where PPPs hospitals are compared with others under the direct management model, from an economic efficiency and quality performance perspective.
Performance budgeting - Jakub Haas, Czech RepublicOECD Governance
This presentation was made by Jakub Haas, Czech Republic, at the 2nd Health Systems joint Network Meeting for Central, Eastern and Southeastern European Countries held in Tallinn, Estonia, on 1-2 December 2016
January 23, 2017
The Fifth Annual Health Law Year in P/Review symposium featured leading experts discussing major developments during 2016 and what to watch out for in 2017. The discussion at this day-long event covered hot topics in such areas as health policy under the new administration, regulatory issues in clinical research, law at the end-of-life, patient rights and advocacy, pharmaceutical policy, reproductive health, and public health law.
The Fifth Annual Health Law Year in P/Review was sponsored by the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School, Harvard Health Publications at Harvard Medical School, Health Affairs, the Hastings Center, the Program On Regulation, Therapeutics, And Law (PORTAL) in the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women’s Hospital, and the Center for Bioethics at Harvard Medical School, with support from the Oswald DeN. Cammann Fund.
Learn more on our website: http://petrieflom.law.harvard.edu/events/details/5th-annual-health-law-year-in-p-review
Today, there is a strong media coverage on the increasing cost of health care in the United States andin many other countries around the world. This gives rise to a common concern in these countries. So, the question is how best to control the rate of growth in health care expenditures whilst still delivering good healthcare.
Abstract public private partnerships in healthcare. Evaluation of 10 years´ex...Antonio Clemente Collado
Abstract of a study where PPPs hospitals are compared with others under the direct management model, from an economic efficiency and quality performance perspective.
Performance budgeting - Jakub Haas, Czech RepublicOECD Governance
This presentation was made by Jakub Haas, Czech Republic, at the 2nd Health Systems joint Network Meeting for Central, Eastern and Southeastern European Countries held in Tallinn, Estonia, on 1-2 December 2016
January 23, 2017
The Fifth Annual Health Law Year in P/Review symposium featured leading experts discussing major developments during 2016 and what to watch out for in 2017. The discussion at this day-long event covered hot topics in such areas as health policy under the new administration, regulatory issues in clinical research, law at the end-of-life, patient rights and advocacy, pharmaceutical policy, reproductive health, and public health law.
The Fifth Annual Health Law Year in P/Review was sponsored by the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School, Harvard Health Publications at Harvard Medical School, Health Affairs, the Hastings Center, the Program On Regulation, Therapeutics, And Law (PORTAL) in the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women’s Hospital, and the Center for Bioethics at Harvard Medical School, with support from the Oswald DeN. Cammann Fund.
Learn more on our website: http://petrieflom.law.harvard.edu/events/details/5th-annual-health-law-year-in-p-review
Pharmacoeconomic Assessment through Market Approval and Beyond: Theory and Op...Medpace
Pharmacoeconomic assessment of a drug, medical device, or other healthcare product can take on many forms and occur at multiple points in the development cycle. Cost-effectiveness analysis, a major component of pharmacoeconomic assessment, has traditionally occurred in the later phases of product development—either as a piggy-back to a phase III or pivotal clinical trial, or peri-authorization.
Presentation delivered by Dr Adham Ismail, Regional Adviser, Health Technologies at the 62nd Session of the WHO Regional Committee for the Eastern Mediterranean
January 23, 2017
The Fifth Annual Health Law Year in P/Review symposium featured leading experts discussing major developments during 2016 and what to watch out for in 2017. The discussion at this day-long event covered hot topics in such areas as health policy under the new administration, regulatory issues in clinical research, law at the end-of-life, patient rights and advocacy, pharmaceutical policy, reproductive health, and public health law.
The Fifth Annual Health Law Year in P/Review was sponsored by the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School, Harvard Health Publications at Harvard Medical School, Health Affairs, the Hastings Center, the Program On Regulation, Therapeutics, And Law (PORTAL) in the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women’s Hospital, and the Center for Bioethics at Harvard Medical School, with support from the Oswald DeN. Cammann Fund.
Learn more on our website: http://petrieflom.law.harvard.edu/events/details/5th-annual-health-law-year-in-p-review
SWPHO's Helen Cooke delivers a training session on online resources to help inform understanding about Public Health issues and to aid decision making.
How Israel reimburses hospitals based on activity: the Procedure-Related Grou...OECD Governance
This presentation was made by Ruth Waitzberg, Israel, at the 4th meeting of the Joint DELSA/GOV-SBO Network on Fiscal Sustainability of Health Systems, held in Paris on 16-17 February 2015.
Health technology assessment (HTA) is familiar as technique for gauging the value of specific medical technologies or approaches to care. As Adrian Towse points out, however, HTA has a much broader, ‘macro’ role in contributing to the efficiency of health care systems and supporting universal health coverage. This is particularly crucial in the face of increasing demands and limited budgets.
With an increased focus on improving patient outcomes and satisfaction through integrated care delivery, Accountable Care Organizations (ACO) continue to increase in numbers and evolve in maturity. While ACO operational models will differ based on the healthcare needs of local communities, there are common competencies that every ACO must address. Focusing on 4 key priorities – People, Process, Technology and Financials – will help every ACO achieve sustained success.
Our experts explain how to:
- Create a roadmap for success in every stage in the ACO lifecycle
- Develop strategies to improve operations in the 4 key areas: People, Process, Technology and Financials
- Build a successful ACO with lessons learned from Dennis Horrigan, President and CEO at Catholic Medical Partner (CMP)
Dennis Horrigan, President and CEO of CMP, shares his experience contributing to CMP’s ACO success. CMP became a successful, top-performing ACO in the Medicare Shared Saving Program (MSSP).
ACO expert Doris Stein with Optimity Advisors discusses core competencies within the framework of the ACO lifecycle.
Whether you’re in the early planning stages or have shared in savings, this webinar will help you prioritize your efforts in 4 core operational areas - People, Process, Technology and Financials.
Evaluating Health Technology Assessment Reports and New Assessment Techniques...bpstat
2nd Annual Health Outcomes and Pharmacoeconomics Research Conference
• Setting up internal processes to ensure proper Health
Technology Assessment (HTA)
• Exploring initiatives to translate reported outcomes to
ensure proper understanding of data
• Assessing the key HTA entities in the U.S. and establishing
assessment protocol
• Differentiating HTA strategies with new technology
assessment strategies to improve assessment processes
Aspirador de humos GEMI MANN ideal para solucionar problemas de tiro en chimeneas y para la extracción de aire viciado en locales comerciales o industriales.
El equipo incluye un regulador de velocidad de 6 posiciones para poder adaptar las necesidades de extracción de cualquier tipo de chimenea.
DATOS TÉCNICOS
Tensión eléctrica: 230V/I/50Hz
Caudal de aire: 282 m3/h hasta los 2.522 m3/h
Nivel sonoro a 1m: 38 dB (A)
Velocidad motor: 174r.p.m a 1350 r.p.m
Potencia motor: 29W a 170W
Consumo eléctrico: 0,20/1,35 (A)
Peso: 22 kg
Dimensiones: 430x430x600mm
Adaptación: Cuadrada / para sección circular consultar precio
Pharmacoeconomic Assessment through Market Approval and Beyond: Theory and Op...Medpace
Pharmacoeconomic assessment of a drug, medical device, or other healthcare product can take on many forms and occur at multiple points in the development cycle. Cost-effectiveness analysis, a major component of pharmacoeconomic assessment, has traditionally occurred in the later phases of product development—either as a piggy-back to a phase III or pivotal clinical trial, or peri-authorization.
Presentation delivered by Dr Adham Ismail, Regional Adviser, Health Technologies at the 62nd Session of the WHO Regional Committee for the Eastern Mediterranean
January 23, 2017
The Fifth Annual Health Law Year in P/Review symposium featured leading experts discussing major developments during 2016 and what to watch out for in 2017. The discussion at this day-long event covered hot topics in such areas as health policy under the new administration, regulatory issues in clinical research, law at the end-of-life, patient rights and advocacy, pharmaceutical policy, reproductive health, and public health law.
The Fifth Annual Health Law Year in P/Review was sponsored by the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School, Harvard Health Publications at Harvard Medical School, Health Affairs, the Hastings Center, the Program On Regulation, Therapeutics, And Law (PORTAL) in the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women’s Hospital, and the Center for Bioethics at Harvard Medical School, with support from the Oswald DeN. Cammann Fund.
Learn more on our website: http://petrieflom.law.harvard.edu/events/details/5th-annual-health-law-year-in-p-review
SWPHO's Helen Cooke delivers a training session on online resources to help inform understanding about Public Health issues and to aid decision making.
How Israel reimburses hospitals based on activity: the Procedure-Related Grou...OECD Governance
This presentation was made by Ruth Waitzberg, Israel, at the 4th meeting of the Joint DELSA/GOV-SBO Network on Fiscal Sustainability of Health Systems, held in Paris on 16-17 February 2015.
Health technology assessment (HTA) is familiar as technique for gauging the value of specific medical technologies or approaches to care. As Adrian Towse points out, however, HTA has a much broader, ‘macro’ role in contributing to the efficiency of health care systems and supporting universal health coverage. This is particularly crucial in the face of increasing demands and limited budgets.
With an increased focus on improving patient outcomes and satisfaction through integrated care delivery, Accountable Care Organizations (ACO) continue to increase in numbers and evolve in maturity. While ACO operational models will differ based on the healthcare needs of local communities, there are common competencies that every ACO must address. Focusing on 4 key priorities – People, Process, Technology and Financials – will help every ACO achieve sustained success.
Our experts explain how to:
- Create a roadmap for success in every stage in the ACO lifecycle
- Develop strategies to improve operations in the 4 key areas: People, Process, Technology and Financials
- Build a successful ACO with lessons learned from Dennis Horrigan, President and CEO at Catholic Medical Partner (CMP)
Dennis Horrigan, President and CEO of CMP, shares his experience contributing to CMP’s ACO success. CMP became a successful, top-performing ACO in the Medicare Shared Saving Program (MSSP).
ACO expert Doris Stein with Optimity Advisors discusses core competencies within the framework of the ACO lifecycle.
Whether you’re in the early planning stages or have shared in savings, this webinar will help you prioritize your efforts in 4 core operational areas - People, Process, Technology and Financials.
Evaluating Health Technology Assessment Reports and New Assessment Techniques...bpstat
2nd Annual Health Outcomes and Pharmacoeconomics Research Conference
• Setting up internal processes to ensure proper Health
Technology Assessment (HTA)
• Exploring initiatives to translate reported outcomes to
ensure proper understanding of data
• Assessing the key HTA entities in the U.S. and establishing
assessment protocol
• Differentiating HTA strategies with new technology
assessment strategies to improve assessment processes
Aspirador de humos GEMI MANN ideal para solucionar problemas de tiro en chimeneas y para la extracción de aire viciado en locales comerciales o industriales.
El equipo incluye un regulador de velocidad de 6 posiciones para poder adaptar las necesidades de extracción de cualquier tipo de chimenea.
DATOS TÉCNICOS
Tensión eléctrica: 230V/I/50Hz
Caudal de aire: 282 m3/h hasta los 2.522 m3/h
Nivel sonoro a 1m: 38 dB (A)
Velocidad motor: 174r.p.m a 1350 r.p.m
Potencia motor: 29W a 170W
Consumo eléctrico: 0,20/1,35 (A)
Peso: 22 kg
Dimensiones: 430x430x600mm
Adaptación: Cuadrada / para sección circular consultar precio
The Coach approach to leadership is catching on fast and is one of the most widely acclaimed tool for getting and keeping the team motivated, focused and productive.
Nutritional anemia refers to types of anemia that can be directly attributed to nutritional disorders. Examples include Iron deficiency anemia and pernicious (Vitamin B12 deficiency) anemia.
Similar to Wennberg International Collaborative Conference 'Developing a disinvestment strategy for the Spanish National Health Service'. S.García-Armesto, Septiembre 2015
Executive Healthcare Seminar - Belgium - Saudi Arabia - Belgian Embassy RiyadhJan Demey
Belgian and Saudi Healthcare executives met in the Belgian Embassy to discuss several topics in the evolving healthcare market and the Vision 2030 of the Kingdom of Saudi Arabia. The ambition to work together to make healthcare better is our joined ambition. This presentation brings the supporting ideas as discussed during the seminar.
Tender for a transactional information system for pharmacy for the Catalan He...wayness
The main aim of this document is to provide an overview of the main characteristics of the tender recently published by the Catalan Health Service under the title “Transactional information system for pharmacy for the Catalan Health System”.
As the tender is published only in Catalonian, we aim this document to serve the purpose to facilitate international bidders in the process of understanding the nature of the services requested.
In this presentation, Shaheen Gauher talks about two things: (1) How data science and machine learning can be used to manage and control escalating healthcare costs, and (2) How to create a Population Health Management Solution using state of the art Azure Data Lake Analytics and Population Health Report with real time visualization capability using Power BI. The solution presented can be deployed on Azure through a one-click deployment option in https://gallery.cortanaintelligence.com/
SNOMED by Professor Martin Severs FRCP FFPHM Chairman Management Board.
There is a media intensive (22MB) version of this presentation with an audio track and video at:
http://hinz.org.nz/media/SNOMED-ProfSevers/
Disclaimer: Huge + You may have to hit refresh a couple of times to get it to load correctly.
Presentation on transparency of doctor performance at Health Datapalooza 2015 by Josh Rosenthal, PhD
Applications of Transparency: From Visibility to Action
As transparency in health care has emerged as a crucial enabler towards achieving the Triple Aim, myriad sources and types of information have become available in the last few years. Join this session to learn new ways of understanding the behaviors of patients and providers, and novel approaches to payment and delivery already underway.
Moderator: Ben Harder, U.S. News & World Report
Panelists: Elizabeth Mitchell, NRHI; Jeanne Pinder, ClearHealthCosts; Josh Rosenthal, PhD, RowdMap, Inc.
Presentation by Rich Pollack, VP and Chief Information Officer, VCU Health, at the marcus evans National Healthcare CIO Summit held in Pasadena, CA March 13-14 2017
This document provides an solution to case study - Feasibility Study Report for a 200 Beded Hospital
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The 12th Annual Health Services Research UK (HSRUK) Conference will be held on 2 and 3 July 2019 at the University of Manchester’s Renold Building, presenting the leading-edge of health services and systems research.
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Improving data collection and information channels to support performance imp...Atlas VPM
Presentation about how to improve data collection and information channels to support performance improvement in Healthcare for the European Parlament - Science and Technology Options Assessment Workshop on 'Health systems for the future - Making EU health systems resilient and innovative'
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TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
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Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
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Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
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3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
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3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
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5. ECG in Medical Practice by ABM Abdullah, 4th edition
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
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Wennberg International Collaborative Conference 'Developing a disinvestment strategy for the Spanish National Health Service'. S.García-Armesto, Septiembre 2015
1. Developing a disinvestment strategy for the
Spanish National Health Service
Funding FIS PI 12/01884
Period 2013-2015
Progress and future steps
2. Outline
• The policy approach
• The analytical approach
• The brokering approach: engaging stakeholders
• Lessons learnt and next steps
3. Outline
• The policy approach
• The analytical approach
• The brokering approach: engaging stakeholders
• Lessons learnt and next steps
4. The timing: Policy after 2012 SNS reform
• Reshaping of the SNS benefits basket into 4 categories (basic,
supplementary and accessory services, plus ACs’ additional services). Co-
payment introduced for supplementary and accessory baskets.
• Changes in procedure for updating the national benefits basket (reviewing
existing/approval of new inclusions)
• Severe expenditure caps imposed on regional administrations (including
health systems)
http://www.hspm.org/countries/spain25062012/countrypage.aspx
5. • How much of the activity is actually lower-value care?
• Which are the opportunity costs for both provider and population served?
• What is the local margin for efficiency enhancing?
The goal: Minimising utilisation of lower-value procedures, fostering the use of
superior alternatives or reallocation of existing resources to other value-for-
money activity
The analytical approach
6. Collaborative health services research initiative
(all 17 regional Governments) since 2002
Aimed at describing systematic and unwarranted
variations in medical practice and healthcare
outcomes, using both a population-based and a
hospital-specific approach.
… providing insight (i.e. underlying factors
analysis) for decision-makers to make better
decisions; and yielding relevant information for
hospital managers to look at those
underperforming quality areas.
… using and developing reliable methodologies
… using several strategies for translating
knowledge into practice
http://www.atlasvpm.org
The tool…
7. The Steps…
• Agreeing on the list of LVC procedures and, when suitable, corresponding alternatives
(literature + wide consensus supported by the national network of HTA agencies)
• Building indicators CIE9-CM language. Refinement to narrow down indications and
“appropriateness”
• Quantifying utilisation of those procedures and their alternatives as well as analysing
the degree of variation across areas and providers in the country
• estimation of excess-cases and “opportunity costs”
The key: LOCAL discussion scenarios of minimisation, based on actual level of use of
lower-value interventions that specifically prevail in each context (provider or policy
relevant decision-making unit, health care area)
8. Literature review and synthesis of evidence (May-Dec 2013)
• International lists of lower value procedures (appraisal of the quality of evidence
underpinning them)
• National lists of lower value procedures and health technology assessment
reports
• Negative recommendations in the SNS clinical practice Guidelines (including
preferred options) related to diagnosis/procedures coded in the hospital
database (CMBD).
• Negative recommendations in the National Health strategies (including
preferred options) related to diagnosis/procedures coded in the hospital
database (CMBD).
9. Lower-value procedures
PRELIMINARY LIST INCLUDED 3 CATEGORÍAS
(Ordered by relevance to the project’s goal):
1. Obsolete technology or superseded by a more cost-effective
alternative (31)
2. Lower-value care when the procedure is used outside its main indication
(17)
3. Procedures backed by insufficient evidence of effectiveness (11)
10. The List…
(low-hanging fruit)
NON EFFECTIVE PROCEDURES PRONE TO OVERUSE (EXTREMELY LIMITED INDICATIONS)
- C-section in low obstetric risk deliveries
- Routine episiotomy in vaginal delivery
-Adenoidectomy
-Tonsillectomy w/wo adenoidectomy
- Grommets
-Dilatation and curettage as a diagnostic tool or treatment
-Trigger finger surgery
- Bypass intra-extracraneal to decrease stroke risk
SUPERSEDED PROCEDURES (BETTER ALTERNATIVE)
- Carpian tunnel surgery vs conservative approach (anti-inflamatorios, férulas, fisioterapia)
- Hysterectomy in bleeding vs drugs and minimal invasive approach (intrauterinelevonorgestel)
- Elective cardiac ablation vs drugs (antiarrhythmics and anticoagulants)
- Mitral clip vs open valve replacement
- Neurosurgical clipping for patients with aneurysmal subarachnoid hemorrhage vs
endovascular embolizacion
A few appropriate indications
11. The Methods…
• How much of the activity is actually lower-value care?
– Data : publicly funded hospital activity in Spain (5 million
admissions/year; 2002-2013)
– Design : Observational, ecologic study on intensity of use of 15 lower-
value procedures and, when suitable, the superior alternatives
(standardised utilisation rates) and its variation (SCV) across the 203
health care areas comprising the SNS and the hospitals serving them -
cross-section analysis with 2012 data and time-trend analysis from
2002-2013
Multilevel models were built to obtain risk adjusted utilisation rates
and median odds ratios (MOR) at provider level.
12. • Which is the local margin for efficiency enhancing?
Identifying those areas and hospitals in the country with higher
potential for realignment to value-based provision of care:
– The benchmark: minimal utilisation rates in the country (p25) per area
and hospital
– Calculating excess-use : observed exposure compared to that expected
if utilisation was equivalent to those areas already on the minimal rates
(indirect standardisation)
• Detecting hospitals with excessive intensity of use: significantly above the
benchmark 95% and 99% CI (alert and alarm intensity )
13. • Which are the opportunity costs for both provider and
population served?
– Estimated excess cases by unit costs of LVC procedures allow for a
rough proxy of expenditure/resources deployed on lower-value care
that could be used otherwise
• When superior alternatives are available, incremental rather than
unitary costs are used
14. The brokering approach
Materials
1. 17 complete reports addressing each of the regional systems
using national benchmarking for health care area and
hospital
– National and regional mapping of quintiles of population exposure
(standardised utilisation rates) and distribution of cases across local
providers
– Regional mapping of area level potential for realignment
benchmarking against the lowest levels of exposure in the country
(p25)
– Hospitals position (average, alerting and alarming) regarding
intensity of lower value indications benchmarking against those with
the lowest utilisation rates in the country (p25)
16. 2. Atlas VPM 10: Utilisation of lower value procedures and
potential for realignment in the SNS
3. Policy briefs: Claves para la transformación
I. The value of analysis to increase value for money
II. Case Studies compilation: Good practices in using information
17. The brokering approach
Local discussions
1. Tailoring discussion priorities to local profile of results
2. Identifying ‘champions‘ and those with room for improvement
3. Discussion of findings with clinical staff in those services (focus on
understanding processes leading to those results) Joint production
of recommendations
4. Recommendations discussed with management using GUNFT
guidelines and STAR aids to guide strategy and set priorities for
their jurisdiction
Forums DBS Health transformación sanitaria:
– Decision makers Evidence in action
– Sociedades Científicas This side of choosing wisely
18. To be continued …
• Monitoring innovation: implementation and adoption/substitution patterns for
superior alternatives
• Innovative practices in minimising LVC (follow-up case studies)
• Analysing the group of elective surgery with LV out of main indication
(orthoprosthetics, cataracts y prostatectomy)
– pathways of care
– Analysis of waiting list