| Autor: |
Otavio Berwanger, Miguel Cendoroglo Neto, Sidney Klajner, Mauro Dirlando Conte de Oliveira, Haggeas da Silveira Fernandes, Ana Luiz Vasconcelos, Fernanda Aparecida de Paula Russo, Daniel Tavares Malheiro, Giancarlo Colombo, Paula Pelegrini, Vanessa Teich, Alexandre Marra, Fernando Gatti de Menezes |
| Jazyk: |
angličtina |
| Rok vydání: |
2023 |
| Předmět: |
|
| Zdroj: |
BMJ Open Quality, Vol 12, Iss 4 (2023) |
| Druh dokumentu: |
article |
| ISSN: |
2399-6641 |
| DOI: |
10.1136/bmjoq-2022-002178 |
| Popis: |
Approximately 45% of patients receive medical services with minimal or no benefit (low-value care). In addition to the increasing costs to the health system, performing invasive procedures without an indication poses a potentially preventable risk to patient safety. This study aimed to determine whether a managed quality improvement programme could prevent cholecystectomy and surgery for endometriosis treatment with minimal or no benefit to patients.This before-and-after study was conducted at a private hospital in São Paulo, Brazil, which has a main medical remuneration model of fee for service. All patients who underwent cholecystectomy or surgery for endometriosis between 1 August 2020 and 31 May 2021 were evaluated.The intervention consisted of allowing the performance of procedures that met previously defined criteria or for which the indications were validated by a board of experts.A total of 430 patients were included in this analysis. The programme prevented the unnecessary performance of 13% of cholecystectomies (p=0.0001) and 22.2% (p=0.0006) of surgeries for the treatment of endometriosis. This resulted in an estimated annual cost reduction to the health system of US$466 094.93.In a hospital with a private practice and fee-for-service medical remuneration, the definition of clear criteria for indicating surgery and the analysis of cases that did not meet these criteria by a board of reputable experts at the institution resulted in a statistically significant reduction in low-value cholecystectomies and endometriosis surgeries. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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