Hospital characteristics associated with low-value care in public hospitals in New South Wales, Australia.
Journal
BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677
Informations de publication
Date de publication:
14 Aug 2020
14 Aug 2020
Historique:
received:
11
06
2019
accepted:
04
08
2020
entrez:
16
8
2020
pubmed:
17
8
2020
medline:
23
12
2020
Statut:
epublish
Résumé
Rates of low-value care vary between hospitals in New South Wales, Australia. Understanding factors associated with this variation will help in understanding the drivers of low-value care and in planning initiatives to reduce low-value care. For eight low-value procedures, we used Poisson regression of the number of low-value episodes at each hospital to assess the association between low-value care and hospital characteristics. We also used hierarchical clustering on the low-value procedures used and their rates at each hospital to try to identify groups of hospitals with higher or lower rates of low-value care across multiple procedures. Some hospital characteristics, such as hospital peer group and proportion of total episodes that involve the specific procedure, showed associations for some procedures, but none were consistent across all eight procedures. We clustered hospitals into five groups, but low-value care rates did not differ much between these groups. Available hospital variables show little association with rates of low-value care and no patterns across different low-value procedures. We need to investigate factors within hospitals, such as clinician knowledge and beliefs about low-value care.
Sections du résumé
BACKGROUND
BACKGROUND
Rates of low-value care vary between hospitals in New South Wales, Australia. Understanding factors associated with this variation will help in understanding the drivers of low-value care and in planning initiatives to reduce low-value care.
METHODS
METHODS
For eight low-value procedures, we used Poisson regression of the number of low-value episodes at each hospital to assess the association between low-value care and hospital characteristics. We also used hierarchical clustering on the low-value procedures used and their rates at each hospital to try to identify groups of hospitals with higher or lower rates of low-value care across multiple procedures.
RESULTS
RESULTS
Some hospital characteristics, such as hospital peer group and proportion of total episodes that involve the specific procedure, showed associations for some procedures, but none were consistent across all eight procedures. We clustered hospitals into five groups, but low-value care rates did not differ much between these groups.
CONCLUSION
CONCLUSIONS
Available hospital variables show little association with rates of low-value care and no patterns across different low-value procedures. We need to investigate factors within hospitals, such as clinician knowledge and beliefs about low-value care.
Identifiants
pubmed: 32795365
doi: 10.1186/s12913-020-05625-4
pii: 10.1186/s12913-020-05625-4
pmc: PMC7427854
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
750Subventions
Organisme : Capital Markets Cooperative Research Centre
ID : --
Organisme : Capital Markets Cooperative Research Centre
ID : --
Organisme : NSW Ministry of Health
ID : --
Organisme : NSW Ministry of Health
ID : --
Organisme : The University of Sydney
ID : --
Organisme : The University of Sydney
ID : --
Organisme : HCF Research Foundation
ID : --
Organisme : National Health and Medical Research Council (NHMRC)
ID : 1109626
Organisme : National Health and Medical Research Council (NHMRC)
ID : 1109626
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