RT Journal Article
T1 Low-value care practice in headache: a Spanish mixed methods research study.
A1 Pozo-Rosich, Patricia
A1 Layos-Romero, Almudena
A1 Martin-Delgado, Jimmy
A1 Pascual, Julio
A1 Bailón, Cristina
A1 Tentor, Ana
A1 Santiago, Alejandro
A1 Ignacio, Emilio
A1 Torrés, Antonio
A1 Mira, José Joaquín
K1 Care
K1 Cost
K1 Do not Do recommendations
K1 Headache
K1 Mixed methods
K1 Patient safety
AB Headache is one of the most prevalent diseases. The Global Burden of Disease Study ranks it as the seventh most common disease overall and the second largest neurological cause of disability in the world. The "Do Not Do" recommendations are a strategy for increasing the quality of care and reducing the cost of care for headache. This study aimed to identify specific low-value practices in headache care, determine their frequency, and estimate the cost overrun that they represent, in order to establish "Do not Do" recommendations specifically for headache by consensus and according to scientific evidence. This was a mixed methods research study that combined qualitative consensus-building techniques, involving a multidisciplinary panel of experts to define the "Do Not Do" recommendations in headache care, and a retrospective observational study with review of a randomized set of patient records from the past 6 months in four hospitals, to quantify the frequency of these "Do Not Do" practices. We calculated the sum of direct costs of medical consultations, medicines, and unnecessary diagnostic tests. Seven "Do Not Do" recommendations were established for headache. In total, 3507 medical records were randomly reviewed. Low-value practices had a highly variable occurrence, depending on the hospital and type of headache. Overall, 34.1% of low-value practices were related to treatment, 21% were related to overuse of imaging in consultation, and 19% were related to emergency care. The estimated cost of low-value practices in the four hospitals was 203,520.47 euros per 1000 patients. This study identified low-value headache practices that need to be eradicated and provided data on their frequency and cost overruns.
YR 2020
FD 2020-06-10
LK http://hdl.handle.net/10668/15718
UL http://hdl.handle.net/10668/15718
LA en
DS RISalud
RD Apr 5, 2025